Sample records for countries results suggest

  1. Comparative water law, policies, and administration in Asia: Evidence from 17 countries

    NASA Astrophysics Data System (ADS)

    Araral, Eduardo; Yu, David J.

    2013-09-01

    Conventional wisdom suggests that improving water governance is the key to solving water insecurity in developing countries but there are also many disagreements on operational and methodological issues. In this paper, we build on the work of Saleth and Dinar and surveyed 100 water experts from 17 countries in Asia to compare 19 indicators of water laws, policies, and administration among and within countries from 2001 to 2010. We present the results of our study in a comparative dashboard and report how water governance indicators vary with a country's level of economic development, which ones do not and how and why some indicators change overtime in some countries. We have two main results. First, our initial findings suggest the possibility of water Kuznet's curve, i.e., certain water governance indicators vary with a country's level of economic development. However, more studies are needed given the caveats and limitations of our study. Second, the results have practical value for policy makers and researchers for benchmarking with other countries and tracking changes within their countries overtime. We conclude with implications for a second-generation research agenda on water governance.

  2. Library Education in the ASEAN Countries.

    ERIC Educational Resources Information Center

    Atan, H. B.; Havard-Williams, P.

    1987-01-01

    Identifies the hierarchy of library development in Southeast Asian countries that results in the neglect of public and school libraries. Developing local library school curricula which focus on the specific needs of each country and cooperation among library schools are suggested as methods of correcting this situation. (CLB)

  3. National differences in environmental concern and performance are predicted by country age.

    PubMed

    Hershfield, Hal E; Bang, H Min; Weber, Elke U

    2014-01-01

    There are obvious economic predictors of ability and willingness to invest in environmental sustainability. Yet, given that environmental decisions represent trade-offs between present sacrifices and uncertain future benefits, psychological factors may also play a role in country-level environmental behavior. Gott's principle suggests that citizens may use perceptions of their country's age to predict its future continuation, with longer pasts predicting longer futures. Using country- and individual-level analyses, we examined whether longer perceived pasts result in longer perceived futures, which in turn motivate concern for continued environmental quality. Study 1 found that older countries scored higher on an environmental performance index, even when the analysis controlled for country-level differences in gross domestic product and governance. Study 2 showed that when the United States was framed as an old country (vs. a young one), participants were willing to donate more money to an environmental organization. The findings suggest that framing a country as a long-standing entity may effectively prompt proenvironmental behavior.

  4. Mortality by country of birth in the Nordic countries - a systematic review of the literature.

    PubMed

    Honkaniemi, Helena; Bacchus-Hertzman, Jennie; Fritzell, Johan; Rostila, Mikael

    2017-05-25

    Immigration to the Nordic countries has increased in the last decades and foreign-born inhabitants now constitute a considerable part of the region's population. Several studies suggest poorer self-reported health among foreign-born compared to natives, while results on mortality and life expectancy are inconclusive. To date, few studies have summarized knowledge on mortality differentials by country of birth. This article aims to systematically review previous results on all-cause and cause-specific mortality by country of birth in the Nordic countries. The methodology was conducted and documented systematically and transparently using a narrative approach. We identified 43 relevant studies out of 6059 potentially relevant studies in August 2016, 35 of which used Swedish data, 8 Danish and 1 Norwegian. Our findings from fully-adjusted models on Swedish data support claims of excess mortality risks in specific categories of foreign-born. Most notably, immigrants from other Nordic countries, especially Finland, experience increased risk of mortality from all causes, and specifically by suicide, breast and gynaecological cancers, and circulatory diseases. Increased risks in people from Central and Eastern Europe can also be found. On the contrary, decreased risks for people with Southern European and Middle Eastern origins are found for all-cause, suicide, and breast and gynaecological cancer mortality. The few Danish studies are more difficult to compare, with conflicting results arising in the analysis. Finally, results from the one Norwegian study suggest significantly decreased mortality risks among foreign-born, to be explored in further research. With new studies being published on mortality differentials between native and foreign-born populations in the Nordic countries, specific risk patterns have begun to arise. Regardless, data from most Nordic countries remains limited, as does the information on specific causes of death. The literature should be expanded in upcoming years to capture associations between country of birth and mortality more clearly.

  5. Convergence and determinants of health expenditures in OECD countries.

    PubMed

    Nghiem, Son Hong; Connelly, Luke Brian

    2017-08-17

    This study examines the trend and determinants of health expenditures in OECD countries over the 1975-2004 period. Based on recent developments in the economic growth literature we propose and test the hypothesis that health care expenditures in countries of similar economic development level may converge. We hypothesise that the main drivers for growth in health care costs include: aging population, technological progress and health insurance. The results reveal no evidence that health expenditures among OECD countries converge. Nevertheless, there is evidence of convergence among three sub-groups of countries. We found that the main driver of health expenditure is technological progress. Our results also suggest that health care is a (national) necessity, not a luxury good as some other studies in this field have found.

  6. Country clustering applied to the water & sanitation sector: a new tool with potential applications in research & policy

    PubMed Central

    Onda, Kyle; Crocker, Jonny; Kayser, Georgia Lyn; Bartram, Jamie

    2013-01-01

    The fields of global health and international development commonly cluster countries by geography and income to target resources and describe progress. For any given sector of interest, a range of relevant indicators can serve as a more appropriate basis for classification. We create a new typology of country clusters specific to the water and sanitation (WatSan) sector based on similarities across multiple WatSan-related indicators. After a literature review and consultation with experts in the WatSan sector, nine indicators were selected. Indicator selection was based on relevance to and suggested influence on national water and sanitation service delivery, and to maximize data availability across as many countries as possible. A hierarchical clustering method and a gap statistic analysis were used to group countries into a natural number of relevant clusters. Two stages of clustering resulted in five clusters, representing 156 countries or 6.75 billion people. The five clusters were not well explained by income or geography, and were unique from existing country clusters used in international development. Analysis of these five clusters revealed that they were more compact and well separated than United Nations and World Bank country clusters. This analysis and resulting country typology suggest that previous geography- or income-based country groupings can be improved upon for applications in the WatSan sector by utilizing globally available WatSan-related indicators. Potential applications include guiding and discussing research, informing policy, improving resource targeting, describing sector progress, and identifying critical knowledge gaps in the WatSan sector. PMID:24054545

  7. Photovoltaic system costs using local labor and materials in developing countries

    NASA Technical Reports Server (NTRS)

    Jacobson, E.; Fletcher, G.; Hein, G.

    1980-01-01

    The use of photovoltaic (PV) technology in countries that do not presently have high technology industrial capacity was investigated. The relative cost of integrating indigenous labor (and manufacturing where available) into the balance of the system industry of seven countries (Egypt, Haiti, the Ivory Coast, Kenya, Mexico, Nepal, and the Phillipines) was determined. The results were then generalized to other countries, at most levels of development. The results of the study imply several conclusions: (1) the cost of installing and maintaining comparable photovoltaic systems in developing countries is less than in the United States; (2) skills and some materials are available in the seven subject countries that may be applied to constructing and maintaining PV systems; (3) there is an interest in foreign countries in photovoltaics; and (4) conversations with foreign nationals suggest that photovoltaics must be introduced in foreign markets as an appropriate technology with high technology components rather than as a high technology system.

  8. Productivity in physical and chemical science predicts the future economic growth of developing countries better than other popular indices.

    PubMed

    Jaffe, Klaus; Caicedo, Mario; Manzanares, Marcos; Gil, Mario; Rios, Alfredo; Florez, Astrid; Montoreano, Claudia; Davila, Vicente

    2013-01-01

    Scientific productivity of middle income countries correlates stronger with present and future wealth than indices reflecting its financial, social, economic or technological sophistication. We identify the contribution of the relative productivity of different scientific disciplines in predicting the future economic growth of a nation. Results show that rich and poor countries differ in the relative proportion of their scientific output in the different disciplines: countries with higher relative productivity in basic sciences such as physics and chemistry had the highest economic growth in the following five years compared to countries with a higher relative productivity in applied sciences such as medicine and pharmacy. Results suggest that the economies of middle income countries that focus their academic efforts in selected areas of applied knowledge grow slower than countries which invest in general basic sciences.

  9. Photovoltaic system costs using local labor and materials in developing countries

    NASA Astrophysics Data System (ADS)

    Jacobson, E.; Fletcher, G.; Hein, G.

    1980-05-01

    The use of photovoltaic (PV) technology in countries that do not presently have high technology industrial capacity was investigated. The relative cost of integrating indigenous labor (and manufacturing where available) into the balance of the system industry of seven countries (Egypt, Haiti, the Ivory Coast, Kenya, Mexico, Nepal, and the Phillipines) was determined. The results were then generalized to other countries, at most levels of development. The results of the study imply several conclusions: (1) the cost of installing and maintaining comparable photovoltaic systems in developing countries is less than in the United States; (2) skills and some materials are available in the seven subject countries that may be applied to constructing and maintaining PV systems; (3) there is an interest in foreign countries in photovoltaics; and (4) conversations with foreign nationals suggest that photovoltaics must be introduced in foreign markets as an appropriate technology with high technology components rather than as a high technology system.

  10. The nexus between energy consumption and financial development: estimating the role of globalization in Next-11 countries.

    PubMed

    Danish; Saud, Shah; Baloch, Muhammad Awais; Lodhi, Rab Nawaz

    2018-04-28

    In the modern era of globalization, the economic activities expand with the passage of time. This expansion may increase demand for energy both in developing and developed countries. Therefore, this study assesses the impact of financial development on energy consumption incorporating the role of globalization in Next-11 countries. A group of panel estimation techniques is used to analyze the panel data and time series data for the time 1990-2014. The empirical results of the study suggest that financial development stimulates energy consumption. Also, globalization increases demand for energy consumption, although the single country analysis suggests that the effect of globalization on energy demand is heterogeneous among N-11 countries. Furthermore, feedback hypothesis is confirmed between financial development and energy consumption. Also, bidirectional causality is found between economic growth and energy consumption. The findings urge for the attention of policymaker in emerging countries to develop a strategy to reduce the consequences of energy consumption by controlling resource transfer through globalization to the host country and by adopting energy conversation policies.

  11. Conflict or Cooperation Over Global Warming Policy? AN Analysis Based on the Interaction of Countries

    NASA Astrophysics Data System (ADS)

    Ihara, Daniel Michael

    Response to climatic change due to global warming, rather than being the common response of humankind to a common problem, may well be the product of decisions made by countries with diverse and possibly divergent interests. This dissertation analyzes the interactions of countries with diverse interests. Each country's economic production is assumed to increase at a decreasing rate with respect to the country's own fossil fuel use and the country's climatic damage is assumed to increase at an increasing rate with respect to the sum of all countries' fossil fuel uses. Each country is assumed to seek to maximize its production minus its climatic damage. The analysis begins with a one-period, two-country case with a single fossil fuel and without binding agreements, without side-payments between countries, and without prior history of fossil fuel use. The cases implied by relaxing restrictions are then analyzed. The dissertation shows explictly how countries' global warming policy decisions could define a prisoners' dilemma game. It characterizes "cooperative" outcomes such as the Nash bargaining solution and Coasean bargaining. The dissertation compares non-side-payment outcomes with the side-payment outcomes implied by tradeable carbon emission quotas. In addition to qualitative results, the dissertation has the following quantitative analysis. First, it conducts a two-country simulation of a tradeable emission quota agreement. The simulation illustrates a case where reduction in carbon emissions, even with significant increase in world population, results in economic growth and manageable climatic damage. Second, based on World Resource Institute data on carbon emissions, carbon elasticities of GNP are estimated for 138 countries. The small estimated elasticities suggest that economic growth may not be greatly reduced by restricting fossil fuel use and that economic growth may depend primarily on non-fossil fuel factors. Overall, the dissertation creates a conceptual framework that analyses the interactions among countries' global warming policy decisions and suggests areas for future research.

  12. A network-based frequency analysis of Inclusive Wealth to track sustainable development in world countries.

    PubMed

    Ahmad, Nasir; Derrible, Sybil; Managi, Shunsuke

    2018-07-15

    Using human (HC), natural (NC), and produced (PC) capital from Inclusive Wealth as representatives of the triple bottom line of sustainability and utilizing elements of network science, we introduce a Network-based Frequency Analysis (NFA) method to track sustainable development in world countries from 1990 to 2014. The method compares every country with every other and links them when values are close. The country with the most links becomes the main trend, and the performance of every other country is assessed based on its 'orbital' distance from the main trend. Orbital speeds are then calculated to evaluate country-specific dynamic trends. Overall, we find an optimistic trend for HC only, indicating positive impacts of global initiatives aiming towards socio-economic development in developing countries like the Millennium Development Goals and 'Agenda 21'. However, we also find that the relative performance of most countries has not changed significantly in this period, regardless of their gradual development. Specifically, we measure a decrease in produced and natural capital for most countries, despite an increase in GDP, suggesting unsustainable development. Furthermore, we develop a technique to cluster countries and project the results to 2050, and we find a significant decrease in NC for nearly all countries, suggesting an alarming depletion of natural resources worldwide. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Cluster Analysis of International Information and Social Development.

    ERIC Educational Resources Information Center

    Lau, Jesus

    1990-01-01

    Analyzes information activities in relation to socioeconomic characteristics in low, middle, and highly developed economies for the years 1960 and 1977 through the use of cluster analysis. Results of data from 31 countries suggest that information development is achieved mainly by countries that have also achieved social development. (26…

  14. Urban-rural differentials in child malnutrition: trends and socioeconomic correlates in sub-Saharan Africa.

    PubMed

    Fotso, Jean-Christophe

    2007-03-01

    This paper examines levels and trends of urban-rural differentials in child malnutrition, and investigates whether residual differences exist between urban and rural areas, given comparable measures of socioeconomic status (SES) of households and communities. Using data from Demographic and Health Surveys of 15 sub-Saharan African countries, and multilevel modelling, it shows that urban-rural differentials are considerable in all countries, that they have narrowed in most countries due primarily to an increase in urban malnutrition, and have widened in few countries as a result of sharp decline in urban malnutrition. These urban-rural gaps are abolished in almost all countries when SES is controlled. These results suggest that policies and programs contributing to the attainment of the MDGs should pay particular attention to the urban poor.

  15. International study of perceived neighbourhood environmental attributes and Body Mass Index: IPEN Adult study in 12 countries.

    PubMed

    De Bourdeaudhuij, Ilse; Van Dyck, Delfien; Salvo, Deborah; Davey, Rachel; Reis, Rodrigo S; Schofield, Grant; Sarmiento, Olga L; Mitas, Josef; Christiansen, Lars Breum; MacFarlane, Duncan; Sugiyama, Takemi; Aguinaga-Ontoso, Ines; Owen, Neville; Conway, Terry L; Sallis, James F; Cerin, Ester

    2015-05-16

    Ecological models of health behaviour are an important conceptual framework to address the multiple correlates of obesity. Several single-country studies previously examined the relationship between the built environment and obesity in adults, but results are very diverse. An important reason for these mixed results is the limited variability in built environments in these single-country studies. Therefore, the aim of this study was to examine associations between perceived neighbourhood built environmental attributes and BMI/weight status in a multi-country study including 12 environmentally and culturally diverse countries. A multi-site cross-sectional study was conducted in 17 cities (study sites) across 12 countries (Australia, Belgium, Brazil, China, Colombia, Czech Republic, Denmark, Mexico, New Zealand, Spain, the UK and USA). Participants (n = 14222, 18-66 years) self-reported perceived neighbourhood environmental attributes. Height and weight were self-reported in eight countries, and measured in person in four countries. Three environmental attributes were associated with BMI or weight status in pooled data from 12 countries. Safety from traffic was the most robust correlate, suggesting that creating safe routes for walking/cycling by reducing the speed and volume of traffic might have a positive impact upon weight status/BMI across various geographical locations. Close proximity to several local destinations was associated with BMI across all countries, suggesting compact neighbourhoods with more places to walk related to lower BMI. Safety from crime showed a curvilinear relationship with BMI, with especially poor crime safety being related to higher BMI. Environmental interventions involving these three attributes appear to have international relevance and focusing on these might have implications for tackling overweight/obesity.

  16. Country clustering applied to the water and sanitation sector: a new tool with potential applications in research and policy.

    PubMed

    Onda, Kyle; Crocker, Jonny; Kayser, Georgia Lyn; Bartram, Jamie

    2014-03-01

    The fields of global health and international development commonly cluster countries by geography and income to target resources and describe progress. For any given sector of interest, a range of relevant indicators can serve as a more appropriate basis for classification. We create a new typology of country clusters specific to the water and sanitation (WatSan) sector based on similarities across multiple WatSan-related indicators. After a literature review and consultation with experts in the WatSan sector, nine indicators were selected. Indicator selection was based on relevance to and suggested influence on national water and sanitation service delivery, and to maximize data availability across as many countries as possible. A hierarchical clustering method and a gap statistic analysis were used to group countries into a natural number of relevant clusters. Two stages of clustering resulted in five clusters, representing 156 countries or 6.75 billion people. The five clusters were not well explained by income or geography, and were distinct from existing country clusters used in international development. Analysis of these five clusters revealed that they were more compact and well separated than United Nations and World Bank country clusters. This analysis and resulting country typology suggest that previous geography- or income-based country groupings can be improved upon for applications in the WatSan sector by utilizing globally available WatSan-related indicators. Potential applications include guiding and discussing research, informing policy, improving resource targeting, describing sector progress, and identifying critical knowledge gaps in the WatSan sector. Copyright © 2013 Elsevier GmbH. All rights reserved.

  17. A comparison of generic drug prices in seven European countries: a methodological analysis.

    PubMed

    Wouters, Olivier J; Kanavos, Panos G

    2017-03-31

    Policymakers and researchers frequently compare the prices of medicines between countries. Such comparisons often serve as barometers of how pricing and reimbursement policies are performing. The aim of this study was to examine methodological challenges to comparing generic drug prices. We calculated all commonly used price indices based on 2013 IMS Health data on sales of 3156 generic drugs in seven European countries. There were large differences in generic drug prices between countries. However, the results varied depending on the choice of index, base country, unit of volume, method of currency conversion, and therapeutic category. The results also differed depending on whether one looked at the prices charged by manufacturers or those charged by pharmacists. Price indices are a useful statistical approach for comparing drug prices across countries, but researchers and policymakers should interpret price indices with caution given their limitations. Price-index results are highly sensitive to the choice of method and sample. More research is needed to determine the drivers of price differences between countries. The data suggest that some governments should aim to reduce distribution costs for generic drugs.

  18. Does multilingualism affect the incidence of Alzheimer's disease?: A worldwide analysis by country.

    PubMed

    Klein, Raymond M; Christie, John; Parkvall, Mikael

    2016-12-01

    It has been suggested that the cognitive requirements associated with bi- and multilingual processing provide a form of mental exercise that, through increases in cognitive reserve and brain fitness, may delay the symptoms of cognitive failure associated with Alzheimer's disease and other forms of dementia. We collected data on a country-by-country basis that might shed light on this suggestion. Using the best available evidence we could find, the somewhat mixed results we obtained provide tentative support for the protective benefits of multilingualism against cognitive decline. But more importantly, this study exposes a critical issue, which is the need for more comprehensive and more appropriate data on the subject.

  19. Comparisons of mathematics achievement of grade 8 students in the United States and the Russian Federation.

    PubMed

    Bazarova, Saodat I; Engelhard, George

    2004-01-01

    Using the Mantel-Haenszel (MH) Procedure, we analyzed data for 7,087 American and 4,022 Russian Grade 8 students from the Third International Mathematics and Science Study (TIMSS) to compare mathematics achievement in the two countries on each of the 124 multiple-choice items. The results of the analyses indicate that the performance of the students on individual multiple-choice mathematics items vary by country. The results also suggest that the relationship between country and item performance differ as a function of content area. A total score of a country's achievement does not provide the whole picture of achievement dynamics; it averages out potentially important information on student achievement and the causes of their performance relative to other countries. The dynamics of achievement across countries will not be revealed unless the analyses are done at the item level.

  20. Association between Soy Isoflavone Intake and Breast Cancer Risk for Pre- and Post-Menopausal Women: A Meta-Analysis of Epidemiological Studies

    PubMed Central

    Zheng, Yi; Wei, Shiqing; Li, Ye; Guo, Tong; Yin, Ping

    2014-01-01

    Background Conclusions drawn from meta-analyses on the association between soy isoflavone intake and breast cancer risk for pre- and post-menopausal women are not fully consistent. These meta-analyses did not explore the influence of different study designs on the pooled results on the basis of distinguishing between pre- and post-menopausal women. Methodology and Principal Findings We performed a meta-analysis of 35 studies which reported results of association between soy isoflavone intake and breast cancer risk for pre- and/or post-menopausal women, calculated pooled odds ratios and their 95% confidence intervals of pre- and post-menopausal women respectively, and further explored soy isoflavone-breast cancer association on the basis of considering different study regions and designs. Summary results suggested that soy isoflavone intake has a protective effect against breast cancer for both pre- and post-menopausal women. However, they are influenced by study design and region. Pooled ORs of studies carried out in Asian countries suggested that soy isoflavone’s protective effect exist in both pre- and post-menopausal women (OR = 0.59, 95%CI: 0.48–0.69 for premenopausal women; OR = 0.59, 95%CI: 0.44–0.74 for postmenopausal women). However, there are some differences between the results pooled from different study designs for women in Asian countries (test for consistency, P = 0.04). Pooled OR of studies on postmenopausal women in Western countries suggested that soy isoflavone intake has a marginally significant protective effect (OR = 0.92; 95%CI: 0.83∼1.00), but further analyses stratifying by study design found no statistically significant association. Conclusions We meta-analyzed more and newer research results, and separated women according to menopausal status to explore soy isoflavone-breast cancer association. We founded that soy isoflavone intake could lower the risk of breast cancer for both pre- and post-menopausal women in Asian countries. However, for women in Western countries, pre- or post-menopausal, there is no evidence to suggest an association between intake of soy isoflavone and breast cancer. PMID:24586662

  1. A methodology for producing small scale rural land use maps in semi-arid developing countries using orbital imagery

    NASA Technical Reports Server (NTRS)

    Vangenderen, J. L. (Principal Investigator); Lock, B. F.

    1976-01-01

    The author has identified the following significant results. Results have shown that it is feasible to design a methodology that can provide suitable guidelines for operational production of small scale rural land use maps of semiarid developing regions from LANDSAT MSS imagery, using inexpensive and unsophisticated visual techniques. The suggested methodology provides immediate practical benefits to map makers attempting to produce land use maps in countries with limited budgets and equipment. Many preprocessing and interpretation techniques were considered, but rejected on the grounds that they were inappropriate mainly due to the high cost of imagery and/or equipment, or due to their inadequacy for use in operational projects in the developing countries. Suggested imagery and interpretation techniques, consisting of color composites and monocular magnification proved to be the simplest, fastest, and most versatile methods.

  2. Incidence and case-fatality of varicella-zoster virus infection among pediatric cancer patients in developing countries.

    PubMed

    Ojha, Rohit P; Stallings-Smith, Sericea; Aviles-Robles, Martha J; Gomez, Sergio; Somarriba, María Mercedes; Caniza, Miguela A

    2016-04-01

    Limited evidence is available about varicella-zoster virus (VZV) infection among pediatric cancer patients in developing countries, which raises questions about the generalizability of VZV vaccine recommendations for pediatric cancer patients (derived from developed countries) to these settings. We assessed the incidence and case-fatality of VZV infection at three institutions in developing countries (Argentina, Mexico, and Nicaragua). Individuals eligible for our study were aged <20 years and actively receiving cancer-directed therapy. We estimated a summary incidence rate (IR) and case-fatality risk with corresponding 95 % confidence limits (CL) of VZV infection across sites using random-effects models. Our study population comprised 511 pediatric cancer patients, of whom 64 % were aged <10 years, 58 % were male, and 58 % were diagnosed with leukemia. We observed a total of 10 infections during 44,401 person-days of follow-up across the 3 sites (IR = 2.3, 95 % CL 1.2, 4.2). The summary case-fatality risk was 10 % (95 % CL 1.4, 47 %) based on one death. Our results suggest low incidence and case-fatality of VZV infections among pediatric cancer patients in three developing countries. VZV vaccine recommendations for pediatric cancer patients in developed countries may be generalizable to developing countries. • Current recommendations, based on evidence from pediatric cancer patients in developed countries, contraindicate varicella-zoster virus (VZV) vaccination until completion of cancer-directed therapy and recovery of immune function. • The generalizability of these VZV vaccine recommendations to pediatric cancer patients in developing countries is unknown because of limited information about the incidence and case-fatality of VZV in these settings. What is New: • Our results suggest low incidence and case-fatality of VZV infections among pediatric cancer patients in three developing countries. • VZV vaccine recommendations based on evidence from pediatric cancer patients in developed countries may be generalizable to pediatric cancer patients in developing countries.

  3. Ecologically unequal exchange, recessions, and climate change: A longitudinal study.

    PubMed

    Huang, Xiaorui

    2018-07-01

    This study investigates how the ecologically unequal exchange of carbon dioxide emissions varies with economic recessions. I propose a country-specific approach to examine (1) the relationship between carbon dioxide emissions in developing countries and the "vertical flow" of exports to the United States; and (2) the variations of the relationship before, during, and after two recent economic recessions in 2001 and 2008. Using data on 69 developing nations between 2000 and 2010, I estimate time-series cross-sectional regression models with two-way fixed effects. Results suggest that the vertical flow of exports to the United States is positively associated with carbon dioxide emissions in developing countries. The magnitude of this relationship increased in 2001, 2009, and 2010, and decreased in 2008, but remained stable in non-recession periods, suggesting that economic recessions in the United States are associated with variations of ecologically unequal exchange. Results highlight the impacts of U.S. recessions on carbon emissions in developing countries through the structure of international trade. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Regional and longitudinal estimation of product lifespan distribution: a case study for automobiles and a simplified estimation method.

    PubMed

    Oguchi, Masahiro; Fuse, Masaaki

    2015-02-03

    Product lifespan estimates are important information for understanding progress toward sustainable consumption and estimating the stocks and end-of-life flows of products. Publications reported actual lifespan of products; however, quantitative data are still limited for many countries and years. This study presents regional and longitudinal estimation of lifespan distribution of consumer durables, taking passenger cars as an example, and proposes a simplified method for estimating product lifespan distribution. We estimated lifespan distribution parameters for 17 countries based on the age profile of in-use cars. Sensitivity analysis demonstrated that the shape parameter of the lifespan distribution can be replaced by a constant value for all the countries and years. This enabled a simplified estimation that does not require detailed data on the age profile. Applying the simplified method, we estimated the trend in average lifespans of passenger cars from 2000 to 2009 for 20 countries. Average lifespan differed greatly between countries (9-23 years) and was increasing in many countries. This suggests consumer behavior differs greatly among countries and has changed over time, even in developed countries. The results suggest that inappropriate assumptions of average lifespan may cause significant inaccuracy in estimating the stocks and end-of-life flows of products.

  5. Consumer willingness-to-pay for packaging and contents in Asian countries.

    PubMed

    Kojima, Risa; Ishikawa, Masanobu

    2017-10-01

    This study was conducted using a hedonic pricing model to evaluate consumer preference for packaging and contents in five Asian countries: Japan, Indonesia, Singapore, Taiwan, and China. Results revealed that the marginal rate of substitution (MRS) of packaging for contents differs significantly among countries: 17.7 for Singapore, 8.58 for China, 2.71 for Taiwan, 1.65 for Japan and not significant for Indonesia. Share of Willingness-to-pay (WTP) for packaging accounted for 52.8% of the WTP for sales unit of a representative product in Japan and 46.2% in Taiwan, which were significantly higher than the results for Singapore (32.6%) and China (18.2%). Results showed that the higher the share of packaging in the WTP for a product, the higher the relative packaging weight per unit weight of contents. These results suggest that the relative demand for packaging to contents differs among countries. The results underscore the necessity of choosing suitable policy instruments and marketing strategies for different countries. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Persistent Differences in Mortality Patterns across Industrialized Countries

    PubMed Central

    d'Albis, Hippolyte; Esso, Loesse Jacques; Pifarré i Arolas, Héctor

    2014-01-01

    The epidemiological transition has provided the theoretical background for the expectation of convergence in mortality patterns. We formally test and reject the convergence hypothesis for a sample of industrialized countries in the period from 1960 to 2008. After a period of convergence in the decade of 1960 there followed a sustained process of divergence with a pronounced increase at the end of the 1980's, explained by trends within former Socialist countries (Eastern countries). While Eastern countries experienced abrupt divergence after the dissolution of the Soviet Union, differences within Western countries remained broadly constant for the whole period. Western countries transitioned from a strong correlation between life expectancy and variance in 1960 to no association between both moments in 2008 while Eastern countries experienced the opposite evolution. Taken together, our results suggest that convergence can be better understood when accounting for shared structural similarities amongst groups of countries rather than through global convergence. PMID:25181447

  7. [Tax expenses and their impacts on performance in health and education].

    PubMed

    Paes, Nelson Leitão

    2014-04-01

    The increase in tax expenditures is a trend observed in many countries. In Brazil, the increase in tax expenditures was marked, with an increase of 47% between 2006 and 2011. Based on data from Latin American countries and the OECD, this paper investigates whether countries with high tax expenditures in relation to budget expenditures perform better in the areas of health and education. The results show that the group of Latin American countries spends much more via taxation than the OECD countries, with Brazil showing a relatively low relationship between tax expenditures and total expenditures for health and education. In relation to social indicators, this article suggests that countries that use tax expenditures more intensively have systematically worse social indicators in education and health.

  8. P.C.A.P. Project Profiles. Queensland Priority Country Area Program--Evaluation Series.

    ERIC Educational Resources Information Center

    Fowler, C. F.; Peters, J. E.

    Thirty-two projects designed to improve educational opportunities of rural Queensland children were funded as part of the Disadvantaged Schools Program in 1979 and 1980. This program resulted from a 1977-79 Schools Commission report which suggested that students in country areas may be disadvantaged compared to urban dwellers, with respect to…

  9. Is Expenditure on Higher Education Per Student Converging across EU-15 Countries?

    ERIC Educational Resources Information Center

    Agasisti, Tommaso; Perez-Esparrells, Carmen; Catalano, Giuseppe; Morales, Susana

    2012-01-01

    This article examines the trend in expenditure per student at higher education institutions in the EU-15 countries, during the period 1998-2006. The results show that there was a tendency towards convergence (as measured by sigma and beta convergence analysis). The ratio of convergence is higher after 2001, suggesting that the implementation of…

  10. Corruption costs lives: evidence from a cross-country study.

    PubMed

    Li, Qiang; An, Lian; Xu, Jing; Baliamoune-Lutz, Mina

    2018-01-01

    This paper investigates the effect of corruption on health outcomes by using cross-country panel data covering about 150 countries for the period of 1995 to 2012. We employ ordinary least squares (OLS), fixed-effects and two-stage least squares (2SLS) estimation methods, and find that corruption significantly increases mortality rates, and reduces life expectancy and immunization rates. The results are consistent across different regions, gender, and measures of corruption. The findings suggest that reducing corruption can be an effective method to improve health outcomes.

  11. The educational gradient in marriage: a comparison of 25 European countries.

    PubMed

    Kalmijn, Matthijs

    2013-08-01

    Previous research has suggested that a new marriage gradient has emerged in the United States, with marriage becoming increasingly the privilege of the better-educated. This article examines whether this is true for Europe and explores differences in the marriage gradient among 25 European countries, using multilevel models. The focus is on the chances of living in a marital (or cohabiting) union during midlife (ages 40-49). Multilevel analyses show that the direction and strength of the gradient depend on the societal context. In countries where gender roles are traditional, better-educated women are less likely to be married than less-educated women; in gender-egalitarian countries, better-educated women are more likely to be married. For men, the educational effect on marriage is absent in traditional countries but becomes positive as gender roles become more equal. Inequality in a society also modifies the gradient: if the degree of economic inequality between educational groups in a society is strong, better-educated men are more likely to be married than less-educated men. In general, the results suggest that there may be an accumulation of social and economic disadvantages for the less well educated in more-developed countries.

  12. Differences in health care spending across countries: statistical evidence.

    PubMed

    Pfaff, M

    1990-01-01

    The empirical evidence available for OECD countries suggests that economic factors play a major role and that demographic factors play a minor role in explaining differences in health care spending across countries. When countries are grouped on the basis of their health care systems, some significant cross-country differences result: countries with higher transfer rates (a larger share of collective financing) are not generally characterized by higher health care expenditures, and conversely, countries with a larger share of private financing (including higher coinsurance rates) do not have lower expenditures. Rather, the opposite holds true. Similar conclusions apply to the share of public versus private production of health goods. Furthermore, the results do not support the claims of those critics of universal public insurance systems who consider the expansion of the coverage to be a major source of expenditure growth. These findings cast serious doubt on the claim that cost containment can be achieved via market reforms that rely heavily on direct consumer payments and cost sharing as instruments of financing. A comparative analysis of the historic record of the United States, Canada, and the Federal Republic of Germany generally supports these conclusions; it also suggests that a greater degree of public penetration offers a better chance for control of health spending, particularly in periods of austerity. There is a strong presumption that health care systems relying on some overall control of spending generally are more cost-effective than those relying more on decentralized mechanisms of control. Services are more equitably distributed in relation to health and payment for health services is far more progressive in the former type of system.

  13. Valuation of preference-based measures: can existing preference data be used to generate better estimates?

    PubMed

    Kharroubi, Samer A

    2018-06-05

    Experimental studies to develop valuations of health state descriptive systems like EQ-5D or SF-6D need to be conducted in different countries, because social and cultural differences are likely to lead to systematically different valuations. There is a scope utilize the evidence in one country to help with the design and the analysis of a study in another, for this to enable the generation of utility estimates of the second country much more precisely than would have been possible when collecting and analyzing the country's data alone. We analyze SF-6D valuation data elicited from representative samples corresponding to the Hong Kong (HK) and United Kingdom (UK) general adult populations through the use of the standard gamble technique to value 197 and 249 health states respectively. We apply a nonparametric Bayesian model to estimate a HK value set using the UK dataset as informative prior to improve its estimation. Estimates are compared to a HK value set estimated using HK values alone using mean predictions and root mean square error. The novel method of modelling utility functions permitted the UK valuations to contribute significant prior information to the Hong Kong analysis. The results suggest that using HK data alongside the existing UK data produces HK utility estimates better than using the HK study data by itself. The promising results suggest that existing preference data could be combined with valuation study in a new country to generate preference weights, making own country value sets more achievable for low and middle income countries. Further research is encouraged.

  14. Has Malaysia's antidrug effort been effective?

    PubMed

    Scorzelli, J F

    1992-01-01

    It is a common belief that a massive effort in law enforcement, preventive education and rehabilitation will result in the elimination of a country's drug problem. Based on this premise. Malaysia in 1983 implemented such a multifaceted anti-drug strategy, and the results of a 1987 study by the author suggested that Malaysia's effort had begun to contribute to a steady decrease in the number of identified drug abusers. Although the number of drug-addicted individuals declined, the country's recidivism rates were still high. Because of this high relapse rate, Malaysia expanded their rehabilitation effort and developed a community transition program. In order to determine the impact of these changes on the country's battle against drug abuse, a follow-up study was conducted in 1990. The results of this study did not clearly demonstrate that the Malaysian effort had been successful in eliminating the problem of drug abuse, and raised some questions concerning the effectiveness of the country's drug treatment programs.

  15. Mental Disorders among Persons with Heart Disease - Results from the World Mental Health Surveys

    PubMed Central

    Ormel, Johan; Von Korff, Michael; Burger, Huibert; Scott, Kate; Demyttenaere, Koen; Huang, Yue-qin; Posada-Villa, José; Lepine, Jean Pierre; Angermeyer, Matthias C.; Levinson, Daphna; de Girolamo, Giovanni; Kawakami, Norito; Karam, Elie; Medina-Mora, María Elena; Gureje, Oye; Williams, David; Haro, Josep Maria; Bromet, Evelyn J.; Alonso, Jordi; Kessler, Ron

    2007-01-01

    Objective While in western countries depression and heart disease often co-occur, less is known about the association of anxiety and alcohol use disorders with heart disease and about the cross-cultural consistency of these associations. Consistency across emotional disorders and cultures would suggest that relatively universal mechanisms underlie the association. Method Surveys in 18 random population samples of household-residing adults in 17 countries in Europe, the Americas, the Middle East, Africa, Asia and the South Pacific. Medically recognized heart disease was ascertained by self-report. Mental disorders were assessed with the WMH-CIDI, a fully structured diagnostic interview. Results Specific mood and anxiety disorders occurred among persons with heart disease at higher rates than among persons without heart disease. Adjusted for gender and age, the pooled odds ratios (95% CI) were 2.1 (1.9,2.5) for mood disorders, 2.2 (1.9,2.5) for anxiety disorders, and 1.4 (1.0,1.9) for alcohol abuse/dependence among persons with versus without heart disease. This pattern was similar across countries. Conclusions An excess of anxiety disorders, as well as mood disorders, is found among persons with heart disease. These associations hold across countries despite substantial between-country differences in culture and mental disorder prevalence rates. These results suggest that similar mechanisms underlie the associations and that a broad spectrum of mood-anxiety disorders should be considered in research on the comorbidity of mental disorders and heart disease. PMID:17591509

  16. Trends of improved water and sanitation coverage around the globe between 1990 and 2010: inequality among countries and performance of official development assistance

    PubMed Central

    Cha, Seungman; Mankadi, Paul Mansiangi; Elhag, Mousab Siddig; Lee, Yongjoo; Jin, Yan

    2017-01-01

    ABSTRACT Background: As the Millennium Development Goals ended, and were replaced by the Sustainable Development Goals, efforts have been made to evaluate the achievements and performance of official development assistance (ODA) in the health sector. In this study, we explore trends in the expansion of water and sanitation coverage in developing countries and the performance of ODA. Design: We explored inequality across developing countries by income level, and investigated how ODA for water and sanitation was committed by country, region, and income level. Changes in inequality were tested via slope changes by investigating the interaction of year and income level with a likelihood ratio test. A random effects model was applied according to the results of the Hausman test. Results: The slope of the linear trend between economic level and sanitation coverage has declined over time. However, a random effects model suggested that the change in slope across years was not significant (e.g. for the slope change between 2000 and 2010: likelihood ratio χ2 = 2.49, probability > χ2 = 0.1146). A similar pro-rich pattern across developing countries and a non-significant change in the slope associated with different economic levels were demonstrated for water coverage. Our analysis shows that the inequality of water and sanitation coverage among countries across the world has not been addressed effectively during the past decade. Our findings demonstrate that the countries with the least coverage persistently received far less ODA per capita than did countries with much more extensive water and sanitation coverage, suggesting that ODA for water and sanitation is poorly targeted. Conclusion: The most deprived countries should receive more attention for water and sanitation improvements from the world health community. A strong political commitment to ODA targeting the countries with the least coverage is needed at the global level. PMID:28604256

  17. Belonging, believing, bonding, and behaving: the relationship between religion and business ownership at the country level.

    PubMed

    Hoogendoorn, Brigitte; Rietveld, Cornelius A; van Stel, André

    2016-01-01

    This cross-country study adopts a competing theories approach in which both a value perspective and a social capital perspective are used to understand the relation between religion and a country's business ownership rate. We distinguish among four dimensions of religion: belonging to a religious denomination, believing certain religious propositions, bonding to religious practices, and behaving in a religious manner. An empirical analysis of data from 30 OECD countries with multiple data points per country covering the period 1984-2010 suggests a positive relationship between religion and business ownership based on those dimensions that reflect the internal aspects of religiosity (i.e., believing and behaving). We do not observe a significant association for those dimensions that reflect more external aspects of religion (i.e., belonging and bonding). These results suggest that the social capital perspective prevails the value perspective, at least when internal aspects of religiosity are concerned. More generally, our study demonstrates the importance of distinguishing between different dimensions of religion when investigating the link between religion and entrepreneurship.

  18. Comparing Teachers' Views on Morality and Moral Education, a Comparative Study in Turkey and the United States

    ERIC Educational Resources Information Center

    LePage, Pamela; Akar, Hanife; Temli, Yeliz; Sen, Derya; Hasser, Neil; Ivins, Ilene

    2011-01-01

    In this study, the researchers examined how K-8 teachers approach morality, moral education, and the moral development of children in Turkey and in the United States. Both countries have diverse cultures and long histories with secular education systems. Surveys were sent to teachers in nine cities in both countries. Results suggest that Turkish…

  19. "No God and no Norway": collective resource loss among members of Tamil NGO's in Norway during and after the last phase of the civil war in Sri Lanka

    PubMed Central

    2011-01-01

    Background Studies on the mental health of refugees have tended to focus upon the impact of traumatic experiences in the country of origin, and acculturation processes in exile. The effects of crises in the country of origin on refugees living in exile have been little studied. This article examines how the final stages of the civil war in Sri Lanka in 2009 influenced members of pro-LTTE Tamil NGO's in Norway. Method Ethnographic fieldwork methods were employed within Tamil NGO's in the two largest cities in Norway between November 2008 and June 2011. Results The findings suggest that collective resources became severely drained as a result of the crisis, severely disrupting the fabric of social life. Public support from the majority community remained scarce throughout the crisis. Conclusions The study suggests that there is a need for public support to exile groups indirectly affected by man-made crises in their country of origin. PMID:21849029

  20. Examining Road Traffic Mortality Status in China: A Simulation Study

    PubMed Central

    Schwebel, David C.; Li, Li; Hu, Guoqing

    2016-01-01

    Background Data from the Chinese police service suggest substantial reductions in road traffic injuries since 2002, but critics have questioned the accuracy of those data, especially considering conflicting data reported by the health department. Methods To address the gap between police and health department data and to determine which may be more accurate, we conducted a simulation study based on the modified Smeed equation, which delineates a non-linear relation between road traffic mortality and the level of motorization in a country or region. Our goal was to simulate trends in road traffic mortality in China and compare performances in road traffic safety management between China and 13 other countries. Results Chinese police data indicate a peak in road traffic mortalities in 2002 and a significant and a gradual decrease in population-based road traffic mortality since 2002. Health department data show the road traffic mortality peaked in 2012. In addition, police data suggest China’s road traffic mortality peaked at a much lower motorization level (0.061 motor vehicles per person) in 2002, followed by a reduction in mortality to a level comparable to that of developed countries. Simulation results based on health department data suggest high road traffic mortality, with a mortality peak in 2012 at a moderate motorization level (0.174 motor vehicles per person). Comparisons to the other 13 countries suggest the health data from China may be more valid than the police data. Conclusion Our simulation data indicate China is still at a stage of high road traffic mortality, as suggested by health data, rather than a stage of low road traffic mortality, as suggested by police data. More efforts are needed to integrate safety into road design, improve road traffic management, improve data quality, and alter unsafe behaviors of pedestrians, drivers and passengers in China. PMID:27071008

  1. Growth in emission transfers via international trade from 1990 to 2008.

    PubMed

    Peters, Glen P; Minx, Jan C; Weber, Christopher L; Edenhofer, Ottmar

    2011-05-24

    Despite the emergence of regional climate policies, growth in global CO(2) emissions has remained strong. From 1990 to 2008 CO(2) emissions in developed countries (defined as countries with emission-reduction commitments in the Kyoto Protocol, Annex B) have stabilized, but emissions in developing countries (non-Annex B) have doubled. Some studies suggest that the stabilization of emissions in developed countries was partially because of growing imports from developing countries. To quantify the growth in emission transfers via international trade, we developed a trade-linked global database for CO(2) emissions covering 113 countries and 57 economic sectors from 1990 to 2008. We find that the emissions from the production of traded goods and services have increased from 4.3 Gt CO(2) in 1990 (20% of global emissions) to 7.8 Gt CO(2) in 2008 (26%). Most developed countries have increased their consumption-based emissions faster than their territorial emissions, and non-energy-intensive manufacturing had a key role in the emission transfers. The net emission transfers via international trade from developing to developed countries increased from 0.4 Gt CO(2) in 1990 to 1.6 Gt CO(2) in 2008, which exceeds the Kyoto Protocol emission reductions. Our results indicate that international trade is a significant factor in explaining the change in emissions in many countries, from both a production and consumption perspective. We suggest that countries monitor emission transfers via international trade, in addition to territorial emissions, to ensure progress toward stabilization of global greenhouse gas emissions.

  2. Growth in emission transfers via international trade from 1990 to 2008

    PubMed Central

    Peters, Glen P.; Minx, Jan C.; Weber, Christopher L.; Edenhofer, Ottmar

    2011-01-01

    Despite the emergence of regional climate policies, growth in global CO2 emissions has remained strong. From 1990 to 2008 CO2 emissions in developed countries (defined as countries with emission-reduction commitments in the Kyoto Protocol, Annex B) have stabilized, but emissions in developing countries (non-Annex B) have doubled. Some studies suggest that the stabilization of emissions in developed countries was partially because of growing imports from developing countries. To quantify the growth in emission transfers via international trade, we developed a trade-linked global database for CO2 emissions covering 113 countries and 57 economic sectors from 1990 to 2008. We find that the emissions from the production of traded goods and services have increased from 4.3 Gt CO2 in 1990 (20% of global emissions) to 7.8 Gt CO2 in 2008 (26%). Most developed countries have increased their consumption-based emissions faster than their territorial emissions, and non–energy-intensive manufacturing had a key role in the emission transfers. The net emission transfers via international trade from developing to developed countries increased from 0.4 Gt CO2 in 1990 to 1.6 Gt CO2 in 2008, which exceeds the Kyoto Protocol emission reductions. Our results indicate that international trade is a significant factor in explaining the change in emissions in many countries, from both a production and consumption perspective. We suggest that countries monitor emission transfers via international trade, in addition to territorial emissions, to ensure progress toward stabilization of global greenhouse gas emissions. PMID:21518879

  3. What Deters Crime? Comparing the Effectiveness of Legal, Social, and Internal Sanctions Across Countries.

    PubMed

    Mann, Heather; Garcia-Rada, Ximena; Hornuf, Lars; Tafurt, Juan

    2016-01-01

    The question of what deters crime is of both theoretical and practical interest. The present paper focuses on what factors deter minor, non-violent crimes, i.e., dishonest actions that violate the law. Much research has been devoted to testing the effectiveness of legal sanctions on crime, while newer models also include social sanctions (judgment of friends or family) and internal sanctions (feelings of guilt). Existing research suggests that both internal sanctions and, to a lesser extent, legal sanctions deter crime, but it is unclear whether this pattern is unique to Western countries or robust across cultures. We administered a survey study to participants in China, Colombia, Germany, Portugal, and USA, five countries from distinct cultural regions of the world. Participants were asked to report the likelihood of engaging in seven dishonest and illegal actions, and were asked to indicate the probability and severity of consequences for legal, friend, family, and internal sanctions. Results indicated that across countries, internal sanctions had the strongest deterrent effects on crime. The deterrent effects of legal sanctions were weaker and varied across countries. Furthermore, the deterrent effects of legal sanctions were strongest when internal sanctions were lax. Unexpectedly, social sanctions were positively related to likelihood of engaging in crime. Taken together, these results suggest that the relative strengths of legal and internal sanctions are robust across cultures and dishonest actions.

  4. What Deters Crime? Comparing the Effectiveness of Legal, Social, and Internal Sanctions Across Countries

    PubMed Central

    Mann, Heather; Garcia-Rada, Ximena; Hornuf, Lars; Tafurt, Juan

    2016-01-01

    The question of what deters crime is of both theoretical and practical interest. The present paper focuses on what factors deter minor, non-violent crimes, i.e., dishonest actions that violate the law. Much research has been devoted to testing the effectiveness of legal sanctions on crime, while newer models also include social sanctions (judgment of friends or family) and internal sanctions (feelings of guilt). Existing research suggests that both internal sanctions and, to a lesser extent, legal sanctions deter crime, but it is unclear whether this pattern is unique to Western countries or robust across cultures. We administered a survey study to participants in China, Colombia, Germany, Portugal, and USA, five countries from distinct cultural regions of the world. Participants were asked to report the likelihood of engaging in seven dishonest and illegal actions, and were asked to indicate the probability and severity of consequences for legal, friend, family, and internal sanctions. Results indicated that across countries, internal sanctions had the strongest deterrent effects on crime. The deterrent effects of legal sanctions were weaker and varied across countries. Furthermore, the deterrent effects of legal sanctions were strongest when internal sanctions were lax. Unexpectedly, social sanctions were positively related to likelihood of engaging in crime. Taken together, these results suggest that the relative strengths of legal and internal sanctions are robust across cultures and dishonest actions. PMID:26903898

  5. An international perspective on interest in a general surgery career among final-year medical students.

    PubMed

    Are, Chandrakanth; Stoddard, Hugh A; Prete, Francesco; Tianqiang, Song; Northam, Lindsay M; Chan, Sharon; Lee, Janet; Jani, Pankaj; Protic, Mladjan; Venkateshwarulu, S; Sarela, Abeezar; Thompson, Jon S

    2011-09-01

    The level of interest in general surgery among US seniors has been declining; however, it may be perceived as a more attractive career outside the United States. A survey was developed and distributed to students at medical schools in 8 countries. Results were analyzed to determine whether interest in general surgery was related to sex of the respondent or economic standing of the country. We noted differences in the level of interest in general surgery, ranging from 8% in Italy to 58% in India. As in the United States, there was a difference in the level of interest between sexes, with a male preponderance. Students from economically less developed countries expressed a greater interest in general surgery compared with students from countries with high development. Our study suggested the level of interest for general surgery may depend on the sex and the location of the student. Further comparison studies may suggest means to stimulate student interest in the field. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Government Investment and Follow-on Private Sector Investment in Pakistan, 1972-1995

    DTIC Science & Technology

    1997-06-01

    private sector investment has long been suggested. Until recently, an appropriate model to test for the relationship in developing countries has been absent. In 1984, Blejer and Khan developed and estimated a model for 24 developing countries between 1971 and 1979. They found that higher rates of investment took place when the private sector took a large role in capital formation. This paper estimates a similar model for one developing country, Pakistan, for the period 1972 to 1995. Our results are broadly similar to those obtained by Blejer and Khan

  7. Phylogenetic Analysis and Epidemic History of Hepatitis C Virus Genotype 2 in Tunisia, North Africa

    PubMed Central

    Rajhi, Mouna; Ghedira, Kais; Chouikha, Anissa; Djebbi, Ahlem; Cheikh, Imed; Ben Yahia, Ahlem; Sadraoui, Amel; Hammami, Walid; Azouz, Msaddek; Ben Mami, Nabil; Triki, Henda

    2016-01-01

    HCV genotype 2 (HCV-2) has a worldwide distribution with prevalence rates that vary from country to country. High genetic diversity and long-term endemicity were suggested in West African countries. A global dispersal of HCV-2 would have occurred during the 20th century, especially in European countries. In Tunisia, genotype 2 was the second prevalent genotype after genotype 1 and most isolates belong to subtypes 2c and 2k. In this study, phylogenetic analyses based on the NS5B genomic sequences of 113 Tunisian HCV isolates from subtypes 2c and 2k were carried out. A Bayesian coalescent-based framework was used to estimate the origin and the spread of these subtypes circulating in Tunisia. Phylogenetic analyses of HCV-2c sequences suggest the absence of country-specific or time-specific variants. In contrast, the phylogenetic grouping of HCV-2k sequences shows the existence of two major genetic clusters that may represent two distinct circulating variants. Coalescent analysis indicated a most recent common ancestor (tMRCA) of Tunisian HCV-2c around 1886 (1869–1902) before the introduction of HCV-2k in 1901 (1867–1931). Our findings suggest that the introduction of HCV-2c in Tunisia is possibly a result of population movements between Tunisia and European population following the French colonization. PMID:27100294

  8. Phylogenetic Analysis and Epidemic History of Hepatitis C Virus Genotype 2 in Tunisia, North Africa.

    PubMed

    Rajhi, Mouna; Ghedira, Kais; Chouikha, Anissa; Djebbi, Ahlem; Cheikh, Imed; Ben Yahia, Ahlem; Sadraoui, Amel; Hammami, Walid; Azouz, Msaddek; Ben Mami, Nabil; Triki, Henda

    2016-01-01

    HCV genotype 2 (HCV-2) has a worldwide distribution with prevalence rates that vary from country to country. High genetic diversity and long-term endemicity were suggested in West African countries. A global dispersal of HCV-2 would have occurred during the 20th century, especially in European countries. In Tunisia, genotype 2 was the second prevalent genotype after genotype 1 and most isolates belong to subtypes 2c and 2k. In this study, phylogenetic analyses based on the NS5B genomic sequences of 113 Tunisian HCV isolates from subtypes 2c and 2k were carried out. A Bayesian coalescent-based framework was used to estimate the origin and the spread of these subtypes circulating in Tunisia. Phylogenetic analyses of HCV-2c sequences suggest the absence of country-specific or time-specific variants. In contrast, the phylogenetic grouping of HCV-2k sequences shows the existence of two major genetic clusters that may represent two distinct circulating variants. Coalescent analysis indicated a most recent common ancestor (tMRCA) of Tunisian HCV-2c around 1886 (1869-1902) before the introduction of HCV-2k in 1901 (1867-1931). Our findings suggest that the introduction of HCV-2c in Tunisia is possibly a result of population movements between Tunisia and European population following the French colonization.

  9. Perinatal mortality--a suitable index of health worldwide?

    PubMed

    Savage, A

    1986-11-22

    As a result of cultural factors, perinatal mortality may not be the most appropriate measure of health. Comparisons of the health of different countries should not be based on only 1 criterion unless general attitudes are the same. In developed countries, where abortion is widely available, unwanted pregnancies are handled before delivery. In some developing countries in Africa, however, population control may take the form of allowing a newborn to die of starvation, for example. Given this cultural difference, Third World countries rank lowest in perinatal health. It is suggested that mortality and morbidity should be calculated decade by decade before an index is derived. A 20-year old from a developing country, where there is no drug problem and attempted suicide is rare, might receive a higher health rating than his counterpart in developed countries.

  10. Are Some Countries More Prone to Pressure Evaluators than Others? Comparing Findings from the United States, United Kingdom, Germany, and Switzerland

    ERIC Educational Resources Information Center

    Pleger, Lyn; Sager, Fritz; Morris, Michael; Meyer, Wolfgang; Stockmann, Reinhard

    2017-01-01

    Pressure on evaluators has been investigated recently by surveys in the USA, the UK, Germany, and Switzerland. This study compares the results of those studies regarding pressure on evaluators in different countries. The findings suggest that independence of evaluations does not exist for many respondents. Moreover, the person who commissioned the…

  11. Who Decides: Me or We? Family Involvement in Medical Decision Making in Eastern and Western Countries.

    PubMed

    Alden, Dana L; Friend, John; Lee, Ping Yein; Lee, Yew Kong; Trevena, Lyndal; Ng, Chirk Jenn; Kiatpongsan, Sorapop; Lim Abdullah, Khatijah; Tanaka, Miho; Limpongsanurak, Supanida

    2018-01-01

    Research suggests that desired family involvement (FI) in medical decision making may depend on cultural values. Unfortunately, the field lacks cross-cultural studies that test this assumption. As a result, providers may be guided by incomplete information or cultural biases rather than patient preferences. Researchers developed 6 culturally relevant disease scenarios varying from low to high medical seriousness. Quota samples of approximately 290 middle-aged urban residents in Australia, China, Malaysia, India, South Korea, Thailand, and the USA completed an online survey that examined desired levels of FI and identified individual difference predictors in each country. All reliability coefficients were acceptable. Regression models met standard assumptions. The strongest finding across all 7 countries was that those who desired higher self-involvement (SI) in medical decision making also wanted lower FI. On the other hand, respondents who valued relational-interdependence tended to want their families involved - a key finding in 5 of 7 countries. In addition, in 4 of 7 countries, respondents who valued social hierarchy desired higher FI. Other antecedents were less consistent. These results suggest that it is important for health providers to avoid East-West cultural stereotypes. There are meaningful numbers of patients in all 7 countries who want to be individually involved and those individuals tend to prefer lower FI. On the other hand, more interdependent patients are likely to want families involved in many of the countries studied. Thus, individual differences within culture appear to be important in predicting whether a patient desires FI. For this reason, avoiding culture-based assumptions about desired FI during medical decision making is central to providing more effective patient centered care.

  12. Globalization, democracy, and child health in developing countries.

    PubMed

    Welander, Anna; Lyttkens, Carl Hampus; Nilsson, Therese

    2015-07-01

    Good health is crucial for human and economic development. In particular poor health in childhood is of utmost concern since it causes irreversible damage and has implications later in life. Recent research suggests globalization is a strong force affecting adult and child health outcomes. Yet, there is much unexplained variation with respect to the globalization effect on child health, in particular in low- and middle-income countries. One factor that could explain such variation across countries is the quality of democracy. Using panel data for 70 developing countries between 1970 and 2009 this paper disentangles the relationship between globalization, democracy, and child health. Specifically the paper examines how globalization and a country's democratic status and historical experience with democracy, respectively, affect infant mortality. In line with previous research, results suggest that globalization reduces infant mortality and that the level of democracy in a country generally improves child health outcomes. Additionally, democracy matters for the size of the globalization effect on child health. If for example Côte d'Ivoire had been a democracy in the 2000-2009 period, this effect would translate into 1200 fewer infant deaths in an average year compared to the situation without democracy. We also find that nutrition is the most important mediator in the relationship. To conclude, globalization and democracy together associate with better child health in developing countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Globalization and economic growth: empirical evidence on the role of complementarities.

    PubMed

    Samimi, Parisa; Jenatabadi, Hashem Salarzadeh

    2014-01-01

    This study was carried out to investigate the effect of economic globalization on economic growth in OIC countries. Furthermore, the study examined the effect of complementary policies on the growth effect of globalization. It also investigated whether the growth effect of globalization depends on the income level of countries. Utilizing the generalized method of moments (GMM) estimator within the framework of a dynamic panel data approach, we provide evidence which suggests that economic globalization has statistically significant impact on economic growth in OIC countries. The results indicate that this positive effect is increased in the countries with better-educated workers and well-developed financial systems. Our finding shows that the effect of economic globalization also depends on the country's level of income. High and middle-income countries benefit from globalization whereas low-income countries do not gain from it. In fact, the countries should receive the appropriate income level to be benefited from globalization. Economic globalization not only directly promotes growth but also indirectly does so via complementary reforms.

  14. Does the ‘hikikomori’ syndrome of social withdrawal exist outside Japan?: A preliminary international investigation

    PubMed Central

    Kato, Takahiro A.; Tateno, Masaru; Shinfuku, Naotaka; Fujisawa, Daisuke; Teo, Alan R.; Sartorius, Norman; Akiyama, Tsuyoshi; Ishida, Tetsuya; Choi, Tae Young; Balhara, Yatan Pal Singh; Matsumoto, Ryohei; Umene-Nakano, Wakako; Fujimura, Yota; Wand, Anne; Chang, Jane Pei-Chen; Chang, Rita Yuan-Feng; Shadloo, Behrang; Ahmed, Helal Uddin; Lerthattasilp, Tiraya; Kanba, Shigenobu

    2016-01-01

    Purpose To explore whether the ‘hikikomori’ syndrome (social withdrawal) described in Japan exists in other countries, and if so, how patients with the syndrome are diagnosed and treated. Methods Two hikikomori case vignettes were sent to psychiatrists in Australia, Bangladesh, India, Iran, Japan, Korea, Taiwan, Thailand and the USA. Participants rated the syndrome's prevalence in their country, etiology, diagnosis, suicide risk, and treatment. Results Out of 247 responses to the questionnaire (123 from Japan and 124 from other countries), 239 were enrolled in the analysis. Respondents’ felt the hikikomori syndrome is seen in all countries examined and especially in urban areas. Biopsychosocial, cultural, and environmental factors were all listed as probable causes of hikikomori, and differences among countries were not significant. Japanese psychiatrists suggested treatment in outpatient wards and some did not think that psychiatric treatment is necessary. Psychiatrists in other countries opted for more active treatment such as hospitalization. Conclusions Patients with the hikikomori syndrome are perceived as occurring across a variety of cultures by psychiatrists in multiple countries. Our results provide a rational basis for study of the existence and epidemiology of hikikomori in clinical or community populations in international settings. PMID:21706238

  15. Life satisfaction in the new country: a multilevel longitudinal analysis of effects of culture and 5-HTT allele frequency distribution in country of origin

    PubMed Central

    Kent, Stephen; Kashima, Yoshihisa

    2015-01-01

    Life satisfaction of migrants to Australia from 17 countries, assessed at 4–5 months, 16–17 months and 3½ years after arrival, was analyzed with a longitudinal, multilevel analysis. The results indicated that migrants were more satisfied, if the national average life satisfaction was higher in their country of origin, after adjustment for individual-level income, age, and sex and a linear temporal trend. Simultaneously, the migrants were also happier if people in their country of origin had a higher frequency of 5-HTT long allele, a genotype known to be associated with resilience under life stresses. These two relationships were independent, suggesting that both culture and gene matter in international transitions. PMID:24532702

  16. Educational inequalities in obesity and gross domestic product: evidence from 70 countries.

    PubMed

    Kinge, Jonas Minet; Strand, Bjørn Heine; Vollset, Stein Emil; Skirbekk, Vegard

    2015-12-01

    We test the reversal hypothesis, which suggests that the relationship between obesity and education depends on the economic development in the country; in poor countries, obesity is more prevalent in the higher educated groups, while in rich countries the association is reversed-higher prevalence in the lower educated. We assembled a data set on obesity and education including 412,921 individuals from 70 countries in the period 2002-2013. Gross domestic product (GDP) per capita was used as a measure of economic development. We assessed the association between obesity and GDP by education using a two-stage mixed effects model. Country-specific educational inequalities in obesity were investigated using regression-based inequality indices. The reversal hypothesis was supported by our results in men and women. Obesity was positively associated with country GDP only among individuals with lower levels of education, while this association was absent or reduced in those with higher levels of education. This pattern was more pronounced in women than in men. Furthermore, educational inequalities in obesity were reversed with GDP; in low-income countries, obesity was more prevalent in individuals with higher education, in medium-income and high-income countries, obesity shifts to be more prevalent among those with lower levels of education. Obesity and economic development were positively associated. Our findings suggest that education might mitigate this effect. Global and national action aimed at the obesity epidemic should take this into account. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Developing a Nuclear Grade of Alloy 617 for Gen IV Nuclear Energy Systems

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

    Ren, Weiju; Swindeman, Robert W; Santella, Michael L

    2010-01-01

    Alloy 617, an attractive material not particularly developed for nuclear use, is now being considered as a leading candidate alloy by several countries for applications in the Gen IV Nuclear Energy Systems. An extensive review of its existing data suggests that it would be beneficial to refine the alloy s specification to a nuclear grade for the intended Gen IV systems. In this paper, rationale for developing a nuclear grade of the alloy is first discussed through an analysis on existing data from various countries. Then initial experiments for refining the alloy specification are described. Preliminary results have suggested themore » feasibility of the refinement approach, as well as the possibility for achieving a desirable nuclear grade. Based on the results, further research activities are recommended.« less

  18. Communication in health care delivery in developing countries: which way out?

    PubMed

    Olutimayin, Jide

    2002-09-01

    Most governments in developing countries have adopted frameworks for health development which stressed community based initiatives and intervention at all levels of the health pyramid (WHO, 1992). But even today, most of the rural communities in these countries are still not developed in terms of available health facilities. What then is/are responsible for these failures? Various authors have come up with various reasons, principal amongst which are inadequate resources, lack of planning, insincerity/non-commitment of the governments, lack of modern information technology, etc. This paper examines some of these factors in relation to how they accentuate or hamper healthcare delivery in developing countries, using African rural communities as a study field. The resultant suggestions are a consortium of varying factors, some of which are economic in nature, policy changes, human resources development, and re-orientation of social and government attitudes towards achieving meaningful results in healthcare delivery, particularly in the rural communities.

  19. Is the demand for alcoholic beverages in developing countries sensitive to price? Evidence from China.

    PubMed

    Tian, Guoqiang; Liu, Feng

    2011-06-01

    Economic literature in developed countries suggests that demand for alcoholic beverages is sensitive to price, with an estimated price elasticity ranging from -0.38 for beer and -0.7 for liquor. However, few studies have been conducted in developing countries. We employ a large individual-level dataset in China to estimate the effects of price on alcohol demand. Using the data from China Health and Nutrition Survey for the years 1993, 1997, 2000, 2004 and 2006, we estimate two-part models of alcohol demand. Results show the price elasticity is virtually zero for beer and only -0.12 for liquor, which is far smaller than those derived from developed countries. Separate regressions by gender reveals the results are mainly driven by men. The central implication of this study is, while alcohol tax increases can raise government revenue, it alone is not an effective policy to reduce alcohol related problems in China.

  20. A cross-cultural study on noise problems: Comparison of the results obtained in Japan, West Germany, the U.S.A., China and Turkey

    NASA Astrophysics Data System (ADS)

    Namba, S.; Kuwano, S.; Schick, A.; Açlar, A.; Florentine, M.; Da Rui, Zheng

    1991-12-01

    Neighborhood noise has become a serious problem in many countries, and it is difficult to regulate by physical means alone. A cross-cultural survey was conducted in five countries, Japan, West Germany, the United States, China and Turkey, among residents of apartment houses in order to examine the cultural differences involved. Interesting differences were found in preferred countermeasures, highly annoying sounds, attitudes against noise, expectations for laws, etc. The use of loudspeakers in public places was accepted in all five countries, provided that they were used for conveying necessary information. The results suggest that it is important to take cultural or social backgrounds into consideration in order to find suitable countermeasures.

  1. The Double Burden of Undernutrition and Overnutrition in Developing Countries: an Update.

    PubMed

    Abdullah, Asnawi

    2015-09-01

    Many developing countries have achieved a remarkable improvement in nutrition status in the past decades. However, the prevalence of undernutrition remains a serious problem. At the same time, the prevalence of obesity is increasing substantially, and in some countries, it has approached that of developed countries. This article provides an update on this double burden of malnutrition (DBMN) in developing nations. One hundred countries (lower, middle-lower, and upper-middle income countries) were selected and analysed, and to support the analysis, a systematic review of current published studies was performed. The results show that DBMN already exists in almost all developing countries and that the DBMN ratio (i.e., overweight/underweight) has increased as income per capita has increased. DBMN may manifest within the community, household, or individual. In addition to common factors, poor nutrition in early childhood is suggested as another important driving factor behind the rising obesity rate in most developing countries. A life-course approach has been proposed to prevent undernutrition and overnutrition and should be integrated into the development of health systems to control double burden in developing countries.

  2. A Network Analysis of Countries’ Export Flows: Firm Grounds for the Building Blocks of the Economy

    PubMed Central

    Caldarelli, Guido; Cristelli, Matthieu; Gabrielli, Andrea; Pietronero, Luciano; Scala, Antonio; Tacchella, Andrea

    2012-01-01

    In this paper we analyze the bipartite network of countries and products from UN data on country production. We define the country-country and product-product projected networks and introduce a novel method of filtering information based on elements’ similarity. As a result we find that country clustering reveals unexpected socio-geographic links among the most competing countries. On the same footings the products clustering can be efficiently used for a bottom-up classification of produced goods. Furthermore we mathematically reformulate the “reflections method” introduced by Hidalgo and Hausmann as a fixpoint problem; such formulation highlights some conceptual weaknesses of the approach. To overcome such an issue, we introduce an alternative methodology (based on biased Markov chains) that allows to rank countries in a conceptually consistent way. Our analysis uncovers a strong non-linear interaction between the diversification of a country and the ubiquity of its products, thus suggesting the possible need of moving towards more efficient and direct non-linear fixpoint algorithms to rank countries and products in the global market. PMID:23094044

  3. The role of wages in the migration of health care professionals from developing countries

    PubMed Central

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

    2004-01-01

    Several countries are increasingly relying on immigration as a means of coping with domestic shortages of health care professionals. This trend has led to concerns that in many of the source countries – especially within Africa – the outflow of health care professionals is adversely affecting the health care system. This paper examines the role of wages in the migration decision and discusses the likely effect of wage increases in source countries in slowing migration flows. This paper uses data on wage differentials in the health care sector between source country and receiving country (adjusted for purchasing power parity) to test the hypothesis that larger wage differentials lead to a larger supply of health care migrants. Differences in other important factors affecting migration are discussed and, where available, data are presented. There is little correlation between the supply of health care migrants and the size of the wage differential between source and destination country. In cases where data are available on other factors affecting migration, controlling for these factors does not affect the result. At current levels, wage differentials between source and destination country are so large that small increases in health care wages in source countries are unlikely to affect significantly the supply of health care migrants. The results suggest that non-wage instruments might be more effective in altering migration flows. PMID:15115549

  4. Corruption and population health outcomes: an analysis of data from 133 countries using structural equation modeling.

    PubMed

    Factor, Roni; Kang, Minah

    2015-09-01

    The current study aims to develop a theoretical framework for understanding the antecedents of corruption and the effects of corruption on various health indicators. Using structural equation models, we analyzed a multinational dataset of 133 countries that included three main groups of variables--antecedents of corruption, corruption measures, and health indicators. Controlling for various factors, our results suggest that corruption rises as GDP per capita falls and as the regime becomes more autocratic. Higher corruption is associated with lower levels of health expenditure as a percentage of GDP per capita, and with poorer health outcomes. Countries with higher GDP per capita and better education for women have better health outcomes regardless of health expenditures and regime type. Our results suggest that there is no direct relationship between health expenditures and health outcomes after controlling for the other factors in the model. Our study enhances our understanding of the conceptual and theoretical links between corruption and health outcomes in a population, including factors that may mediate how corruption can affect health outcomes.

  5. Brain cancer mortality rates increase with Toxoplasma gondii seroprevalence in France

    USGS Publications Warehouse

    Vittecoq, Marion; Elguero, Eric; Lafferty, Kevin D.; Roche, Benjamin; Brodeur, Jacques; Gauthier-Clerc, Michel; Missé, Dorothée; Thomas, Frédéric

    2012-01-01

    The incidence of adult brain cancer was previously shown to be higher in countries where the parasite Toxoplasma gondii is common, suggesting that this brain protozoan could potentially increase the risk of tumor formation. Using countries as replicates has, however, several potential confounding factors, particularly because detection rates vary with country wealth. Using an independent dataset entirely within France, we further establish the significance of the association between T. gondii and brain cancer and find additional demographic resolution. In adult age classes 55 years and older, regional mortality rates due to brain cancer correlated positively with the local seroprevalence of T. gondii. This effect was particularly strong for men. While this novel evidence of a significant statistical association between T. gondii infection and brain cancer does not demonstrate causation, these results suggest that investigations at the scale of the individual are merited.

  6. Globalization and Economic Growth: Empirical Evidence on the Role of Complementarities

    PubMed Central

    Samimi, Parisa; Jenatabadi, Hashem Salarzadeh

    2014-01-01

    This study was carried out to investigate the effect of economic globalization on economic growth in OIC countries. Furthermore, the study examined the effect of complementary policies on the growth effect of globalization. It also investigated whether the growth effect of globalization depends on the income level of countries. Utilizing the generalized method of moments (GMM) estimator within the framework of a dynamic panel data approach, we provide evidence which suggests that economic globalization has statistically significant impact on economic growth in OIC countries. The results indicate that this positive effect is increased in the countries with better-educated workers and well-developed financial systems. Our finding shows that the effect of economic globalization also depends on the country’s level of income. High and middle-income countries benefit from globalization whereas low-income countries do not gain from it. In fact, the countries should receive the appropriate income level to be benefited from globalization. Economic globalization not only directly promotes growth but also indirectly does so via complementary reforms. PMID:24721896

  7. Emergency preparedness and public health systems lessons for developing countries.

    PubMed

    Kruk, Margaret E

    2008-06-01

    Low- and middle-income countries, where emerging diseases often make their debut, are also likely to bear the harshest consequences of a potential influenza pandemic. Yet public health systems in developing countries are underfunded, understaffed, and in many cases struggling to deal with the existing burden of disease. As a result, developed countries are beginning to expand assistance for emergency preparedness to the developing world. Given developing countries' weak infrastructure and many competing public health priorities, it is not clear how to best direct these resources. Evidence from the U.S. and other developed countries suggests that some investments in bioterror and pandemic emergency preparedness, although initially implemented as vertical programs, have the potential to strengthen the general public health infrastructure. This experience may hold some lessons for how global funds for emergency preparedness could be invested in developing countries to support struggling public health systems in responding to current health priorities as well as potential future public health threats.

  8. The role of private health providers in HIV testing: analysis of data from 18 countries

    PubMed Central

    2014-01-01

    Introduction HIV testing and counseling is a critical component of the overall response to the HIV epidemic in low and middle income countries. To date, little attention has been paid to the role of private for-profit providers in HIV testing. Methods We use data from Demographic and Health Surveys and AIDS Indicators Surveys to explore the extent to which this sector provides HIV testing in 18 developing countries. Results We find that use of the private sector for HIV testing varies significantly by country, with private for-profit providers playing a significant role in some countries and a relatively minor one in others. At the country level, use of private providers for HIV testing is correlated with use of private providers for other health services yet, in many countries, significant differences between use of the private sector for HIV testing and other services exist. Within countries, we find that wealth is strongly associated with use of the private sector for HIV testing in most countries, but the relative socio-economic profile of clients who receive an HIV test from a private provider varies considerably across countries. On the one measure of quality to which we have access, reported adherence to antenatal care testing guidelines, there are no statistically significant differences in performance between public and private for-profit providers in most countries after controlling for wealth. Conclusions These results suggest that strategies for supervising and engaging private health providers with regard to HIV testing should be country specific and take into account local context. PMID:24884851

  9. Energy demand, energy substitution and economic growth : Evidence from developed and developing countries

    NASA Astrophysics Data System (ADS)

    Abd Aziz, Azlina

    This thesis contributes to the literature on energy demand in three ways. Firstly, it examines the major determinants of energy demand using a panel of 23 developed countries and 16 developing countries during 1978 to 2003. Secondly, it examines the demand for energy in the industrial sector and the extent of inter-fuel substitution, as well as substitution between energy and non-energy inputs, using data from 5 advanced countries and 5 energy producer's developing countries. Third, the thesis investigates empirically the relationship between energy consumption and economic growth for these groups of countries over a 26-year period. The empirical results of this study confirm the majority of the findings in energy demand analysis. Income and price have shown to be important determinants for energy consumption in both developed and developing countries. Moreover, both economic structure and technical progress appear to exert significant impacts on energy consumption. Income has a positive impact on energy demand and the effect is larger in developing countries. In both developed and developing countries, price has a negative impact but these effects are larger in developed countries than in developing countries. The share of industry in GDP is positive and has a greater impact on energy demand in developing countries, whereas technological progress is found to be energy using in developed countries and energy saving in developing countries. With respect to the analysis of inter-factor and inter-fuel substitution in industrial energy demand, the results provide evidence for substitution possibilities between factor inputs and fuels. Substitutability is observed between capital and energy, capital and labour and labour and energy. These findings confirm previous evidence that production technologies in these countries allow flexibility in the capital-energy, capital-labour and labour-energy mix. In the energy sub-model, the elasticities of substitution show that large substitution took place from petroleum to coal, natural gas and especially to electricity. In addition, the evidence for significant inter-fuel substitution between coal and natural gas implies that there is a possibility of replacing the use of coal with natural gas in the industrial sector. The existence of moderate input substitution suggests that there is some flexibility in energy policy options and energy utilization. Finally, the empirical evidence presented in this study suggests that the direction of causality between energy consumption and economic growth varies substantially across countries. There is a unidirectional causality running from GDP to energy consumption in 12 developed countries and in 5 developing countries. A unidirectional causality from energy to GDP exists in Netherlands and bidirectional causality exists in Slovak Republic.

  10. An issue of trust: state corruption, responsibility and greenhouse gas emissions

    NASA Astrophysics Data System (ADS)

    Frame, David J.; Hepburn, Cameron

    2010-01-01

    Climate change is increasingly seen to raise difficult normative issues. To date, cumulative emissions have been disproportionately from the developed world, while the consequences of climate change are anticipated to hit poorer countries hardest. For this reason, amongst others, it is suggested that more economically developed countries with high greenhouse gas emissions ought to transfer resources to less economically developed, lower emissions countries. Some proponents would justify these resource transfers by ethical or justice-based arguments, often based on some function of the emissions per capita of each country, such that rights of some sort are created and those nations which are emitting more (per capita) than some amount are to compensate those who are emitting less. In this letter we show that national emissions per capita, scaled by economic output, show a systematic negative correlation with state corruption. We discuss this result in the context of justice-based arguments for per capita climate mitigation transfers, and suggest that it would be beneficial for the climate mitigation community to consider state corruption as a relevant factor in the development of mitigation policy.

  11. Does healthcare financing converge? Evidence from eight OECD countries.

    PubMed

    Chen, Wen-Yi

    2013-12-01

    This study investigated the convergence of healthcare financing across eight OECD countries during 1960-2009 for the first time. The panel stationary test incorporating both shapes of multiple structural breaks (i.e., sharp drifts and smooth transition shifts) and cross-sectional dependence was used to provide reliable evidence of convergence in healthcare financing. Our results suggested that the public share of total healthcare financing in eight OECD countries has exhibited signs of convergence towards that of the US. The convergence of healthcare financing not only reflected a decline in the share of public healthcare financing in these eight OECD countries but also exhibited an upward trend in the share of public healthcare financing in the US over the period of 1960-2009.

  12. Cost-effectiveness analysis using data from multinational trials: The use of bivariate hierarchical modelling

    PubMed Central

    Manca, Andrea; Lambert, Paul C; Sculpher, Mark; Rice, Nigel

    2008-01-01

    Healthcare cost-effectiveness analysis (CEA) often uses individual patient data (IPD) from multinational randomised controlled trials. Although designed to account for between-patient sampling variability in the clinical and economic data, standard analytical approaches to CEA ignore the presence of between-location variability in the study results. This is a restrictive limitation given that countries often differ in factors that could affect the results of CEAs, such as the availability of healthcare resources, their unit costs, clinical practice, and patient case-mix. We advocate the use of Bayesian bivariate hierarchical modelling to analyse multinational cost-effectiveness data. This analytical framework explicitly recognises that patient-level costs and outcomes are nested within countries. Using real life data, we illustrate how the proposed methods can be applied to obtain (a) more appropriate estimates of overall cost-effectiveness and associated measure of sampling uncertainty compared to standard CEA; and (b) country-specific cost-effectiveness estimates which can be used to assess the between-location variability of the study results, while controlling for differences in country-specific and patient-specific characteristics. It is demonstrated that results from standard CEA using IPD from multinational trials display a large degree of variability across the 17 countries included in the analysis, producing potentially misleading results. In contrast, ‘shrinkage estimates’ obtained from the modelling approach proposed here facilitate the appropriate quantification of country-specific cost-effectiveness estimates, while weighting the results based on the level of information available within each country. We suggest that the methods presented here represent a general framework for the analysis of economic data collected from different locations. PMID:17641141

  13. Rheumatic fever and rheumatic heart disease in developing countries

    PubMed Central

    Padmavati, S.

    1978-01-01

    Studies on the prevalence and other epidemiological features of rheumatic fever and rheumatic heart disease and pilot prophylactic programmes have been carried out in India for the past 12 years or more. The results of these, together with data from other developing countries, have been taken into account in discussing the problems of these diseases in the developing world. Suggestions for their control, to be modified according to local conditions, are made. PMID:310360

  14. Global Measurement of the Quality of Education: A Help to Developing Countries?

    ERIC Educational Resources Information Center

    Vedder, Paul

    1994-01-01

    Addresses the involvement of international interest groups in defining and determining educational quality in developing countries, suggesting that global measures of quality damage the educational systems of developing countries by creating feelings of isolation and inferiority. Suggests alternative measures which meet global standards and may be…

  15. HIV/AIDS-related social anxieties in adolescents in three African countries.

    PubMed

    Venier, J L; Ross, M W; Akande, A

    1998-02-01

    This study examines the social anxieties associated with HIV prevention in adolescents in three African countries (Nigeria, Kenya, and Zimbabwe). The subjects used in this study were black Africans in form 2 or grade 10 in public high schools (Nigeria, n = 387; Kenya, n = 274; Zimbabwe n = 313). Subjects responded to the 33 item AIDS Social Assertiveness Scale (ASAS). Data indicated similar factor structures for each of the three countries and included five factors. The combined sample factor intercorrelations were modestly but significantly correlated. The mean scores for each factor were compared, and ANOVA of the factors by country, by gender, and by interaction between country and gender were performed. The factor structures were very similar between countries, each including five factors that had similar themes: condom interactions, refusal of risk, confiding in significant others, contact with people with HIV/AIDS, and general assertiveness. These factor structures were also very similar to one found in previous studies of Australian adolescents on the ASAS. The Kenyan means for four of the five factors were significantly lower than those for Nigeria, and were also significantly lower than the Zimbabwean means for two of the five factors, suggesting that Kenyan students are less anxious about social situations related to HIV/AIDS than others. Significant variance was found for several factors due to gender, country, and the interaction between gender and country. These results have important implications for designing education programs. The similarities of anxieties regarding HIV/AIDS social situations suggest that these clusters of social barriers to reduction of HIV infection risk might form the basis of educational interventions, and that dimensions of HIV social anxieties are similar across countries.

  16. The direct and indirect effects of corruption on motor vehicle crash deaths.

    PubMed

    Hua, Law Teik; Noland, Robert B; Evans, Andrew W

    2010-11-01

    Recent empirical research has found that there is an inverted U-shaped or Kuznets relationship between income and motor vehicle crash (MVC) deaths, such that MVC deaths increase as national income increases and decrease after reaching a critical level. Corruption has been identified as one of the underlying factors that could affect this relationship, primarily by undermining institutional development and effective enforcement schemes. The total effect of corruption can be decomposed into two components, a direct and an indirect effect. The direct effect measures the immediate impact of corruption on MVC deaths by undermining effective enforcement and regulations, while the indirect effect captures the impact of corruption on hindering increases in per capita income and the consequent impact of reduced income on MVC deaths. By influencing economic growth, corruption can lead to an increase or decrease in MVC deaths depending on the income level. Using data from 60 countries between 1982 and 2003, these effects are estimated using linear panel and fixed effects negative binomial models. The estimation results suggest that corruption has different direct effects for less developed and highly developed countries. It has a negative (decreasing) effect on MVC deaths for less developed countries and a positive (increasing) effect on MVC deaths for highly developed countries. For highly developed countries, the total effect is positive at lower per capita income levels, but decreases with per capita income and becomes negative at per capita income levels of about US$ 38,248. For less developed countries, the total effect is negative within the sample range and decreases with increased per capita income. In summary, the results of this study suggest that reduction of corruption is likely a necessary condition to effectively tackle road safety problems. 2010 Elsevier Ltd. All rights reserved.

  17. Living unrelated-commercial-kidney transplantation: when there is no chance to survive.

    PubMed

    Sever, Mehmet Sukru

    2006-10-01

    Transplantation is the best treatment of end-stage renal disease (ESRD); however, organ shortage is a reality. Deceased donor organ donation is inadequate; hence, the number of patients on the waiting lists is increasing progressively. Since many ESRD patients do not have living genetically related donors, living unrelated transplantation is considered. These transplantations offer excellent graft and patient survival rates if practiced in conventional situations, while the results are not so favorable or even poor in unconventional transplantations, which mostly take place in developing countries. Ethical aspects of living unrelated transplantation are more complicated than the medical side due to concern of commercialization. Making payment to the donors has been considered strictly as nonethical by many authors, while some others suggest reopening previous debates for kidney sales. The latter claim that if exploitation of donors is avoided, the reward (or payment) to the donor can be morally justified. Apart from these controversies, it is uniformly accepted that commercial transplantation is certainly unethical when brokers are involved or the aim is just profit for transplant physicians, because the main reason in favor of organ sales is improving the quality of life of the patients and the donors, not the brokers or the physicians. All these theoretical ethical arguments in the Western countries turn out to become vital concerns in developing countries, because transplantation is the cheapest renal replacement therapy. Recently, it has been suggested that organ shortage problems can partly be solved by establishing controlled donor compensation programs in these countries, which may also prevent exploitation of the donors. However, it is impossible to suggest a uniform solution for all countries because of deep differences in economical status as well as social and cultural values. Thus, every country should build its own ethical standards for commercial transplantation.

  18. Social mobility and health in European countries: Does welfare regime type matter?

    PubMed

    Campos-Matos, Inês; Kawachi, Ichiro

    2015-10-01

    Health inequalities pose an important public health challenge in European countries, for which increased social mobility has been suggested as a cause. We sought to describe how the relationship between health inequalities and social mobility varies among welfare regime types in the European region. Data from six rounds of the European Social Survey was analyzed using multilevel statistical techniques, stratified by welfare regime type, including 237,535 individuals from 136 countries. Social mobility among individuals was defined according to the discrepancy between parental and offspring educational attainment. For each welfare regime type, the association between social mobility and self-rated health was examined using odds ratios and risk differences, controlling for parental education. Upwardly mobile individuals had between 23 and 44% lower odds of reporting bad or very bad self-rated health when compared to those who remained stable. On an absolute scale, former USSR countries showed the biggest and only significant differences for upward movement, while Scandinavian countries showed the smallest. Downward social mobility tended to be associated with worse health, but the results were less consistent. Upward social mobility is associated with worse health in all European welfare regime types. However, in Scandinavian countries the association of upward mobility was smaller, suggesting that the Nordic model is more effective in mitigating the impact of social mobility on health and/or of health on mobility. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries.

    PubMed

    Devaux, Marion

    2015-01-01

    A key policy objective in OECD countries is to achieve adequate access to health care for all people on the basis of need. Previous studies have shown that there are inequities in health care services utilisation (HCSU) in the OECD area. In recent years, measures have been taken to enhance health care access. This paper re-examines income-related inequities in doctor visits among 18 selected OECD countries, updating previous results for 12 countries with 2006-2009 data, and including six new countries. Inequalities in preventive care services are also considered for the first time. The indirect standardisation procedure is used to estimate the need-adjusted HCSU and concentration indexes are derived to gauge inequalities and inequities. Overall, inequities in HCSU remain present in OECD countries. In most countries, for the same health care needs, people with higher incomes are more likely to consult a doctor than those with lower incomes. Pro-rich inequalities in dental visits and cancer screening uptake are also found in nearly all countries, although the magnitude of these varies among countries. These findings suggest that further monitoring of inequalities is essential in order to assess whether country policy objectives are achieved on a regular basis.

  20. Fertilizing growth: Agricultural inputs and their effects in economic development.

    PubMed

    McArthur, John W; McCord, Gordon C

    2017-07-01

    This paper estimates the role of agronomic inputs in cereal yield improvements and the consequences for countries' processes of structural change. The results suggest a clear role for fertilizer, modern seeds and water in boosting yields. We then test for respective empirical links between agricultural yields and economic growth, labor share in agriculture and non-agricultural value added per worker. The identification strategy includes a novel instrumental variable that exploits the unique economic geography of fertilizer production and transport costs to countries' agricultural heartlands. We estimate that a half ton increase in staple yields generates a 14 to 19 percent higher GDP per capita and a 4.6 to 5.6 percentage point lower labor share in agriculture five years later. The results suggest a strong role for agricultural productivity as a driver of structural change.

  1. No global consensus: a cross-sectional survey of maternal weight policies

    PubMed Central

    2014-01-01

    Background Growing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines. Methods This cross sectional survey administered a questionnaire online to key informants with expertise on the subject of maternal weight to assess the presence and content of preconceptional, pregnancy and postpartum maternal weight guidelines, their rationale and availability. We searched 195 countries, identified potential informants in 80 and received surveys representing 66 countries. We estimated the proportion of countries with guidelines by region, income, and formal or informal policy, and described and compared guideline content, including a rubric to assess presence or absence of 4 guidelines: encourage healthy preconceptional weight, antenatal weighing, encourage appropriate gestational gain, and encourage attainment of healthy postpartum weight. Results Fifty-three countries reported either a formal or informal policy regarding maternal weight. The majority of these policies included guidelines to assess maternal weight at the first prenatal visit (90%), to monitor gestational weight gain during pregnancy (81%), and to provide recommendations to women about healthy gestational weight gain (62%). Guidelines related to preconceptional (42%) and postpartum (13%) weight were less common. Only 8% of countries reported policies that included all 4 fundamental guidelines. Guideline content and rationale varied considerably between countries, and respondents perceived that within their country, policies were not widely known. Conclusions These results suggest that maternal weight is a concern throughout the world. However, we found a lack of international consensus on the content of guidelines. Further research is needed to understand which recommendations or interventions work best with respect to maternal weight in different country settings, and how pregnancy weight policies impact clinical practices and health outcomes for the mother and child. PMID:24884985

  2. Bayesian probabilistic population projections for all countries.

    PubMed

    Raftery, Adrian E; Li, Nan; Ševčíková, Hana; Gerland, Patrick; Heilig, Gerhard K

    2012-08-28

    Projections of countries' future populations, broken down by age and sex, are widely used for planning and research. They are mostly done deterministically, but there is a widespread need for probabilistic projections. We propose a bayesian method for probabilistic population projections for all countries. The total fertility rate and female and male life expectancies at birth are projected probabilistically using bayesian hierarchical models estimated via Markov chain Monte Carlo using United Nations population data for all countries. These are then converted to age-specific rates and combined with a cohort component projection model. This yields probabilistic projections of any population quantity of interest. The method is illustrated for five countries of different demographic stages, continents and sizes. The method is validated by an out of sample experiment in which data from 1950-1990 are used for estimation, and applied to predict 1990-2010. The method appears reasonably accurate and well calibrated for this period. The results suggest that the current United Nations high and low variants greatly underestimate uncertainty about the number of oldest old from about 2050 and that they underestimate uncertainty for high fertility countries and overstate uncertainty for countries that have completed the demographic transition and whose fertility has started to recover towards replacement level, mostly in Europe. The results also indicate that the potential support ratio (persons aged 20-64 per person aged 65+) will almost certainly decline dramatically in most countries over the coming decades.

  3. 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 advance, those who implement IPE programs in developing countries will be much more prepared, and can enhance the program's potential success. PMID:24809509

  4. Do Sector Wide Approaches for health aid delivery lead to 'donor-flight'? A comparison of 46 low-income countries.

    PubMed

    Sweeney, Rohan; Mortimer, Duncan; Johnston, David W

    2014-03-01

    Sector Wide Approaches (SWAp) emerged during the 1990s as a new policy mechanism for aid delivery. Eschewing many features of traditional project-based aid, SWAps give greater control of aid allocation to recipient countries. Some critics have questioned whether reducing a donor's level of influence over aid allocation might lead to a decrease in donor contributions. While some qualitative evaluations have described the level of fund pooling and donor participation in SWAps, no previous study has empirically examined this potential 'donor-flight' response to health SWAp implementation. This paper utilises a uniquely compiled dataset of 46 low-income countries over 1990-2009 and a variety of panel data regression models to estimate the impact of health SWAp implementation on levels of health aid. Results suggest that amongst 16 especially poor low-income countries, SWAp implementation is associated with significant decreases in health aid levels compared with non-implementers. This suggests donors are not indifferent to how their contributions are allocated by recipients, and that low-income countries considering a SWAp may need to weigh the benefits of greater control of aid allocations against the possibility of reduced aid income. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Medication use in relation to noise from aircraft and road traffic in six European countries: results of the HYENA study.

    PubMed

    Floud, Sarah; Vigna-Taglianti, Federica; Hansell, Anna; Blangiardo, Marta; Houthuijs, Danny; Breugelmans, Oscar; Cadum, Ennio; Babisch, Wolfgang; Selander, Jenny; Pershagen, Göran; Antoniotti, Maria Chiara; Pisani, Salvatore; Dimakopoulou, Konstantina; Haralabidis, Alexandros S; Velonakis, Venetia; Jarup, Lars

    2011-07-01

    Studies on the health effects of aircraft and road traffic noise exposure suggest excess risks of hypertension, cardiovascular disease and the use of sedatives and hypnotics. Our aim was to assess the use of medication in relation to noise from aircraft and road traffic. This cross-sectional study measured the use of prescribed antihypertensives, antacids, anxiolytics, hypnotics, antidepressants and antasthmatics in 4,861 persons living near seven airports in six European countries (UK, Germany, the Netherlands, Sweden, Italy, and Greece). Exposure was assessed using models with 1 dB resolution (5 dB for UK road traffic noise) and spatial resolution of 250×250 m for aircraft and 10×10 m for road traffic noise. Data were analysed using multilevel logistic regression, adjusting for potential confounders. We found marked differences between countries in the effect of aircraft noise on antihypertensive use; for night-time aircraft noise, a 10 dB increase in exposure was associated with ORs of 1.34 (95% CI 1.14 to 1.57) for the UK and 1.19 (1.02 to 1.38) for the Netherlands but no significant associations were found for other countries. For day-time aircraft noise, excess risks were found for the UK (OR 1.35; CI: 1.13 to 1.60) but a risk deficit for Italy (OR 0.82; CI: 0.71 to 0.96). There was an excess risk of taking anxiolytic medication in relation to aircraft noise (OR 1.28; CI: 1.04 to 1.57 for daytime and OR 1.27; CI: 1.01 to 1.59 for night-time) which held across countries. We also found an association between exposure to 24hr road traffic noise and the use of antacids by men (OR 1.39; CI 1.11 to 1.74). Our results suggest an effect of aircraft noise on the use of antihypertensive medication, but this effect did not hold for all countries. Results were more consistent across countries for the increased use of anxiolytics in relation to aircraft noise.

  6. A fuzzy set approach to economic crisis, austerity and public health. Part II: How are configurations of crisis and austerity related to changes in population health across Europe?

    PubMed

    Saltkjel, Therese; Holm Ingelsrud, Mari; Dahl, Espen; Halvorsen, Knut

    2017-08-01

    Based on the ideal type classification of European countries done in Part I of this paper, Part II explores whether the real 'danger' to public health is the interplay between austerity and crisis, rather than recession itself. We constructed two fuzzy sets of changes in population health based on a pooled file of European Union Statistics on Income and Living Conditions (EU-SILC) data (2008 and 2013) including 29 European countries. The linear probability analyses of 'limiting long-standing illness' and 'less than good' health were restricted to the age group 20-64 years. We performed fuzzy set qualitative comparative analysis (fsQCA) and studied whether configurations of 'severe crisis' and 'austerity' were linked to changes in population health. Overall, the results of this fsQCA do not support the 'crisis-austerity' thesis. Results on 'less than good' health were highly inconsistent, while results on 'limiting long-standing illness', contrary to the thesis, showed a two-path model. Countries with either no severe crisis or no austerity were subsets of the set of countries that experienced deteriorated health. Results also show that several countries combined both paths. This fuzzy set analysis does not support Stuckler and Basu's 'crisis-austerity' thesis, as those European countries that experienced recession and austerity were not consistently the countries with deteriorating health. There may be multiple reasons for this result, including analytical approach and operationalization of key concepts, but also resilient forces such as family support. We suggest more research on the topic based on more recent data and possibly other, or more, dimensions of austerity.

  7. Probabilistic evaluation of integrating resource recovery into wastewater treatment to improve environmental sustainability

    PubMed Central

    Wang, Xu; McCarty, Perry L.; Liu, Junxin; Ren, Nan-Qi; Lee, Duu-Jong; Yu, Han-Qing; Qian, Yi; Qu, Jiuhui

    2015-01-01

    Global expectations for wastewater service infrastructure have evolved over time, and the standard treatment methods used by wastewater treatment plants (WWTPs) are facing issues related to problem shifting due to the current emphasis on sustainability. A transition in WWTPs toward reuse of wastewater-derived resources is recognized as a promising solution for overcoming these obstacles. However, it remains uncertain whether this approach can reduce the environmental footprint of WWTPs. To test this hypothesis, we conducted a net environmental benefit calculation for several scenarios for more than 50 individual countries over a 20-y time frame. For developed countries, the resource recovery approach resulted in ∼154% net increase in the environmental performance of WWTPs compared with the traditional substance elimination approach, whereas this value decreased to ∼60% for developing countries. Subsequently, we conducted a probabilistic analysis integrating these estimates with national values and determined that, if this transition was attempted for WWTPs in developed countries, it would have a ∼65% probability of attaining net environmental benefits. However, this estimate decreased greatly to ∼10% for developing countries, implying a substantial risk of failure. These results suggest that implementation of this transition for WWTPs should be studied carefully in different temporal and spatial contexts. Developing countries should customize their approach to realizing more sustainable WWTPs, rather than attempting to simply replicate the successful models of developed countries. Results derived from the model forecasting highlight the role of bioenergy generation and reduced use of chemicals in improving the sustainability of WWTPs in developing countries. PMID:25605884

  8. Probabilistic evaluation of integrating resource recovery into wastewater treatment to improve environmental sustainability.

    PubMed

    Wang, Xu; McCarty, Perry L; Liu, Junxin; Ren, Nan-Qi; Lee, Duu-Jong; Yu, Han-Qing; Qian, Yi; Qu, Jiuhui

    2015-02-03

    Global expectations for wastewater service infrastructure have evolved over time, and the standard treatment methods used by wastewater treatment plants (WWTPs) are facing issues related to problem shifting due to the current emphasis on sustainability. A transition in WWTPs toward reuse of wastewater-derived resources is recognized as a promising solution for overcoming these obstacles. However, it remains uncertain whether this approach can reduce the environmental footprint of WWTPs. To test this hypothesis, we conducted a net environmental benefit calculation for several scenarios for more than 50 individual countries over a 20-y time frame. For developed countries, the resource recovery approach resulted in ∼154% net increase in the environmental performance of WWTPs compared with the traditional substance elimination approach, whereas this value decreased to ∼60% for developing countries. Subsequently, we conducted a probabilistic analysis integrating these estimates with national values and determined that, if this transition was attempted for WWTPs in developed countries, it would have a ∼65% probability of attaining net environmental benefits. However, this estimate decreased greatly to ∼10% for developing countries, implying a substantial risk of failure. These results suggest that implementation of this transition for WWTPs should be studied carefully in different temporal and spatial contexts. Developing countries should customize their approach to realizing more sustainable WWTPs, rather than attempting to simply replicate the successful models of developed countries. Results derived from the model forecasting highlight the role of bioenergy generation and reduced use of chemicals in improving the sustainability of WWTPs in developing countries.

  9. Estimating Drivers of Autochthonous Transmission of Chikungunya Virus in its Invasion of the Americas

    PubMed Central

    Perkins, T. Alex; Metcalf, C. Jessica E.; Grenfell, Bryan T.; Tatem, Andrew J.

    2015-01-01

    Background Chikungunya is an emerging arbovirus that has caused explosive outbreaks in Africa and Asia for decades and invaded the Americas just over a year ago. During this ongoing invasion, it has spread to 45 countries where it has been transmitted autochthonously, infecting nearly 1.3 million people in total. Methods Here, we made use of weekly, country-level case reports to infer relationships between transmission and two putative climatic drivers: temperature and precipitation averaged across each country on a monthly basis. To do so, we used a TSIR model that enabled us to infer a parametric relationship between climatic drivers and transmission potential, and we applied a new method for incorporating a probabilistic description of the serial interval distribution into the TSIR framework. Results We found significant relationships between transmission and linear and quadratic terms for temperature and precipitation and a linear term for log incidence during the previous pathogen generation. The lattermost suggests that case numbers three to four weeks ago are largely predictive of current case numbers. This effect is quite nonlinear at the country level, however, due to an estimated mixing parameter of 0.74. Relationships between transmission and the climatic variables that we estimated were biologically plausible and in line with expectations. Conclusions Our analysis suggests that autochthonous transmission of Chikungunya in the Americas can be correlated successfully with putative climatic drivers, even at the coarse scale of countries and using long-term average climate data. Overall, this provides a preliminary suggestion that successfully forecasting the future trajectory of a Chikungunya outbreak and the receptivity of virgin areas may be possible. Our results also provide tentative estimates of timeframes and areas of greatest risk, and our extension of the TSIR model provides a novel tool for modeling vector-borne disease transmission. PMID:25737803

  10. Reprioritizing government spending on health: pushing an elephant up the stairs?

    PubMed

    Tandon, Ajay; Fleisher, Lisa; Li, Rong; Yap, Wei Aun

    2014-01-01

    Countries vary widely with respect to the share of government spending on health, a metric that can serve as a proxy for the extent to which health is prioritized by governments. World Health Organization (WHO) data estimate that, in 2011, health's share of aggregate government expenditure averaged 12% in the 170 countries for which data were available. However, country differences were striking: ranging from a low of 1% in Myanmar to a high of 28% in Costa Rica. Some of the observed differences in health's share of government spending across countries are unsurprisingly related to differences in national income. However, significant variations exist in health's share of government spending even after controlling for national income. This paper provides a global overview of health's share of government spending and summarizes some of the key theoretical and empirical perspectives on allocation of public resources to health vis-à-vis other sectors from the perspective of reprioritization, one of the modalities for realizing fiscal space for health. The paper argues that theory and cross-country empirical analyses do not provide clear-cut explanations for the observed variations in government prioritization of health. Standard economic theory arguments that are often used to justify public financing for health are equally applicable to many other sectors including defence, education and infrastructure. To date, empirical work on prioritization has been sparse: available cross-country econometric analyses suggest that factors such as democratization, lower levels of corruption, ethnolinguistic homogeneity and more women in public office are correlated with higher shares of public spending on health; however, these findings are not robust and are sensitive to model specification. Evidence from case studies suggests that country-specific political economy considerations are key, and that results-focused reform efforts - in particular efforts to explicitly expand the breadth and depth of health coverage as opposed to efforts focused only on government budgetary benchmarking targets - are more likely to result in sustained and politically feasible prioritization of health from a fiscal space perspective.

  11. ERP and Four Dimensions of Absorptive Capacity: Lessons from a Developing Country

    NASA Astrophysics Data System (ADS)

    Gil, María José Álvarez; Aksoy, Dilan; Kulcsar, Borbala

    Enterprise resource planning systems can grant crucial strategic, operational and information-based benefits to adopting firms when implemented successfully. However, a failed implementation can often result in financial losses rather than profits. Until now, the research on the failures and successes were focused on implementations in large manufacturing and service organizations firms located in western countries, particularly in USA. Nevertheless, IT has gained intense diffusion to developing countries through declining hardware costs and increasing benefits that merits attention as much as developed countries. The aim of this study is to examine the implications of knowledge transfer in a developing country, Turkey, as a paradigm in the knowledge society with a focus on the implementation activities that foster successful installations. We suggest that absorptive capacity is an important characteristic of a firm that explains the success level of such a knowledge transfer.

  12. Life satisfaction in the new country: a multilevel longitudinal analysis of effects of culture and 5-HTT allele frequency distribution in country of origin.

    PubMed

    Kashima, Emiko S; Kent, Stephen; Kashima, Yoshihisa

    2015-01-01

    Life satisfaction of migrants to Australia from 17 countries, assessed at 4-5 months, 16-17 months and 3½ years after arrival, was analyzed with a longitudinal, multilevel analysis. The results indicated that migrants were more satisfied, if the national average life satisfaction was higher in their country of origin, after adjustment for individual-level income, age, and sex and a linear temporal trend. Simultaneously, the migrants were also happier if people in their country of origin had a higher frequency of 5-HTT long allele, a genotype known to be associated with resilience under life stresses. These two relationships were independent, suggesting that both culture and gene matter in international transitions. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  13. Does culture affect divorce? evidence from European immigrants in the United States.

    PubMed

    Furtado, Delia; Marcén, Miriam; Sevilla, Almudena

    2013-06-01

    This article explores the role of culture in determining divorce by examining country-of-origin differences in divorce rates of immigrants in the United States. Because childhood-arriving immigrants are all exposed to a common set of U.S. laws and institutions, we interpret relationships between their divorce tendencies and home-country divorce rates as evidence of the effect of culture. Our results are robust to controlling for several home-country variables, including average church attendance and gross domestic product (GDP). Moreover, specifications with country-of-origin fixed effects suggest that immigrants from countries with low divorce rates are especially less likely to be divorced if they reside among a large number of coethnics. Supplemental analyses indicate that divorce culture has a stronger impact on the divorce decisions of females than of males, pointing to a potentially gendered nature of divorce taboos.

  14. Diaspora engagement of African migrant health workers – examples from five destination countries

    PubMed Central

    Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth

    2015-01-01

    Background Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Design Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Results Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. Conclusions The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals. PMID:26652910

  15. Financial development, income inequality, and CO2 emissions in Asian countries using STIRPAT model.

    PubMed

    Khan, Abdul Qayyum; Saleem, Naima; Fatima, Syeda Tamkeen

    2018-03-01

    The main purpose of this paper is to find the effects of financial development, income inequality, energy usage, and per capita GDP on carbon dioxide (CO 2 ) emissions as well the environmental Kuznets curve (EKC) for the three developing Asian countries-Bangladesh, India, and Pakistan. Panel data during the period 1980-2014 and the Stochastic Impacts by Regression on Population, Affluence, and Technology model with fully modified ordinary least squares (FMOLS) are employed for empirical investigation. The results show that financial development has a significant negative relationship with CO 2 emission in the three selected Asian countries with the exception of India. The results further reveal that income inequality in Pakistan and India reduce CO 2 emission, while the result for Bangladesh is opposite. Likewise, energy usage has a significant positive effect on CO 2 emission in Bangladesh, Pakistan, and India. Our empirical analysis based on long-run and short-run elasticity appraisal suggests the validation of the EKC in Pakistan and India. The study findings recommend an important policy insinuation. The study suggests introducing a motivational campaign for the inhabitant towards utilization of high-efficiency electrical appliances, constructing mutual cooperation for economic development rather involve in winning development race, and introducing effective pollution absorption measures along with big projects.

  16. Is the Demand for Alcoholic Beverages in Developing Countries Sensitive to Price? Evidence from China

    PubMed Central

    Tian, Guoqiang; Liu, Feng

    2011-01-01

    Economic literature in developed countries suggests that demand for alcoholic beverages is sensitive to price, with an estimated price elasticity ranging from −0.38 for beer and −0.7 for liquor. However, few studies have been conducted in developing countries. We employ a large individual-level dataset in China to estimate the effects of price on alcohol demand. Using the data from China Health and Nutrition Survey for the years 1993, 1997, 2000, 2004 and 2006, we estimate two-part models of alcohol demand. Results show the price elasticity is virtually zero for beer and only −0.12 for liquor, which is far smaller than those derived from developed countries. Separate regressions by gender reveals the results are mainly driven by men. The central implication of this study is, while alcohol tax increases can raise government revenue, it alone is not an effective policy to reduce alcohol related problems in China. PMID:21776220

  17. Global value chains: Building blocks and network dynamics

    NASA Astrophysics Data System (ADS)

    Tsekeris, Theodore

    2017-12-01

    The paper employs measures and tools from complex network analysis to enhance the understanding and interpretation of structural characteristics pertaining to the Global Value Chains (GVCs) during the period 1995-2011. The analysis involves the country, sector and country-sector value chain networks to identify main drivers of structural change. The results indicate significant intertemporal changes, mirroring the increased globalization in terms of network size, strength and connectivity. They also demonstrate higher clustering and increased concentration of the most influential countries and country-sectors relative to all others in the GVC network, with the geographical dimension to prevail over the sectoral dimension in the formation of value chains. The regionalization and less hierarchical organization drive country-sector production sharing, while the sectoral value chain network has become more integrated and more competitive over time. The findings suggest that the impact of country-sector policies and/or shocks may vary with the own-group and network-wide influence of each country, take place in multiple geographical scales, as GVCs have a block structure, and involve time dynamics.

  18. Mind the Gap! A Multilevel Analysis of Factors Related to Variation in Published Cost-Effectiveness Estimates within and between Countries

    PubMed Central

    Boehler, Christian E. H.; Lord, Joanne

    2016-01-01

    Background. Published cost-effectiveness estimates can vary considerably, both within and between countries. Despite extensive discussion, little is known empirically about factors relating to these variations. Objectives. To use multilevel statistical modeling to integrate cost-effectiveness estimates from published economic evaluations to investigate potential causes of variation. Methods. Cost-effectiveness studies of statins for cardiovascular disease prevention were identified by systematic review. Estimates of incremental costs and effects were extracted from reported base case, sensitivity, and subgroup analyses, with estimates grouped in studies and in countries. Three bivariate models were developed: a cross-classified model to accommodate data from multinational studies, a hierarchical model with multinational data allocated to a single category at country level, and a hierarchical model excluding multinational data. Covariates at different levels were drawn from a long list of factors suggested in the literature. Results. We found 67 studies reporting 2094 cost-effectiveness estimates relating to 23 countries (6 studies reporting for more than 1 country). Data and study-level covariates included patient characteristics, intervention and comparator cost, and some study methods (e.g., discount rates and time horizon). After adjusting for these factors, the proportion of variation attributable to countries was negligible in the cross-classified model but moderate in the hierarchical models (14%−19% of total variance). Country-level variables that improved the fit of the hierarchical models included measures of income and health care finance, health care resources, and population risks. Conclusions. Our analysis suggested that variability in published cost-effectiveness estimates is related more to differences in study methods than to differences in national context. Multinational studies were associated with much lower country-level variation than single-country studies. These findings are for a single clinical question and may be atypical. PMID:25878194

  19. Priority Setting for Improvement of Cervical Cancer Prevention in Iran

    PubMed Central

    Majidi, Azam; Ghiasvand, Reza; Hadji, Maryam; Nahvijou, Azin; Mousavi, Azam-Sadat; Pakgohar, Minoo; Khodakarami, Nahid; Abedini, Mehrandokht; Amouzegar Hashemi, Farnaz; Rahnamaye Farzami, Marjan; Shahsiah, Reza; Sajedinejhad, Sima; Mohagheghi, Mohammad Ali; Nadali, Fatemeh; Rashidian, Arash; Weiderpass, Elisabete; Mogensen, Ole; Zendehdel, Kazem

    2016-01-01

    Background: Cervical cancer is the fourth most common cancer among women worldwide. Organized cervical screening and vaccination against human papilloma virus (HPV) have been successful interventions for prevention of invasive cervical cancer (ICC). Because of cultural and religious considerations, ICC has low incidence in Iran and many other Muslim countries. There is no organized cervical screening in these countries. Therefore, ICC is usually diagnosed in advanced stages with poor prognosis in these countries. We performed a priority setting exercise and suggested priorities for prevention of ICC in this setting. Methods: We invited experts and researchers to a workshop and asked them to list important suggestions for ICC prevention in Iran. After merging similar items and removing the duplicates, we asked the experts to rank the list of suggested items. We used a strategy grid and Go-zone analysis to determine final list of priorities for ICC prevention in Iran. Results: From 26 final items suggested as priorities for prevention of ICC, the most important priorities were developing national guidelines for cervical screening and quality control protocol for patient follow-up and management of precancerous lesions. In addition, we emphasized considering insurance coverage for cervical screening, public awareness, and research priorities, and establishment of a cervical screening registry. Conclusion: A comprehensive approach and implementation of organized cervical screening program is necessary for prevention of ICC in Iran and other low incidence Muslim countries. Because of high cost for vaccination and low incidence of cervical cancer, we do not recommend HPV vaccination for the time being in Iran. PMID:27239863

  20. Framing and sources: a study of mass media coverage of climate change in Peru during the V ALCUE.

    PubMed

    Takahashi, Bruno

    2011-07-01

    Studies about mass media framing have found divergent levels of influence on public opinion; moreover, the evidence suggests that issue attributes can contribute to this difference. In the case of climate change, studies have focused exclusively on developed countries, suggesting that media influence perceptions about the issue. This study presents one of the first studies of media coverage in a developing country. It examines newspapers' reporting in Peru during the Fifth Latin America, Caribbean and European Union Summit in May 2008. The study focuses on the frames and the sources to provide an initial exploratory assessment of the coverage. The results show that the media relied mostly on government sources, giving limited access to dissenting voices such as environmentalists. Additionally, a prominence of "solutions" and "effects" frames was found, while "policy" and "science" frames were limited. The results could serve as a reference point for more comprehensive studies.

  1. Trade in labour services and migrant worker protection with special reference to East Asia.

    PubMed

    Stahl, C W

    1999-01-01

    This article discusses the migrant worker protection policy of the East Asian international labor market. The labor-exporting countries of East Asia provide an onerous proportion of low-skilled migrant workers to the region and are responding to the perceived edge of a policy of labor export. Conversely, the movement of highly skilled and professional workers is the result of globalization and internationalization of education, training and professions, rather than the result of explicit labor export of certain countries. In view of the need of international bilateral arrangements for the protection and facilitation of low-skilled workers, the labor-exporting countries have introduced a number of policies aimed at protecting and promoting the welfare of the overseas workers. Thus, various policy measures are suggested to advance the cause of migrant worker protection in East Asia.

  2. Editorial comment on Malkin and Keane (2010).

    PubMed

    Voigt, Herbert F; Krishnan, Shankar M

    2010-07-01

    Malkin and Keane (Med Biol Eng Comput, 2010) take an innovative approach to determine if unused, broken medical and laboratory equipment could be repaired by volunteers with limited resources. Their positive results led them to suggest that resource-poor countries might benefit from an on-the-job educational program for local high school graduates. The program would train biomedical technician assistants (BTAs) who would repair medical devices and instrumentation and return them to service. This is a program worth pursuing in resource-poor countries.

  3. Large and ongoing outbreak of haemolytic uraemic syndrome, Germany, May 2011.

    PubMed

    Frank, C; Faber, M S; Askar, M; Bernard, H; Fruth, A; Gilsdorf, A; Hohle, M; Karch, H; Krause, G; Prager, R; Spode, A; Stark, K; Werber, D

    2011-05-26

    Since early May 2011, an increased incidence of haemolytic uraemic syndrome (HUS) and bloody diarrhoea related to infections with Shiga toxin-producing Escherichia coli (STEC) has been observed in Germany, with most cases in the north of the country. Cases reported from other European countries had travelled to this area. First results of a case–control study conducted in Hamburg suggest an association between the occurrence of disease and the consumption of raw tomatoes, cucumber and leaf salad.

  4. Societal integration and age-standardized suicide rates in 21 developed countries, 1955-1989.

    PubMed

    Fernquist, R M; Cutright, P

    1998-01-01

    Gender-specific age-standardized suicide rates for 21 developed countries over seven 5-year periods (1955-59...1985-89) form the two dependent variables. Durkheim's theory of societal integration is the framework used to generate the independent variables, although several recent theories are also examined. The results from a MGLS multiple regression analysis of both male and female rates provide overwhelming support for a multidimensional theory of societal integration and suicide, as first suggested by Durkheim.

  5. Medical informatics across Europe: analysis of medical informatics scientific output in 33 European countries.

    PubMed

    Polašek, Ozren; Kern, Josipa

    2012-01-01

    To investigate the medical informatics scientific output in 33 European countries. Medical Subject Heading term "medical informatics" was used to identify all relevant articles published in 1998-2007 and indexed in the Medline database. The number of articles was adjusted to the population size of each included country in order to obtain the rates per million inhabitants. A total of 28,604 articles were identified. The highest number per million inhabitants was found for Switzerland and the lowest for Albania. Overall, European Union member states had higher output than non-member states, gross domestic product was strongly associated with the scientific output in the field of medical informatics (r = 0.88, p < 0.001). While most countries had significant increase in the scientific output during the observed period, an adjustment to the European average output trend suggested that Lithuania, Portugal, Serbia and Spain had a greater increase than the rest of Europe. The results suggest large disparities across Europe. Further development of medical informatics as a profession and a clear recognition of the discipline are needed to reduce these disparities and propel further increase in research productivity.

  6. The effect of country wealth on incidence of breast cancer.

    PubMed

    Coccia, Mario

    2013-09-01

    The aim of this study is to analyze the relationship between the incidence of breast cancer and income per capita across countries. Data on breast cancer incidence in 52 countries were obtained from GLOBOCAN, along with economic indicators of gross domestic product per capita from the World Bank. Number of computed tomography scanners and magnetic resonance imaging (from World Health Organization) were used as a surrogate for technology and access to screening for cancer diagnosis. Statistical analyses for correlation and regression were performed, along with an analysis of variance (ANOVA). A strong positive association between breast cancer incidence and gross domestic product per capita, Pearson's r = 65.4 %, controlling latitude, density of computed tomography scanners and magnetic resonance imaging was found in countries of temperate zones. The estimated relationship suggests that 1 % higher gross domestic product per capita, within the temperate zones (latitudes), increases the expected age-standardized breast cancer incidence by about 35.6 % (p < 0.001). ANOVA confirms these vital results. While some have argued that latitude and seasonality may affect breast cancer incidence, these findings suggest that wealthier nations may have a higher incidence of breast cancer independent of geographic location and screening technology.

  7. Reconstruction and systemization of the methodologies for strategic environmental assessment in Taiwan

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

    Liou, M.-L.; Yeh, S.-C.; Yu, Y.-H.

    2006-03-15

    This paper discusses the current SEA procedures and assessment methodologies, aiming to propose strategies that can lead to effective improvement in a newly industrialized Asian country, Taiwan. Institutional and practical problems with regard to the regulations and tools of SEA in Taiwan are compared to those in other countries. According to the research results, it is suggested that extra evaluation processes should be incorporated into the current assessment procedures to improve their scientific validity and integrity. Moreover, it is also suggested that the sustainability appraisal approaches be included in the SEA framework. In this phase, revised evaluation indicators associated withmore » corresponding targets can be the first attempt for modifying the SEA system. It is believed that these can promote the operability in practice and also lead the whole assessment procedures to a direction closer to sustainable development. The trails that Taiwan has followed can help other countries that are going to adopt SEA to find a more effective and efficient way to follow.« less

  8. Income distribution trends and future food demand.

    PubMed

    Cirera, Xavier; Masset, Edoardo

    2010-09-27

    This paper surveys the theoretical literature on the relationship between income distribution and food demand, and identifies main gaps of current food modelling techniques that affect the accuracy of food demand projections. At the heart of the relationship between income distribution and food demand is Engel's law. Engel's law establishes that as income increases, households' demand for food increases less than proportionally. A consequence of this law is that the particular shape of the distribution of income across individuals and countries affects the rate of growth of food demand. Our review of the literature suggests that existing models of food demand fail to incorporate the required Engel flexibility when (i) aggregating different food budget shares among households; and (ii) changing budget shares as income grows. We perform simple simulations to predict growth in food demand under alternative income distribution scenarios taking into account nonlinearity of food demand. Results suggest that (i) distributional effects are to be expected from changes in between-countries inequality, rather than within-country inequality; and (ii) simulations of an optimistic and a pessimistic scenario of income inequality suggest that world food demand in 2050 would be 2.7 per cent higher and 5.4 per cent lower than distributional-neutral growth, respectively.

  9. Cross-Country Differences in Basal and Stress-Induced Cortisol Secretion in Older Adults

    PubMed Central

    Lupien, Sonia J.; Fiocco, Alexandra; Suchecki, Deborah

    2014-01-01

    Objective Several studies have emphasized the association between socioeconomic status (SES) and inadequate response of the biological stress system. However, other factors related to SES are rarely considered, such as cultural values, social norms, organization, language and communication skills, which raises the need to investigate cross-country differences in stress response. Although some studies have shown differences in cortisol levels between immigrants and natives, there is no cross-country evidence regarding cortisol levels in country-native elders. This is particularly important given the high prevalence of stress-related disorders across nations during aging. The current study examined basal diurnal and reactive cortisol levels in healthy older adults living in two different countries. Methods Salivary cortisol of 260 older adults from Canada and Brazil were nalyzed. Diurnal cortisol was measured in saliva samples collected at home throughout two working days at awakening, 30 min after waking, 1400 h, 1600 h and before bedtime. Cortisol reactivity was assessed in response to the Trier Social Stress Test (TSST) in both populations. Results Our results showed that even under similar health status, psychological and cognitive characteristics, Brazilian elders exhibited higher basal and stress-induced cortisol secretion compared to the Canadian participants. Conclusion These findings suggest that country context may modulate cortisol secretion and could impact the population health. PMID:25153322

  10. Estimating least-developed countries' vulnerability to climate-related extreme events over the next 50 years.

    PubMed

    Patt, Anthony G; Tadross, Mark; Nussbaumer, Patrick; Asante, Kwabena; Metzger, Marc; Rafael, Jose; Goujon, Anne; Brundrit, Geoff

    2010-01-26

    When will least developed countries be most vulnerable to climate change, given the influence of projected socio-economic development? The question is important, not least because current levels of international assistance to support adaptation lag more than an order of magnitude below what analysts estimate to be needed, and scaling up support could take many years. In this paper, we examine this question using an empirically derived model of human losses to climate-related extreme events, as an indicator of vulnerability and the need for adaptation assistance. We develop a set of 50-year scenarios for these losses in one country, Mozambique, using high-resolution climate projections, and then extend the results to a sample of 23 least-developed countries. Our approach takes into account both potential changes in countries' exposure to climatic extreme events, and socio-economic development trends that influence countries' own adaptive capacities. Our results suggest that the effects of socio-economic development trends may begin to offset rising climate exposure in the second quarter of the century, and that it is in the period between now and then that vulnerability will rise most quickly. This implies an urgency to the need for international assistance to finance adaptation.

  11. Soft drink prices, sales, body mass index and diabetes: Evidence from a panel of low-, middle- and high-income countries.

    PubMed

    Goryakin, Yevgeniy; Monsivais, Pablo; Suhrcke, Marc

    2017-12-01

    We take advantage of four different cross-country datasets containing data on 78 countries for the period 1999-2014, in order to assess the relationship of carbonated soft drinks' sales, as well as their prices, with body mass index (BMI), overweight, obesity and diabetes. Using an ecological study design and multivariate regression longitudinal estimation approaches, we find that carbonated soft drink sales were significantly positively related to BMI, overweight and obesity - but only in the low and lower-middle income countries. This finding was robust to a number of sensitivity and falsification checks. In this sub-sample, an increase in per capita soft drink sales by 1 litre per year was related to an increase of BMI by about 0.009 kg/m 2 (p < 0.1).. This is a small effect, implying that halving annual consumption per capita in this group of countries would result in a drop of BMI by only about 0.03 kg/m 2 . Although soft drink prices were negatively related to weight-related outcomes in the sample of higher middle income and high income countries, this finding was not robust to falsification checks. The results thus suggest that sales restrictions to steer consumers away from soft drinks could indeed have a beneficial health effects in poorer countries, although the effect magnitude appears to be very small. However, given potential limitations of using ecological research design, results from individual level studies would be required to further ascertain the role of soft drink sales and prices in obesity and diabetes.

  12. Trends in the aetiology of urogenital fistula: a case of 'retrogressive evolution'?

    PubMed

    Hilton, Paul

    2016-06-01

    It has long been held as conventional wisdom that urogenital fistulae in low-income and middle-income countries are almost exclusively of obstetric aetiology, related to prolonged neglected obstructed labour, whereas those seen in high-income countries are largely iatrogenic in nature. There is, however, a growing perception amongst those working in the field that an increasing proportion of urogenital fistulae in low-income and middle-income countries may be iatrogenic, resulting from caesarean section. Recent studies suggest that adverse patterns of care may also be emerging in high-income countries; an increase in the risk of both vesicovaginal and ureterovaginal fistulae following hysterectomy has been reported, concurrently with the reduction in overall use of the procedure. These apparent secular trends are discussed in the context of evolution of practice, teaching and training in obstetrics and gynaecology.

  13. Ageing populations: the challenges ahead

    PubMed Central

    Christensen, Kaare; Doblhammer, Gabriele; Rau, Roland; Vaupel, James W

    2009-01-01

    If the pace of increase in life expectancy in developed countries over the past two centuries continues through the 21st century, most babies born since 2000 in France, Germany, Italy, the UK, the USA, Canada, Japan, and other countries with long life expectancies will celebrate their 100th birthdays. Although trends differ between countries, populations of nearly all such countries are ageing as a result of low fertility, low immigration, and long lives. A key question is: are increases in life expectancy accompanied by a concurrent postponement of functional limitations and disability? The answer is still open, but research suggests that ageing processes are modifiable and that people are living longer without severe disability. This finding, together with technological and medical development and redistribution of work, will be important for our chances to meet the challenges of ageing populations. PMID:19801098

  14. Does reducing food losses and wastes in sub-Saharan Africa make economic sense?

    PubMed

    Aragie, Emerta; Balié, Jean; MoralesOpazo, Cristian

    2018-06-01

    Reducing food losses and waste (FLW) is one of the sustainable ways of closing the food requirement gap in developing countries. However, there is not yet adequate knowledge on the extent of FLW by commodity type and stage of the food supply chain (FSC). Focusing on ten agrarian countries in Africa and building mainly on the Food and Agriculture Organization's Food Balance Sheets (FBSs), this study generates some new insights on the level of FLW by country, FSC and food type. Across the FSC, we find that these countries lose a cumulative amount equivalent to 28% (641 kilocalories per capita per day - kcal/cap/day) of the current calorie intake. Within the FSC, the production and post-harvest handling stages contribute the greater shares of the total losses with 38% or 244 kcal/cap/day and 34% or 218 kcal/cap/day, respectively. Our results also show that farm incomes would increase by 20% if the avoidable losses and waste were recovered. These results are troublesome given the level of poverty and food insecurity in these countries and suggest inefficient and unsustainable use of natural resources (water and cropland) associated with the FSC losses.

  15. Variability of cost-effectiveness estimates for pharmaceuticals in Western Europe: lessons for inferring generalizability.

    PubMed

    Barbieri, Marco; Drummond, Michael; Willke, Richard; Chancellor, Jeremy; Jolain, Bruno; Towse, Adrian

    2005-01-01

    It has long been suggested that, whereas the results of clinical studies of pharmaceuticals are generalizable from one jurisdiction to another, the results of economic evaluations are location dependent. There has been, however, little study of the causes of variation, whether differences in study results among countries are systematic, or whether they are important for decision making. A literature search was conducted to identify economic evaluations of pharmaceuticals conducted in two or more European countries. The studies identified were then classified by methodological type and analyzed to assess their level of variability and to identify the main causes of variation. Assessments were also made of the extent to which differences in study results among countries were systematic and whether they would lead to a different decision, assuming a range of values of the threshold willingness-to-pay for a life-year or quality-adjusted life-year (QALY). In total 46 intercountry drug comparisons were identified, 29 in multicountry studies and 17 in comparable single country studies that were considered to be sufficiently similar in terms of methodology. The type of study (i.e., trial-based or modeling study) had some impact on variability, but the most important factor was the extent of variation across countries in effectiveness, resource use or unit costs, allowed by the researcher's chosen methodology. There were few systematic differences in study results among countries, so a decision maker in country B, on seeing a recent economic evaluation of a new drug in country A, would have little basis on which to predict whether the drug, if evaluated, would be more or less cost-effective in his or her country. Given the extent of variation in cost-effectiveness estimates among countries, the importance of this for decision making depends on decision makers' thresholds in willingness-to-pay for a QALY or life-year. If a cost-effectiveness threshold (i.e., willingness-to-pay) for a life-year or QALY of dollar 50,000 were assumed, the same conclusion regarding cost-effectiveness would be reached in most cases. This review shows that cost-effectiveness results for pharmaceuticals vary from country to country in Western Europe and that these variations are not systematic. In addition, constraints imposed by analysts may reduce apparent variability in the estimates. The lessons for inferring generalizability are not straightforward, although the implications of variation for decision making depend critically on the cost-effectiveness thresholds applying in Western Europe.

  16. Foreign Aid versus Military Intervention in the War on Terror

    ERIC Educational Resources Information Center

    Azam, Jean-Paul; Thelen, Veronique

    2010-01-01

    This article presents a theoretical framework and some empirical results showing that the level of foreign aid received reduces the supply of terrorist attacks from recipient countries, while U.S. military interventions are liable to increase this supply. Due account is taken of endogeneity problems in producing these results. They suggest that…

  17. Resilience Analysis of Countries under Disasters Based on Multisource Data.

    PubMed

    Zhang, Nan; Huang, Hong

    2018-01-01

    Disasters occur almost daily in the world. Because emergencies frequently have no precedent, are highly uncertain, and can be very destructive, improving a country's resilience is an efficient way to reduce risk. In this article, we collected more than 20,000 historical data points from disasters from 207 countries to enable us to calculate the severity of disasters and the danger they pose to countries. In addition, 6 primary indices (disaster, personal attribute, infrastructure, economics, education, and occupation) including 38 secondary influencing factors are considered in analyzing the resilience of countries. Using these data, we obtained the danger, expected number of deaths, and resilience of all 207 countries. We found that a country covering a large area is more likely to have a low resilience score. Through sensitivity analysis of all secondary indices, we found that population density, frequency of disasters, and GDP are the three most critical factors affecting resilience. Based on broad-spectrum resilience analysis of the different continents, Oceania and South America have the highest resilience, while Asia has the lowest. Over the past 50 years, the resilience of many countries has been improved sharply, especially in developing countries. Based on our results, we analyze the comprehensive resilience and provide some optimal suggestions to efficiently improve resilience. © 2017 Society for Risk Analysis.

  18. Health Care Expenditure and GDP in Oil Exporting Countries: Evidence from OPEC Data, 1995-2012

    PubMed Central

    Fazaeli, Ali Akbar; Ghaderi, Hossein; Salehi, Masoud; Fazaeli, Ali Reza

    2016-01-01

    Background: There is a large body of literature examining income in relation to health expenditures. The share of expenditures in health sector from GDP in developed countries is often larger than in non-developed countries, suggesting that as the level of economic growth increases, health spending increase, too. Objectives: This paper estimates long-run relationships between health expenditures and GDP based on panel data of a sample of 12 countries of the Organization of the Petroleum Exporting Countries (OPEC), using data for the period 1995-2012. Patients & Methods: We use panel data unit root tests, cointegration analysis and ECM model to find long-run and short-run relation. This study examines whether health is a luxury or a necessity for OPEC countries within a unit root and cointegration framework. Results: Panel data analysis indicates that health expenditures and GDP are co-integrated and have Engle and Granger causality. In addition, in oil countries that have oil export income, the share of government expenditures in the health sector is often greater than in private health expenditures similar developed countries. Conclusions: The findings verify that health care is not a luxury good and income has a robust relationship to health expenditures in OPEC countries. PMID:26383195

  19. The Hydrothermal System of the Bushveld Complex, South Africa - An Analog for Subduction Zone Hydrothermal Systems

    NASA Astrophysics Data System (ADS)

    Boudreau, A. E.; Connolly, J. A.

    2017-12-01

    Crystallization of the 2.06 Ga Bushveld magma formed a 9 km (maximum) sequence of ultramafic and mafic rocks that generated a large volume of country fluid as it thermally metamorphosed a 3+ km section of previously unaltered underlying sedimentary rocks of the Transvaal sequence - a geometry similar to that seen as subducting lithospheric slabs are heated by overlying mantle rocks. The presence of a diatreme (breccia pipe) and other large, pipe-like features in the Bushveld Complex suggest that overpressured fluids generated during dehydration of the footwall sediments rapidly penetrate the lower portions of the complex. Numeric modeling of the footwall dehydration similarly suggests that most of the country fluids will be confined to pipe-like channels as it percolates into the Bushveld sill. Modeling also suggests that the maximum extent of the metamorphic aureole was reached at about the same time that the Main zone began to crystallize. It is suggested that rapid inflation of the Bushveld sill induced the sudden and catastrophic expulsion of overpressured country fluids (the "whoopee cushion" effect) to both generate the diatreme and contaminate the Main zone magma, resulting in the Main zone enrichment in a crustal Sr isotopic signature. By analogy, it is also suggested that hydration melting in the mantle wedge is episodically driven by similar sudden influxes of slab fluids that are able to retain their geochemical and isotopic character by rapid channeled influx.

  20. Health economics of rubella: a systematic review to assess the value of rubella vaccination

    PubMed Central

    2013-01-01

    Background Most cases of rubella and congenital rubella syndrome (CRS) occur in low- and middle-income countries. The World Health Organization (WHO) has recently recommended that countries accelerate the uptake of rubella vaccination and the GAVI Alliance is now supporting large scale measles-rubella vaccination campaigns. We performed a review of health economic evaluations of rubella and CRS to identify gaps in the evidence base and suggest possible areas of future research to support the planned global expansion of rubella vaccination and efforts towards potential rubella elimination and eradication. Methods We performed a systematic search of on-line databases and identified articles published between 1970 and 2012 on costs of rubella and CRS treatment and the costs, cost-effectiveness or cost-benefit of rubella vaccination. We reviewed the studies and categorized them by the income level of the countries in which they were performed, study design, and research question answered. We analyzed their methodology, data sources, and other details. We used these data to identify gaps in the evidence and to suggest possible future areas of scientific study. Results We identified 27 studies: 11 cost analyses, 11 cost-benefit analyses, 4 cost-effectiveness analyses, and 1 cost-utility analysis. Of these, 20 studies were conducted in high-income countries, 5 in upper-middle income countries and two in lower-middle income countries. We did not find any studies conducted in low-income countries. CRS was estimated to cost (in 2012 US$) between $4,200 and $57,000 per case annually in middle-income countries and up to $140,000 over a lifetime in high-income countries. Rubella vaccination programs, including the vaccination of health workers, children, and women had favorable cost-effectiveness, cost-utility, or cost-benefit ratios in high- and middle-income countries. Conclusions Treatment of CRS is costly and rubella vaccination programs are highly cost-effective. However, in order for research to support the global expansion of rubella vaccination and the drive towards rubella elimination and eradication, additional studies are required in low-income countries, to tackle methodological limitations, and to determine the most cost-effective programmatic strategies for increased rubella vaccine coverage. PMID:23627715

  1. Voluntary Medical Male Circumcision: Modeling the Impact and Cost of Expanding Male Circumcision for HIV Prevention in Eastern and Southern Africa

    PubMed Central

    Reed, Jason; Opuni, Marjorie; Bollinger, Lori; Heard, Nathan; Castor, Delivette; Stover, John; Farley, Timothy; Menon, Veena; Hankins, Catherine

    2011-01-01

    Background There is strong evidence showing that voluntary medical male circumcision (VMMC) reduces HIV incidence in men. To inform the VMMC policies and goals of 13 priority countries in eastern and southern Africa, we estimate the impact and cost of scaling up adult VMMC using updated, country-specific data. Methods and Findings We use the Decision Makers' Program Planning Tool (DMPPT) to model the impact and cost of scaling up adult VMMC in Botswana, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia, Zimbabwe, and Nyanza Province in Kenya. We use epidemiologic and demographic data from recent household surveys for each country. The cost of VMMC ranges from US$65.85 to US$95.15 per VMMC performed, based on a cost assessment of VMMC services aligned with the World Health Organization's considerations of models for optimizing volume and efficiencies. Results from the DMPPT models suggest that scaling up adult VMMC to reach 80% coverage in the 13 countries by 2015 would entail performing 20.34 million circumcisions between 2011 and 2015 and an additional 8.42 million between 2016 and 2025 (to maintain the 80% coverage). Such a scale-up would result in averting 3.36 million new HIV infections through 2025. In addition, while the model shows that this scale-up would cost a total of US$2 billion between 2011 and 2025, it would result in net savings (due to averted treatment and care costs) amounting to US$16.51 billion. Conclusions This study suggests that rapid scale-up of VMMC in eastern and southern Africa is warranted based on the likely impact on the region's HIV epidemics and net savings. Scaling up of safe VMMC in eastern and southern Africa will lead to a substantial reduction in HIV infections in the countries and lower health system costs through averted HIV care costs. Please see later in the article for the Editors' Summary. PMID:22140367

  2. The changing relationship between family size and educational attainment over the course of socioeconomic development: evidence from Indonesia.

    PubMed

    Maralani, Vida

    2008-08-01

    Many studies from developed countries show a negative correlation between family size and children's schooling, while results from developing countries show this association ranging from positive to neutral to negative, depending on the context. The body of evidence suggests that this relationship changes as a society develops, but this theory has been difficult to assess because the existing evidence requires comparisons across countries with different social structures and at different levels of development. The world's fourth most populous nation in 2007, Indonesia has developed rapidly in recent decades. This context provides the opportunity to study these relationships within the same rapidly developing setting to see if and how these associations change. Results show that in urban areas, the association between family size and children's schooling was positive for older cohorts but negative for more recent cohorts. Models using instrumental variables to address the potential endogeneity of fertility confirm these results. In contrast, rural areas show no significant association between family size and children's schooling for any cohort. These findings show how the relationship between family size and children's schooling can differ within the same country and change over time as contextual factors evolve with socioeconomic development.

  3. Economic gradients in early child neurodevelopment: A multi-country study

    PubMed Central

    Wehby, George L.; McCarthy, Ann Marie

    2013-01-01

    Little is known about the importance of household wealth for child neurodevelopment very early in life including during infancy. Previous studies have focused on specific developmental domains instead of more holistic multi-domain measures of neurodevelopment and on economic effects for the “average” child instead of evaluating the heterogeneity in economic gradients by different levels of developmental ability. Furthermore, not much is known about whether economic gradients in early child neurodevelopment are country-specific or generalizable between populations. We evaluate wealth gradients in child neurodevelopment, an important predictor of future health and human capital, between ages 3 and 24 months in four South American countries. We also assess the heterogeneity in these gradients at different locations of the neurodevelopment distribution using quantile regression. Employing a unique dataset of 2032 children with neurodevelopment measures obtained by physicians in 2005–2006, we find a large positive wealth gradient in neurodevelopment in Brazil. The wealth gradient is larger for children at higher neurodevelopment rankings, suggesting that wealth is associated with child development inequalities in the form of a wider gap between low and high achievers on neurodevelopment in Brazil. This result highlights the need to target poverty in Brazil as a key factor in health and human capital disparities earlier in life rather than later as early developmental deficits will be carried forward and possibly multiplied later in life. More importantly, small or insignificant wealth gradients are generally found in the other countries. These results suggest that wealth gradients in child neurodevelopment are country-specific and vary with population demographic, health, and socioeconomic characteristics. Therefore, findings from previous studies based on specific populations may not be generalizable to other countries. Furthermore, wealth gradients in child neurodevelopment appear to be dynamic rather than fixed and sensitive to population characteristics that modify their intensity. PMID:23273409

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

    Ezeah, Chukwunonye, E-mail: C.Ezeah2@wlv.ac.uk; Fazakerley, Jak A.; Roberts, Clive L.

    Highlights: • Reviewed emerging trends in Informal Sector Recycling (ISR) in developing countries. • In some countries we found that ISR is the key factor in the recycling of waste materials. • Overall impact of ISR upon the urban economy and environment is positive. • In some instances ISR subsidises large areas of the formal sector. • Ignoring the informal sector could result in unsustainable interventions. - Abstract: Optimistic estimates suggest that only 30–70% of waste generated in cities of developing countries is collected for disposal. As a result, uncollected waste is often disposed of into open dumps, along themore » streets or into water bodies. Quite often, this practice induces environmental degradation and public health risks. Notwithstanding, such practices also make waste materials readily available for itinerant waste pickers. These ‘scavengers’ as they are called, therefore perceive waste as a resource, for income generation. Literature suggests that Informal Sector Recycling (ISR) activity can bring other benefits such as, economic growth, litter control and resources conservation. This paper critically reviews trends in ISR activities in selected developing and transition countries. ISR often survives in very hostile social and physical environments largely because of negative Government and public attitude. Rather than being stigmatised, the sector should be recognised as an important element for achievement of sustainable waste management in developing countries. One solution to this problem could be the integration of ISR into the formal waste management system. To achieve ISR integration, this paper highlights six crucial aspects from literature: social acceptance, political will, mobilisation of cooperatives, partnerships with private enterprises, management and technical skills, as well as legal protection measures. It is important to note that not every country will have the wherewithal to achieve social inclusion and so the level of integration must be ‘flexible’. In addition, the structure of the ISR should not be based on a ‘universal’ model but should instead take into account local contexts and conditions.« less

  5. The Effect of Empowerment and Self-Determination on Health Outcomes.

    PubMed

    Garces-Ozanne, Arlene; Kalu, Edna Ikechi; Audas, Richard

    2016-12-01

    There remains a persistent gap in health outcomes between wealthy and poor countries. Basic measures such as life expectancy and infant and under-five mortality remain divergent, with preventable deaths being unacceptably high, despite significant efforts to reduce these disparities. We examine the impact of empowerment, measured by Freedom House's ratings of country's political rights and civil liberties, while controlling for per capita gross domestic product, secondary school enrollment, and income inequality, on national health outcomes. Using data from 1970 to 2013 across 149 countries, our results suggest, quite strongly, that higher levels of empowerment have a significant positive association with life expectancy, particularly for females, and lower rates of infant and under-five mortality. Our results point to the need for efforts to stimulate economic growth be accompanied with reforms to increase the levels empowerment through increasing political rights and civil liberties. © 2016 Society for Public Health Education.

  6. A New EO-Based Indicator for Assessing and Monitoring Climate-Related Vegetation Stress

    NASA Astrophysics Data System (ADS)

    McCormick, Niall; Gobron, Nadine

    2016-08-01

    This paper describes a study in which a new environmental indicator, called Annual Vegetation Stress (AVS), has been developed, based on annual anomalies of satellite-measured Fraction of Absorbed Photosynthetically Active Radiation (FAPAR ), and used to map the area affected annually by vegetation stress during the period 2003-2014, for 108 selected developing countries. Analysis of the results for six countries in the "tropical and subtropical forests" ecoregion, reveals good correspondence between high AVS values, and the occurrence of climatic extremes (droughts) and anthropogenic disturbance (deforestation). The results for Equatorial Guinea suggest that the recent trend of large-scale droughts and rainfall deficits in Central and Western Africa, contribute to increased vegetation stress in the region's tropical rainforests. In East Timor there is evidence of a "biological lag" effect, whereby the main impacts of drought on the country's seasonally dry tropical forests are delayed until the year following the climate event.

  7. What research tells us about knowledge transfer strategies to improve public health in low-income countries: a scoping review.

    PubMed

    Siron, Stéphanie; Dagenais, Christian; Ridde, Valéry

    2015-11-01

    This study describes the current state of research on knowledge transfer strategies to improve public health in low-income countries, to identify the knowledge gaps on this topic. In this scoping review, a descriptive and systematic process was used to analyse, for each article retained, descriptions of research context and methods, types of knowledge transfer activities and results reported. 28 articles were analysed. They dealt with the evaluation of transfer strategies that employed multiple activities, mostly targeting health professionals and women with very young children. Most often these studies used quantitative designs and measurements of instrumental use with some methodological shortcomings. Results were positive and suggested recommendations for improving professional practices, knowledge and health-related behaviours. The review highlights the great diversity of transfer strategies used, strategies and many conditions for knowledge use. The review provides specific elements for understanding the transfer processes in low-income countries and highlights the need for systematic evaluation of the conditions for research results utilization.

  8. High fructose corn syrup and diabetes prevalence: a global perspective.

    PubMed

    Goran, Michael I; Ulijaszek, Stanley J; Ventura, Emily E

    2013-01-01

    The overall aim of this study was to evaluate, from a global and ecological perspective, the relationships between availability of high fructose corn syrup (HFCS) and prevalence of type 2 diabetes. Using published resources, country-level estimates (n =43 countries) were obtained for: total sugar, HFCS and total calorie availability, obesity, two separate prevalence estimates for diabetes, prevalence estimate for impaired glucose tolerance and fasting plasma glucose. Pearson's correlations and partial correlations were conducted in order to explore associations between dietary availability and obesity and diabetes prevalence. Diabetes prevalence was 20% higher in countries with higher availability of HFCS compared to countries with low availability, and these differences were retained or strengthened after adjusting for country-level estimates of body mass index (BMI), population and gross domestic product (adjusted diabetes prevalence=8.0 vs. 6.7%, p=0.03; fasting plasma glucose=5.34 vs. 5.22 mmol/L, p=0.03) despite similarities in obesity and total sugar and calorie availability. These results suggest that countries with higher availability of HFCS have a higher prevalence of type 2 diabetes independent of obesity.

  9. The Global Inventor Gap: Distribution and Equality of World-Wide Inventive Effort, 1990–2010

    PubMed Central

    Toivanen, Hannes; Suominen, Arho

    2015-01-01

    Applying distance-to-frontier analysis, we have used 2.9 million patents and population data to assess whether the relative capacity of world countries and major regions to create new knowledge and technology has become globally more equal or less equal between 1990 and 2010. We show with the Gini coefficient that the global distribution of inventors has become more equal between major countries and regions. However, this trend has been largely due to the improved performance of only two major countries, China and India. The worst performing regions, totalling a population of almost 2 billion, are actually falling behind. Our results suggest that substantial parts of the global population have fallen further behind countries at the global frontier in their ability to create new knowledge and inventions, and that the catch-up among the least developed and middle-income countries is highly uneven, prompting questions about the nature and future of the global knowledge economy. PMID:25849202

  10. Healthcare system and the wealth-health gradient: a comparative study of older populations in six countries.

    PubMed

    Maskileyson, Dina

    2014-10-01

    The present study provides a comparative analysis of the association between wealth and health in six healthcare systems (Sweden, the United Kingdom, Germany, the Czech Republic, Israel, the United States). National samples of individuals fifty years and over reveal considerable cross-country variations in health outcomes. In all six countries wealth and health are positively associated. The findings also show that state-based healthcare systems produce better population health outcomes than private-based healthcare systems. The results indicate that in five out of the six countries studied, the wealth-health gradients were remarkably similar, despite significant variations in healthcare system type. Only in the United States was the association between wealth and health substantially different from, and much greater than that in the other five countries. The findings suggest that private-based healthcare system in the U.S. is likely to promote stronger positive associations between wealth and health. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Corruption costs lives: a cross-country study using an IV approach.

    PubMed

    Lio, Mon-Chi; Lee, Ming-Hsuan

    2016-04-01

    This study quantitatively estimates the effects of corruption on five major health indicators by using recent cross-country panel data covering 119 countries for the period of 2005-2011. The corruption indicators provided by the World Bank and Transparency International are used, and both the two-way fixed effect and the two-stage least squares approaches are employed for our estimation. The estimation results show that, in general, corruption is negatively associated with a country's health outcomes. A lower level of corruption or a better control of corruption in a country can lead to longer life expectancy, a lower infant mortality rate and a lower under-five mortality rate for citizens. However, our estimation finds no significant association between corruption and individual diseases including human immunodeficiency virus prevalence and tuberculosis incidence. The findings suggest that corruption reduction itself is an effective method to promote health. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Health Care System Reforms in Developing Countries

    PubMed Central

    Han, Wei

    2012-01-01

    This article proposes a critical but non-systematic review of recent health care system reforms in developing countries. The literature reports mixed results as to whether reforms improve the financial protection of the poor or not. We discuss the reasons for these differences by comparing three representative countries: Mexico, Vietnam, and China. First, the design of the health care system reform, as well as the summary of its evaluation, is briefly described for each country. Then, the discussion is developed along two lines: policy design and evaluation methodology. The review suggests that i) background differences, such as social development, poverty level, and population health should be considered when taking other countries as a model; ii) although demand-side reforms can be improved, more attention should be paid to supply-side reforms; and iii) the findings of empirical evaluation might be biased due to the evaluation design, the choice of outcome, data quality, and evaluation methodology, which should be borne in mind when designing health care system reforms. PMID:25170464

  13. Tailoring science education graduate programs to the needs of science educators in low-income countries

    NASA Astrophysics Data System (ADS)

    Lunetta, Vincent N.; van den Berg, Euwe

    Science education graduate programs in high-income countries frequently enroll students from low-income countries. Upon admission these students have profiles of knowledge, skills, and experiences which can be quite different from those of students from the host high-income countries. Upon graduation, they will normally return to work in education systems with conditions which differ greatly from those in high-income countries. This article attempts to clarify some of the differences and similarities between such students. It offers suggestions for making graduate programs more responsive to the special needs of students from low-income countries and to the opportunities they offer for enhancing cross-cultural sensitivity. Many of the suggestions can be incorporated within existing programs through choices of elective courses and topics for papers, projects, and research. Many references are provided to relevant literature on cultural issues and on science education in low-income countries.

  14. The association between nutrition transition score and measures of obesity: results from a cross-sectional study among Latina/o immigrants in Baltimore

    PubMed Central

    2014-01-01

    Background Studies suggest that US Latinos have a higher prevalence of obesity than White Americans. However, obesity may differ by pre-immigration factors and Latinos’ cultural representations of ideal body image. This paper explores whether country of origin’s stage in the nutrition transition is related to Latino immigrants’ BMI category and self-perception of weight. Methods Primary data originated from a cross-sectional questionnaire of Latina/o immigrants in Baltimore in 2011. A convenience sample of self-identified Latinos, ≥18 years old, living in Baltimore was recruited from a community-based organization. Data for each country represented in the sample were obtained from the WHO Demographic and Health Surveys and the UN Food and Agriculture Organization. Each country was scored for its stage in the nutrition transition using a six-point scoring system. Descriptive statistics were conducted to characterize the sample. Bivariate analyses were conducted to examine the relationship between the outcome variables and the predictors. Multivariate logistic regressions were conducted to examine whether a country’s stage in the nutrition transition increased one’s odds of having an obese BMI score (≥30 kg/cm2) and perceiving one’s weight as overweight, while controlling for socio-demographic variables. Results The sample (n = 149) consisted of immigrants from 12 Latin American countries. Participants lived in the US for x=10.24 years. About 40% of the sample had BMI ≥30 kg/m2 (obese). The longer Latina immigrants’ lived in the US, the less likely their country of origin’s nutrition transition score would increase their odds of having a BMI ≥30 kg/m2 (OR = 0.97 p < 0.04). The higher the country of origin’s nutrition transition score, the more likely BMI influenced Latino immigrants’ perception of their weight as above normal (OR = 1.06, p < 0.04). The effect of the nutrition transition score had a stronger effect on females than males. Conclusion These results suggest that country of origin’s nutrition transition score and gender affect Latino immigrants’ objective and subjective measures of weight. Future investigation should investigate the relationship between gender and the nutrition transition in Latin America and how the nutrition transition globalizes obesity and weight consciousness. PMID:25001844

  15. The impact of economic recession on maternal and infant mortality: lessons from history.

    PubMed

    Ensor, Tim; Cooper, Stephanie; Davidson, Lisa; Fitzmaurice, Ann; Graham, Wendy J

    2010-11-24

    The effect of the recent world recession on population health has featured heavily in recent international meetings. Maternal health is a particular concern given that many countries were already falling short of their MDG targets for 2015. We utilise 20th century time series data from 14 high and middle income countries to investigate associations between previous economic recession and boom periods on maternal and infant outcomes (1936 to 2005). A first difference logarithmic model is used to investigate the association between short run fluctuations in GDP per capita (individual incomes) and changes in health outcomes. Separate models are estimated for four separate time periods. The results suggest a modest but significant association between maternal and infant mortality and economic growth for early periods (1936 to 1965) but not more recent periods. Individual country data display markedly different patterns of response to economic changes. Japan and Canada were vulnerable to economic shocks in the post war period. In contrast, mortality rates in countries such as the UK and Italy and particularly the US appear little affected by economic fluctuations. The data presented suggest that recessions do have a negative association with maternal and infant outcomes particularly in earlier stages of a country's development although the effects vary widely across different systems. Almost all of the 20 least wealthy countries have suffered a reduction of 10% or more in GDP per capita in at least one of the last five decades. The challenge for today's policy makers is the design and implementation of mechanisms that protect vulnerable populations from the effects of fluctuating national income.

  16. Integrating habitat status, human population pressure, and protection status into biodiversity conservation priority setting

    USGS Publications Warehouse

    Shi, Hua; Singh, Ashbindu; Kant, S.; Zhu, Zhiliang; Waller, E.

    2005-01-01

    Priority setting is an essential component of biodiversity conservation. Existing methods to identify priority areas for conservation have focused almost entirely on biological factors. We suggest a new relative ranking method for identifying priority conservation areas that integrates both biological and social aspects. It is based on the following criteria: the habitat's status, human population pressure, human efforts to protect habitat, and number of endemic plant and vertebrate species. We used this method to rank 25 hotspots, 17 megadiverse countries, and the hotspots within each megadiverse country. We used consistent, comprehensive, georeferenced, and multiband data sets and analytical remote sensing and geographic information system tools to quantify habitat status, human population pressure, and protection status. The ranking suggests that the Philippines, Atlantic Forest, Mediterranean Basin, Caribbean Islands, Caucasus, and Indo-Burma are the hottest hotspots and that China, the Philippines, and India are the hottest megadiverse countries. The great variation in terms of habitat, protected areas, and population pressure among the hotspots, the megadiverse countries, and the hotspots within the same country suggests the need for hotspot- and country-specific conservation policies.

  17. Water security for productive economies: Applying an assessment framework in southern Africa

    NASA Astrophysics Data System (ADS)

    Holmatov, Bunyod; Lautze, Jonathan; Manthrithilake, Herath; Makin, Ian

    2017-08-01

    Achieving water security has emerged as a major objective in Africa, yet an analytical or diagnostic framework for assessing water security in African countries is not known to exist. This paper applies one key dimension of the 2016 Asian Development Bank's (ADB) Asian Water Development Outlook (AWDO) to assess levels of water security for productive economies in countries of the Southern African Development Community (SADC). Economic aspects of water security cover four areas: economic activities in the broad sense, agriculture, electricity, and industry. Water security in each area is measured through application of a set of indicators; results of indicator application are then aggregated to determine economic water security at a country-level. Results show that economic water security in SADC is greatest in the Seychelles and South Africa, and lowest in Madagascar and Malawi. Opportunities for strengthening economic water security in the majority of SADC countries exist through improving agricultural water productivity, strengthening resilience, and expanding sustainable electricity generation. More profoundly, this paper suggests that there is clear potential and utility in applying approaches used elsewhere to assess economic water security in southern Africa.

  18. Balancing Evidence and Uncertainty when Considering Rubella Vaccine Introduction

    PubMed Central

    Lessler, Justin; Metcalf, C. Jessica E.

    2013-01-01

    Background Despite a safe and effective vaccine, rubella vaccination programs with inadequate coverage can raise the average age of rubella infection; thereby increasing rubella cases among pregnant women and the resulting congenital rubella syndrome (CRS) in their newborns. The vaccination coverage necessary to reduce CRS depends on the birthrate in a country and the reproductive number, R0, a measure of how efficiently a disease transmits. While the birthrate within a country can be known with some accuracy, R0 varies between settings and can be difficult to measure. Here we aim to provide guidance on the safe introduction of rubella vaccine into countries in the face of substantial uncertainty in R0. Methods We estimated the distribution of R0 in African countries based on the age distribution of rubella infection using Bayesian hierarchical models. We developed an age specific model of rubella transmission to predict the level of R0 that would result in an increase in CRS burden for specific birth rates and coverage levels. Combining these results, we summarize the safety of introducing rubella vaccine across demographic and coverage contexts. Findings The median R0 of rubella in the African region is 5.2, with 90% of countries expected to have an R0 between 4.0 and 6.7. Overall, we predict that countries maintaining routine vaccination coverage of 80% or higher are can be confident in seeing a reduction in CRS over a 30 year time horizon. Conclusions Under realistic assumptions about human contact, our results suggest that even in low birth rate settings high vaccine coverage must be maintained to avoid an increase in CRS. These results lend further support to the WHO recommendation that countries reach 80% coverage for measles vaccine before introducing rubella vaccination, and highlight the importance of maintaining high levels of vaccination coverage once the vaccine is introduced. PMID:23861777

  19. Balancing evidence and uncertainty when considering rubella vaccine introduction.

    PubMed

    Lessler, Justin; Metcalf, C Jessica E

    2013-01-01

    Despite a safe and effective vaccine, rubella vaccination programs with inadequate coverage can raise the average age of rubella infection; thereby increasing rubella cases among pregnant women and the resulting congenital rubella syndrome (CRS) in their newborns. The vaccination coverage necessary to reduce CRS depends on the birthrate in a country and the reproductive number, R0, a measure of how efficiently a disease transmits. While the birthrate within a country can be known with some accuracy, R0 varies between settings and can be difficult to measure. Here we aim to provide guidance on the safe introduction of rubella vaccine into countries in the face of substantial uncertainty in R0. We estimated the distribution of R0 in African countries based on the age distribution of rubella infection using Bayesian hierarchical models. We developed an age specific model of rubella transmission to predict the level of R0 that would result in an increase in CRS burden for specific birth rates and coverage levels. Combining these results, we summarize the safety of introducing rubella vaccine across demographic and coverage contexts. The median R0 of rubella in the African region is 5.2, with 90% of countries expected to have an R0 between 4.0 and 6.7. Overall, we predict that countries maintaining routine vaccination coverage of 80% or higher are can be confident in seeing a reduction in CRS over a 30 year time horizon. Under realistic assumptions about human contact, our results suggest that even in low birth rate settings high vaccine coverage must be maintained to avoid an increase in CRS. These results lend further support to the WHO recommendation that countries reach 80% coverage for measles vaccine before introducing rubella vaccination, and highlight the importance of maintaining high levels of vaccination coverage once the vaccine is introduced.

  20. Yellow Fever Virus Maintenance in Trinidad and Its Dispersal throughout the Americas▿ †

    PubMed Central

    Auguste, Albert J.; Lemey, Philippe; Pybus, Oliver G.; Suchard, Marc A.; Salas, Rosa Alba; Adesiyun, Abiodun A.; Barrett, Alan D.; Tesh, Robert B.; Weaver, Scott C.; Carrington, Christine V. F.

    2010-01-01

    Trinidad, like many other American regions, experiences repeated epizootics of yellow fever virus (YFV). However, it is unclear whether these result from in situ evolution (enzootic maintenance) or regular reintroduction of YFV from the South American mainland. To discriminate between these hypotheses, we carried out a Bayesian phylogeographic analysis of over 100 prM/E gene sequences sampled from 8 South American countries. These included newly sequenced isolates from the recent 2008-2009 Trinidad epizootic and isolates derived from mainland countries within the last decade. The results indicate that the most recent common ancestor of the 2008-2009 epizootic existed in Trinidad 4.2 years prior to 2009 (95% highest probability density [HPD], 0.5 to 9.0 years). Our data also suggest a Trinidad origin for the progenitor of the 1995 Trinidad epizootic and support in situ evolution of YFV between the 1979 and 1988-1989 Trinidad epizootics. Using the same phylogeographic approach, we also inferred the historical spread of YFV in the Americas. The results suggest a Brazilian origin for YFV in the Americas and an overall dispersal rate of 182 km/year (95% HPD, 52 to 462 km/year), with Brazil as the major source population for surrounding countries. There is also strong statistical support for epidemiological links between four Brazilian regions and other countries. In contrast, while there were well-supported epidemiological links within Peru, the only statistically supported external link was a relatively weak link with neighboring Bolivia. Lastly, we performed a complete analysis of the genome of a newly sequenced Trinidad 2009 isolate, the first complete genome for a genotype I YFV isolate. PMID:20631128

  1. Empirical impact evaluation of the WHO Global Code of Practice on the International Recruitment of Health Personnel in Australia, Canada, UK and USA

    PubMed Central

    2013-01-01

    Background The active recruitment of health workers from developing countries to developed countries has become a major threat to global health. In an effort to manage this migration, the 63rd World Health Assembly adopted the World Health Organization (WHO) Global Code of Practice on the International Recruitment of Health Personnel in May 2010. While the Code has been lauded as the first globally-applicable regulatory framework for health worker recruitment, its impact has yet to be evaluated. We offer the first empirical evaluation of the Code’s impact on national and sub-national actors in Australia, Canada, United Kingdom and United States of America, which are the English-speaking developed countries with the greatest number of migrant health workers. Methods 42 key informants from across government, civil society and private sectors were surveyed to measure their awareness of the Code, knowledge of specific changes resulting from it, overall opinion on the effectiveness of non-binding codes, and suggestions to improve this Code’s implementation. Results 60% of respondents believed their colleagues were not aware of the Code, and 93% reported that no specific changes had been observed in their work as a result of the Code. 86% reported that the Code has not had any meaningful impact on policies, practices or regulations in their countries. Conclusions This suggests a gap between awareness of the Code among stakeholders at global forums and the awareness and behaviour of national and sub-national actors. Advocacy and technical guidance for implementing the Code are needed to improve its impact on national decision-makers. PMID:24228827

  2. Yellow fever virus maintenance in Trinidad and its dispersal throughout the Americas.

    PubMed

    Auguste, Albert J; Lemey, Philippe; Pybus, Oliver G; Suchard, Marc A; Salas, Rosa Alba; Adesiyun, Abiodun A; Barrett, Alan D; Tesh, Robert B; Weaver, Scott C; Carrington, Christine V F

    2010-10-01

    Trinidad, like many other American regions, experiences repeated epizootics of yellow fever virus (YFV). However, it is unclear whether these result from in situ evolution (enzootic maintenance) or regular reintroduction of YFV from the South American mainland. To discriminate between these hypotheses, we carried out a Bayesian phylogeographic analysis of over 100 prM/E gene sequences sampled from 8 South American countries. These included newly sequenced isolates from the recent 2008-2009 Trinidad epizootic and isolates derived from mainland countries within the last decade. The results indicate that the most recent common ancestor of the 2008-2009 epizootic existed in Trinidad 4.2 years prior to 2009 (95% highest probability density [HPD], 0.5 to 9.0 years). Our data also suggest a Trinidad origin for the progenitor of the 1995 Trinidad epizootic and support in situ evolution of YFV between the 1979 and 1988-1989 Trinidad epizootics. Using the same phylogeographic approach, we also inferred the historical spread of YFV in the Americas. The results suggest a Brazilian origin for YFV in the Americas and an overall dispersal rate of 182 km/year (95% HPD, 52 to 462 km/year), with Brazil as the major source population for surrounding countries. There is also strong statistical support for epidemiological links between four Brazilian regions and other countries. In contrast, while there were well-supported epidemiological links within Peru, the only statistically supported external link was a relatively weak link with neighboring Bolivia. Lastly, we performed a complete analysis of the genome of a newly sequenced Trinidad 2009 isolate, the first complete genome for a genotype I YFV isolate.

  3. Stigma in response to mental disorders: a comparison of Australia and Japan

    PubMed Central

    Griffiths, Kathleen M; Nakane, Yoshibumi; Christensen, Helen; Yoshioka, Kumiko; Jorm, Anthony F; Nakane, Hideyuki

    2006-01-01

    Background There are few national or cross-cultural studies of the stigma associated with mental disorders. Australia and Japan have different systems of psychiatric health care, and distinct differences in cultural values, but enjoy similar standards of living. This study seeks to compare the nature and extent of stigma among the public in the two countries. Methods A household survey of the public was conducted in each country using similar methodologies. The Australian study comprised a national survey of 3998 adults aged over 18 years. The Japanese survey involved 2000 adults aged 20 to 69 from 25 regional sites distributed across the country. Interviewees reported their personal attitudes (personal stigma, social distance) and perceptions of the attitudes of others (perceived stigma, perceived discrimination) in the community with respect to four case vignettes. These vignettes described a person with: depression; depression with suicidal ideation; early schizophrenia; and chronic schizophrenia. Results Personal stigma and social distance were typically greater among the Japanese than the Australian public whereas the reverse was true with respect to the perception of the attitudes and discriminatory behaviour of others. In both countries, personal stigma was significantly greater than perceived stigma. The public in both countries showed evidence of greater social distance, greater personal stigma and greater perceived stigma for schizophrenia (particularly in its chronic form) than for depression. There was little evidence of a difference in stigma for depression with and without suicide for either country. However, social distance was greater for chronic compared to early schizophrenia for the Australian public. Conclusion Stigmatising attitudes were common in both countries, but negative attitudes were greater among the Japanese than the Australian public. The results suggest that there is a need to implement national public awareness interventions tailored to the needs of each country. The current results provide a baseline for future tracking of national stigma levels in each country. PMID:16716231

  4. Prevalence of metastasis at diagnosis of osteosarcoma: an international comparison

    PubMed Central

    Marko, Tracy A.; Diessner, Brandon J.; Spector, Logan G.

    2016-01-01

    Background Osteosarcoma is the most common primary malignant bone tumor in many countries, with metastatic disease responsible for most patient deaths. This study compares the prevalence of metastatic osteosarcoma at diagnosis across countries to inform the critical question of whether diagnostic delay or tumor biology drives metastases development prior to diagnosis. Procedure A literature search of the PubMed database was conducted to compare the prevalence of metastatic disease at the time of OS diagnosis between countries. A pooled prevalence with 95% confidence intervals was calculated for each study meeting inclusion criteria. Studies were grouped for analysis based on human development index (HDI) scores. Results Our analysis found an 18% (95% CI: 15%, 20%) average global pooled proportion of metastasis at osteosarcoma diagnosis. The average prevalence of metastasis at diagnosis increased as HDI groupings decreased, with very high HDI, high HDI, and medium/ low HDI groups found to be 15% (95% CI: 13%, 17%), 20% (95% CI: 14%, 28%), and 31% (95% CI: 15%, 52%), respectively. Conclusions Our evidence suggests there is a biological baseline for metastatic OS at diagnosis, which is observed in countries with very high HDI. In countries with medium/ low HDI, where there are more barriers to accessing healthcare, the higher prevalence of metastasis may result from treatment delay or an artificial prevalence inflation due to patients with less severe symptoms not presenting to clinic. Additional research in countries with medium/ low HDI may reveal that earlier detection and treatment could improve patient outcomes in those countries. PMID:26929018

  5. Bayesian probabilistic population projections for all countries

    PubMed Central

    Raftery, Adrian E.; Li, Nan; Ševčíková, Hana; Gerland, Patrick; Heilig, Gerhard K.

    2012-01-01

    Projections of countries’ future populations, broken down by age and sex, are widely used for planning and research. They are mostly done deterministically, but there is a widespread need for probabilistic projections. We propose a Bayesian method for probabilistic population projections for all countries. The total fertility rate and female and male life expectancies at birth are projected probabilistically using Bayesian hierarchical models estimated via Markov chain Monte Carlo using United Nations population data for all countries. These are then converted to age-specific rates and combined with a cohort component projection model. This yields probabilistic projections of any population quantity of interest. The method is illustrated for five countries of different demographic stages, continents and sizes. The method is validated by an out of sample experiment in which data from 1950–1990 are used for estimation, and applied to predict 1990–2010. The method appears reasonably accurate and well calibrated for this period. The results suggest that the current United Nations high and low variants greatly underestimate uncertainty about the number of oldest old from about 2050 and that they underestimate uncertainty for high fertility countries and overstate uncertainty for countries that have completed the demographic transition and whose fertility has started to recover towards replacement level, mostly in Europe. The results also indicate that the potential support ratio (persons aged 20–64 per person aged 65+) will almost certainly decline dramatically in most countries over the coming decades. PMID:22908249

  6. National support to public health research: a survey of European ministries.

    PubMed

    Conceição, Cláudia; Leandro, Alexandra; McCarthy, Mark

    2009-06-25

    Within SPHERE (Strengthening Public Health Research in Europe), a collaborative study funded by the European Commission, we have assessed the support for public health research at ministry level in European countries. We surveyed the health and science ministries in 25 EU countries and 3 EEA countries, using a broad definition of public-health research at population level. We made over 600 phone calls and emails to identify respondents and to gain answers. We gained formal replies from 42 out of 56 ministries (73% response) in 25 countries. There were 22 completed questionnaires (from 25 ministries), 6 short answers and 11 contacts declaring that their ministries were not responsible for public health research, while in 14 ministries (both ministries in three countries) no suitable ministry contact could be found. In most European countries, ministries of health, or their devolved agencies, were regarded as the leading organizations. Most ministries were able to specify thematic areas for public-health research (from three to thirty), and others ministries referred to policy documents, health plans or public-health plans to define research priorities. Ministries and their agencies led on decisions for financial support of public-health research, with less involvement of other external organisations compared with the process of identifying priorities. However, the actual funds available for public health were not easily identifiable. Most ministries relied on general academic means for dissemination of results of public-health research, while ministries get information on the use of public-health research usually through informal means. Ministries made suggestions for strengthening public-health research through initiatives of their own countries and of the European Union: as well as more resources, improving coordination was most frequently suggested. There is no common approach to support for public-health research across Europe, and significant gaps in organisation and funding. Health ministries and national agencies value exchange between researchers and policy-makers, civil society organizations, and academic and public authorities, and the application of public-health research results. There would be benefits from better processes of priority setting and improved coordination for research, at regional, national and European levels.

  7. Rehabilitation of landmine victims--the ultimate challenge.

    PubMed Central

    Walsh, Nicolas E.; Walsh, Wendy S.

    2003-01-01

    Antipersonnel landmines are often used indiscriminately and frequently result in injury or death of non-combatants. In the last 65 years, over 110 million mines have been spread throughout the world into an estimated 70 countries. Landmine victims use a disproportionately high amount of medical resources; the vast majority of incidents occur in regions and countries without a sophisticated medical infrastructure and with limited resources, where rehabilitation is difficult in the best of circumstances. It is suggested that only a quarter of the patients with amputation secondary to landmines receive appropriate care. PMID:14710508

  8. Trends and affordability of cigarette prices: ample room for tax increases and related health gains

    PubMed Central

    Guindon, G; Tobin, S; Yach, D

    2002-01-01

    Objectives: To compare cigarette price data from more than 80 countries using varying methods, examine trends in prices and affordability during the 1990s, and explore various policy implications pertaining to tobacco prices. Design: March 2001 cigarette price data from the Economist Intelligence Unit are used to compare cigarette prices across countries. To facilitate comparison and to assess affordability, prices are presented in US dollars, purchasing power parity (PPP) units using the Big Mac index as an indicator of PPP and in terms of minutes of labour required to purchase a pack of cigarettes. Annual real percentage changes in cigarette prices between 1990 and 2000 and annual changes in the minutes of labour required to buy cigarettes between 1991 and 2000 are also calculated to examine trends. Results: Cigarette prices tend to be higher in wealthier countries and in countries that have strong tobacco control programmes. On the other hand, minutes of labour required to purchase cigarettes vary vastly between countries. Trends between 1990 and 2000 in real prices and minutes of labour indicate, with some exceptions, that cigarettes have become more expensive in most developed countries but more affordable in many developing countries. However, in the UK, despite recent increases in price, cigarettes are still more affordable than they were in the 1960s. Conclusions: The results suggest that there is ample room to increase tobacco prices through taxation. In too many countries, cigarette prices have failed to keep up with increases in the general price level of goods and services, rendering them more affordable in 2000 than they were at the beginning of the decade. Opportunities to increase government revenue and improve health through reduced consumption brought about by higher prices have been overlooked in many countries. PMID:11891366

  9. Education Modifies the Association of Wealth with Obesity in Women in Middle-Income but Not Low-Income Countries: An Interaction Study Using Seven National Datasets, 2005-2010

    PubMed Central

    Aitsi-Selmi, Amina; Bell, Ruth; Shipley, Martin J.; Marmot, Michael G.

    2014-01-01

    Background Education and wealth may have different associations with female obesity but this has not been investigated in detail outside high-income countries. This study examines the separate and inter-related associations of education and household wealth in relation to obesity in women in a representative sample of low- and middle-income countries (LMICs). Methods The seven largest national surveys were selected from a list of Demographic and Health Surveys (DHS) ordered by decreasing sample size and resulted in a range of country income levels. These were nationally representative data of women aged 15–49 years collected in the period 2005–2010. The separate and joint effects, unadjusted and adjusted for age group, parity, and urban/rural residence using a multivariate logistic regression model are presented Results In the four middle-income countries (Colombia, Peru, Jordan, and Egypt), an interaction was found between education and wealth on obesity (P-value for interaction <0.001). Among women with no/primary education the wealth effect was positive whereas in the group with higher education it was either absent or inverted (negative). In the poorer countries (India, Nigeria, Benin), there was no evidence of an interaction. Instead, the associations between each of education and wealth with obesity were independent and positive. There was a statistically significant difference between the average interaction estimates for the low-income and middle-income countries (P<0.001). Conclusions The findings suggest that education may protect against the obesogenic effects of increased household wealth as countries develop. Further research could examine the factors explaining the country differences in education effects. PMID:24608086

  10. Multisource drug policies in Latin America: survey of 10 countries.

    PubMed Central

    Homedes, Núria; Ugalde, Antonio

    2005-01-01

    Essential drug lists and generic drug policies have been promoted as strategies to improve access to pharmaceuticals and control their rapidly escalating costs. This article reports the results of a preliminary survey conducted in 10 Latin American countries. The study aimed to document the experiences of different countries in defining and implementing generic drug policies, determine the cost of registering different types of pharmaceutical products and the time needed to register them, and uncover the incentives governments have developed to promote the use of multisource drugs. The survey instrument was administered in person in Chile, Ecuador and Peru and by email in Argentina, Brazil, Bolivia, Colombia, Costa Rica, Nicaragua and Uruguay. There was a total of 22 respondents. Survey responses indicated that countries use the terms generic and bioequivalence differently. We suggest there is a need to harmonize definitions and technical concepts. PMID:15682251

  11. Capacity Building in Global Mental Health: Professional Training

    PubMed Central

    Fricchione, Gregory L; Borba, Christina P C; Alem, Atalay; Shibre, Teshome; Carney, Julia R; Henderson, David C

    2012-01-01

    We suggest that the optimal approach to building capacity in global mental health care will require partnerships between professional resources in high-income countries and promising health-related institutions in low- and middle-income countries. The result of these partnerships will be sustainable academic relationships that can educate a new generation of in-country primary care physicians and, eventually, specialized health professionals. Research capabilities will be an essential educational component to inform policy and practice, and to ensure careful outcome measurements of training and of intervention, prevention, and promotion strategies. The goal of these academic centers of excellence will be to develop quality, in-country clinical and research professionals, and to build a productive environment for these professionals to advance their careers locally. In sum, this article discusses human capacity building in global mental health, provides recommendations for training, and offers examples of recent initiatives. (Harv Rev Psychiatry 2012;20:47–57.) PMID:22335182

  12. A country that never had a BSE crisis: consensus and tensions in transforming the Norwegian food system.

    PubMed

    Terragni, Laura

    2006-09-01

    Norway is often described as a country where the safety of domestically produced food is not questioned and where there is a prevailing consensus about the division of responsibility for food safety. For this reason it was surprising to find that Norwegian consumers trust the safety of their meat less than do their British counterparts. This result is particularly interesting, as Norway is one of the few countries that has never experienced BSE, while Britain has been the country most affected by it. The data discussed in the article suggest that not having to cope with a BSE crisis meant that some problems within the Norwegian food safety system remained unresolved. This in turn has affected patterns of consumer trust. The article is based on the data collected for a comparative study on European consumers' confidence in food safety.

  13. Enhancing the comparability of costing methods: cross-country variability in the prices of non-traded inputs to health programmes

    PubMed Central

    Johns, Benjamin; Adam, Taghreed; Evans, David B

    2006-01-01

    Background National and international policy makers have been increasing their focus on developing strategies to enable poor countries achieve the millennium development goals. This requires information on the costs of different types of health interventions and the resources needed to scale them up, either singly or in combinations. Cost data also guides decisions about the most appropriate mix of interventions in different settings, in view of the increasing, but still limited, resources available to improve health. Many cost and cost-effectiveness studies include only the costs incurred at the point of delivery to beneficiaries, omitting those incurred at other levels of the system such as administration, media, training and overall management. The few studies that have measured them directly suggest that they can sometimes account for a substantial proportion of total costs, so that their omission can result in biased estimates of the resources needed to run a programme or the relative cost-effectiveness of different choices. However, prices of different inputs used in the production of health interventions can vary substantially within a country. Basing cost estimates on a single price observation runs the risk that the results are based on an outlier observation rather than the typical costs of the input. Methods We first explore the determinants of the observed variation in the prices of selected "non-traded" intermediate inputs to health programmes – printed matter and media advertising, and water and electricity – accounting for variation within and across countries. We then use the estimated relationship to impute average prices for countries where limited data are available with uncertainty intervals. Results Prices vary across countries with GDP per capita and a number of determinants of supply and demand. Media and printing were inelastic with respect to GDP per capita, with a positive correlation, while the utilities had a surprisingly negative relationship. All equations had relatively good fits with the data. Conclusion While the preferred option is to derive costs from a random sample of prices in each setting, this option is often not available to analysts. In this case, we suggest that the approach described in this paper could represent a better option than basing policy recommendations on results that are built on the basis of a single, or a few, price observations. PMID:16630364

  14. Quantitative relations between corruption and economic factors

    NASA Astrophysics Data System (ADS)

    Shao, Jia; Ivanov, Plamen Ch.; Podobnik, Boris; Stanley, H. Eugene

    2007-03-01

    We report quantitative relations between corruption level and economic factors, such as country wealth and foreign investment per capita, which are characterized by a power law spanning multiple scales of wealth and investment per capita. These relations hold for diverse countries, and also remain stable over different time periods. We also observe a negative correlation between level of corruption and long-term economic growth. We find similar results for two independent indices of corruption, suggesting that the relation between corruption and wealth does not depend on the specific measure of corruption. The functional relations we report have implications when assessing the relative level of corruption for two countries with comparable wealth, and for quantifying the impact of corruption on economic growth and foreign investment.

  15. Wastage in the health workforce: some perspectives from African countries

    PubMed Central

    Dovlo, Delanyo

    2005-01-01

    Background Sub-Saharan Africa faces a human resources crisis in the health sector. Over the past two decades its population has increased substantially, with a significant rise in the disease burden due to HIV/AIDS and recurrent communicable diseases and an increased incidence of noncommunicable diseases. This increased demand for health services is met with a rather low supply of health workers, but this notwithstanding, sub-Saharan African countries also experience significant wastage of their human resources stock. Methods This paper is a desk review to illustrate suggestions that the way human resources for health (HRH) are trained and deployed in Africa does not enhance productivity and that countries are unable to realize the full potential expected from the working life of their health workers. The paper suggests data types for use in measuring various forms of "wastage". Results "Direct" wastage – or avoidable increases in loss of staff through factors such as emigration and death – is on the rise, perhaps as a result of the HIV/AIDS epidemic. "Indirect" wastage – which is the result of losses in output and productivity from health professionals' misapplied skills, absenteeism, poor support and lack of supervision – is also common. HIV/AIDS represents a special cause of wastage in Africa. Deaths of health workers, fear of infection, burnout, absenteeism, heavy workloads and stress affect productivity. Conclusion The paper reviews strategies that have been proposed and/or implemented. It suggests areas needing further attention, including: developing and using indicators for monitoring and managing wastage; enhancing motivation and morale of health workers; protecting and valuing the health worker with enhanced occupational safety and welfare systems; and establishing the moral leadership to effectively tackle HIV/AIDS and the brain drain. PMID:16092964

  16. Taxonomic and Phylogenetic Determinants of Functional Composition of Bolivian Bat Assemblages

    PubMed Central

    Aguirre, Luis F.; Montaño-Centellas, Flavia A.; Gavilanez, M. Mercedes; Stevens, Richard D.

    2016-01-01

    Understanding diversity patterns and the potential mechanisms driving them is a fundamental goal in ecology. Examination of different dimensions of biodiversity can provide insights into the relative importance of different processes acting upon biotas to shape communities. Unfortunately, patterns of diversity are still poorly understood in hyper-diverse tropical countries. Here, we assess spatial variation of taxonomic, functional and phylogenetic diversity of bat assemblages in one of the least studied Neotropical countries, Bolivia, and determine whether changes in biodiversity are explained by the replacement of species or functional groups, or by differences in richness (i.e., gain or loss of species or functional groups). Further, we evaluate the contribution of phylogenetic and taxonomic changes in the resulting patterns of functional diversity of bats. Using well-sampled assemblages from published studies we examine noctilionoid bats at ten study sites across five ecoregions in Bolivia. Bat assemblages differed from each other in all dimensions of biodiversity considered; however, diversity patterns for each dimension were likely structured by different mechanisms. Within ecoregions, differences were largely explained by species richness, suggesting that the gain or loss of species or functional groups (as opposed to replacement) was driving dissimilarity patterns. Overall, our results suggest that whereas evolutionary processes (i.e., historical connection and dispersal routes across Bolivia) create a template of diversity patterns across the country, ecological mechanisms modify these templates, decoupling the observed patterns of functional, taxonomic and phylogenetic diversity in Bolivian bats. Our results suggests that elevation represents an important source of variability among diversity patterns for each dimension of diversity considered. Further, we found that neither phylogenetic nor taxonomic diversity can fully account for patterns of functional diversity, highlighting the need for examining different dimensions of biodiversity of bats in hyperdiverse ecosystems. PMID:27384441

  17. Taxonomic and Phylogenetic Determinants of Functional Composition of Bolivian Bat Assemblages.

    PubMed

    Aguirre, Luis F; Montaño-Centellas, Flavia A; Gavilanez, M Mercedes; Stevens, Richard D

    2016-01-01

    Understanding diversity patterns and the potential mechanisms driving them is a fundamental goal in ecology. Examination of different dimensions of biodiversity can provide insights into the relative importance of different processes acting upon biotas to shape communities. Unfortunately, patterns of diversity are still poorly understood in hyper-diverse tropical countries. Here, we assess spatial variation of taxonomic, functional and phylogenetic diversity of bat assemblages in one of the least studied Neotropical countries, Bolivia, and determine whether changes in biodiversity are explained by the replacement of species or functional groups, or by differences in richness (i.e., gain or loss of species or functional groups). Further, we evaluate the contribution of phylogenetic and taxonomic changes in the resulting patterns of functional diversity of bats. Using well-sampled assemblages from published studies we examine noctilionoid bats at ten study sites across five ecoregions in Bolivia. Bat assemblages differed from each other in all dimensions of biodiversity considered; however, diversity patterns for each dimension were likely structured by different mechanisms. Within ecoregions, differences were largely explained by species richness, suggesting that the gain or loss of species or functional groups (as opposed to replacement) was driving dissimilarity patterns. Overall, our results suggest that whereas evolutionary processes (i.e., historical connection and dispersal routes across Bolivia) create a template of diversity patterns across the country, ecological mechanisms modify these templates, decoupling the observed patterns of functional, taxonomic and phylogenetic diversity in Bolivian bats. Our results suggests that elevation represents an important source of variability among diversity patterns for each dimension of diversity considered. Further, we found that neither phylogenetic nor taxonomic diversity can fully account for patterns of functional diversity, highlighting the need for examining different dimensions of biodiversity of bats in hyperdiverse ecosystems.

  18. Tropical countries may be willing to pay more to protect their forests

    PubMed Central

    Vincent, Jeffrey R.; Carson, Richard T.; DeShazo, J. R.; Schwabe, Kurt A.; Ahmad, Ismariah; Chong, Siew Kook; Chang, Yii Tan; Potts, Matthew D.

    2014-01-01

    Inadequate funding from developed countries has hampered international efforts to conserve biodiversity in tropical forests. We present two complementary research approaches that reveal a significant increase in public demand for conservation within tropical developing countries as those countries reach upper-middle-income (UMI) status. We highlight UMI tropical countries because they contain nearly four-fifths of tropical primary forests, which are rich in biodiversity and stored carbon. The first approach is a set of statistical analyses of various cross-country conservation indicators, which suggests that protective government policies have lagged behind the increase in public demand in these countries. The second approach is a case study from Malaysia, which reveals in a more integrated fashion the linkages from rising household income to increased household willingness to pay for conservation, nongovernmental organization activity, and delayed government action. Our findings suggest that domestic funding in UMI tropical countries can play a larger role in (i) closing the funding gap for tropical forest conservation, and (ii) paying for supplementary conservation actions linked to international payments for reduced greenhouse gas emissions from deforestation and forest degradation in tropical countries. PMID:24982171

  19. Income, egalitarianism and attitudes towards healthcare policy: a study on public attitudes in 29 countries.

    PubMed

    Azar, A; Maldonado, L; Castillo, J C; Atria, J

    2018-01-01

    To evaluate the relationship between income and egalitarian values and attitudes towards healthcare policy. Cross-sectional and cross-national study. Data for 29 countries from the International Social Survey Programme (ISSP) 2011 were used. The dependent variables are a general attitude towards government involvement in healthcare provision and two attitudes regarding specific policies (taxes and public funding). Income and egalitarianism were also measured by using ISSP. Data were analysed using regression models that account for individual and country-level characteristics, and country-fixed effects. The effect of income is small and non-significant for attitudes towards government involvement and public funding. For willingness to pay (WTP) taxes to improve healthcare services, we find a positive association with income. Results for egalitarianism suggest a positive association with government involvement in healthcare provision and significant interactions with WTP taxes. The distinction of dimensions and mechanisms underlying policy attitudes appears as relevant. Citizens across socioeconomic groups are motivated to support state-funded healthcare, favouring the design of non-selfish policies. These findings suggest that there is space for policymakers who seek to increase healthcare spending encouraging either policies for specific groups or broader institutional changes. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Improved nonhuman animal welfare is related more to income equality than it is to income.

    PubMed

    Morris, Michael C

    2013-01-01

    The link between nonhuman animal welfare, income, and income inequality (Gini coefficient) was tested using consumption of animal products, laws protecting animals on the farm from the worst abuses, and animals used in experimentation as indicators. Experimentation on all animals and on rodents significantly increased in high-income European countries, although there was some evidence that the increase in experimentation on cats and dogs started to flatten out for the highest income countries. Consumption of all flesh products in high-income countries declined in more equal societies. More equal high-income countries also had stricter regulations protecting animals, although the same correlation was not seen between U.S. states. In New Zealand, there was some evidence that testing on cats and dogs declined during years when equality was improving. The results provide little evidence for a Kuznets effect of income on animal welfare, with the possible exception of companion animal treatment. They do, however, suggest that greater equality can be a predictor for better treatment of animals. Previous research has strongly suggested that social conditions for humans improve with greater equality. The same may be true for nonhuman animals. Alternatively, conditions conducive to improving human income equality may also lead to better animal welfare outcomes.

  1. HIV risk behaviors among female IDUs in developing and transitional countries

    PubMed Central

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

    2007-01-01

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

  2. Estimating dead wood during national forest inventories: a review of inventory methodologies and suggestions for harmonization.

    PubMed

    Woodall, Christopher W; Rondeux, Jacques; Verkerk, Pieter J; Ståhl, Göran

    2009-10-01

    Efforts to assess forest ecosystem carbon stocks, biodiversity, and fire hazards have spurred the need for comprehensive assessments of forest ecosystem dead wood (DW) components around the world. Currently, information regarding the prevalence, status, and methods of DW inventories occurring in the world's forested landscapes is scattered. The goal of this study is to describe the status, DW components measured, sample methods employed, and DW component thresholds used by national forest inventories that currently inventory DW around the world. Study results indicate that most countries do not inventory forest DW. Globally, we estimate that about 13% of countries inventory DW using a diversity of sample methods and DW component definitions. A common feature among DW inventories was that most countries had only just begun DW inventories and employ very low sample intensities. There are major hurdles to harmonizing national forest inventories of DW: differences in population definitions, lack of clarity on sample protocols/estimation procedures, and sparse availability of inventory data/reports. Increasing database/estimation flexibility, developing common dimensional thresholds of DW components, publishing inventory procedures/protocols, releasing inventory data/reports to international peer review, and increasing communication (e.g., workshops) among countries inventorying DW are suggestions forwarded by this study to increase DW inventory harmonization.

  3. Health problems of Nepalese migrants working in three Gulf countries

    PubMed Central

    2011-01-01

    Background Nepal is one of the largest suppliers of labour to countries where there is a demand for cheap and low skilled workers. In the recent years the Gulf countries have collectively become the main destinations for international migration. This paper aims to explore the health problems and accidents experienced by a sample of Nepalese migrant in three Gulf countries. Methods A cross-sectional survey was conducted among 408 Nepalese migrants who had at least one period of work experience of at least six months in any of three Gulf countries: Qatar, Saudi Arabia and United Arab Emirates (UAE). Face to face questionnaire interviews were conducted applying a convenience technique to select the study participants. Results Nepalese migrants in these Gulf countries were generally young men between 26-35 years of age. Unskilled construction jobs including labourer, scaffolder, plumber and carpenter were the most common jobs. Health problems were widespread and one quarter of study participants reported experiencing injuries or accidents at work within the last 12 months. The rates of health problems and accidents reported were very similar in the three countries. Only one third of the respondents were provided with insurance for health services by their employer. Lack of leave for illness, cost and fear of losing their job were the barriers to accessing health care services. The study found that construction and agricultural workers were more likely to experience accidents at their workplace and health problems than other workers. Conclusion The findings suggest important messages for the migration policy makers in Nepal. There is a lack of adequate information for the migrants making them aware of their health risks and rights in relation to health services in the destination countries and we suggest that the government of Nepal should be responsible for providing this information. Employers should provide orientation on possible health risks and appropriate training for preventive measures and all necessary access to health care services to all their workers. PMID:21443802

  4. Essays on electricity theft

    NASA Astrophysics Data System (ADS)

    Steadman, Keva Ullanda

    Electricity theft is a relatively unknown crime with high economic costs. In this dissertation, I try to identify the factors that motivate persons to steal electricity. First, I use a panel dataset of 97 countries spanning the five year period 2003--2007 to estimate a model that describes the effect of the unemployment rate, GDP per capita, male population and urbanization on theft, robbery and homicide rates. The results are consistent with previous empirical work on crime and economic opportunity. The second and main contribution of this paper is to estimate the same model using distribution loss as a proxy for electricity theft. The results show that the unemployment rate, a key explanatory economic factor for crime, cannot explain variation in electricity theft, although there is some evidence, albeit weak, supporting correlation in rich countries. Therefore, policies that target the reduction of property crime through a reduction in unemployment will have no effect on electricity theft. The third contribution relates to the role that political institutions play in the incentives to steal electricity. After control for socioeconomic factors, I find that there is no relationship between political governance indicators and electricity theft. In the second and third chapters, I compare the United States, a high income, low electricity theft country with Jamaica, a middle income, high electricity theft country. The effect of unemployment on electricity theft mirrors the results found in the first chapter. In the United States, electricity theft is affected by changes in economic conditions but in Jamaica, it is not. These results suggest that the state of institutions plays a role in how social norms are determined. Poor countries will be more likely than rich countries to have weak institutions with social norms that encourage electricity theft.

  5. Exploring the relationship between convenience and fish consumption: a cross-cultural study.

    PubMed

    Olsen, Svein Ottar; Scholderer, Joachim; Brunsø, Karen; Verbeke, Wim

    2007-07-01

    The purpose of the present study is to explore cultural differences in the meaning of convenience and the relationships between convenience, attitudes and fish consumption in five European countries. The results suggest that the meaning of meal convenience is not culture specific, whilst the absolute levels of convenience orientation and the perceived inconvenience of fish differ between cultures. Convenience orientation was highest in Poland, followed by Spain, and was lowest in the Netherlands. The relationships between convenience orientation and attitudes towards fish, and convenience orientation and fish consumption, were insignificant in most countries. However, convenience orientation was positively related to the perceived inconvenience of fish. Perceived inconvenience of fish was negatively related to both attitudes towards fish and to fish consumption. Together, these results confirm some earlier findings that fish is generally perceived as a relatively inconvenient type of food. This study suggests that convenience orientation can be crucial to understanding food choice or behaviour only when critical mediating constructs are explored.

  6. Developing integrated patient pathways using hybrid simulation

    NASA Astrophysics Data System (ADS)

    Zulkepli, Jafri; Eldabi, Tillal

    2016-10-01

    Integrated patient pathways includes several departments, i.e. healthcare which includes emergency care and inpatient ward; intermediate care which patient(s) will stay for a maximum of two weeks and at the same time be assessed by assessment team to find the most suitable care; and social care. The reason behind introducing the intermediate care in western countries was to reduce the rate of patients that stays in the hospital especially for elderly patients. This type of care setting has been considered to be set up in some other countries including Malaysia. Therefore, to assess the advantages of introducing this type of integrated healthcare setting, we suggest develop the model using simulation technique. We argue that single simulation technique is not viable enough to represent this type of patient pathways. Therefore, we suggest develop this model using hybrid techniques, i.e. System Dynamics (SD) and Discrete Event Simulation (DES). Based on hybrid model result, we argued that the result is viable to be as references for decision making process.

  7. The risk of female genital cutting in Europe: Comparing immigrant attitudes toward uncut girls with attitudes in a practicing country.

    PubMed

    Vogt, Sonja; Efferson, Charles; Fehr, Ernst

    2017-12-01

    Worldwide, an estimated 200 million girls and women have been subjected to female genital cutting. Female genital cutting is defined as an intentional injury to the female genitalia without medical justification. The practice occurs in at least 29 countries in Africa, the Middle East, and Asia. In addition, globalization and migration have brought immigrants from countries where cutting is commonly practiced to countries where cutting is not traditionally practiced and may even be illegal. In countries receiving immigrants, governments and development agencies would like to know if girls with parents who immigrated from practicing countries are at risk of being cut. Risk assessments, for example, could help governments identify the need for programs promoting the abandonment of cutting among immigrants. Extrapolating from the prevalence and incidence rates in practicing countries, however, is generally not sufficient to guarantee a valid estimate of risk in immigrant populations. In particular, immigrants might differ from their counterparts in the country of origin in terms of attitudes toward female genital cutting. Attitudes can differ because migrants represent a special sample of people from the country of origin or because immigrants acculturate after arriving in a new country. To examine these possibilities, we used a fully anonymous, computerized task to elicit implicit attitudes toward female genital cutting among Sudanese immigrants living in Switzerland and Sudanese people in Sudan. Results show that Sudanese immigrants in Switzerland were significantly more positive about uncut girls than Sudanese in Sudan, and that selective migration out of Sudan likely contributed substantially to this difference. We conclude by suggesting how our method could potentially be coupled with recent efforts to refine extrapolation methods for estimating cutting risk among immigrant populations. More broadly, our results highlight the need to better understand how heterogeneous attitudes can affect the risk of cutting among immigrant communities and in countries of origin.

  8. Variation in Educational Outcomes and Policies across Countries and of Schools within Countries. NBER Working Paper No. 16293

    ERIC Educational Resources Information Center

    Freeman, Richard B.; Machin, Stephen; Viarengo, Martina

    2010-01-01

    This study examines the variation in educational outcomes across and within countries using the TIMSS mathematics tests. It documents the wide cross-country variation in the level and dispersion of test scores. Countries with the highest test scores are those with the least inequality in scores, which suggests a "virtuous" equity-efficiency…

  9. Mental health research priorities in low- and middle-income countries of Africa, Asia, Latin America and the Caribbean.

    PubMed

    Sharan, P; Gallo, C; Gureje, O; Lamberte, E; Mari, J J; Mazzotti, G; Patel, V; Swartz, L; Olifson, S; Levav, I; de Francisco, A; Saxena, S

    2009-10-01

    Studies suggest a paucity of and lack of prioritisation in mental health research from low- and middle-income (LAMI) countries. To investigate research priorities in mental health among researchers and other stakeholders in LAMI countries. We used a two-stage design that included identification, through literature searches and snowball technique, of researchers and stakeholders in 114 countries of Africa, Asia, Latin America and the Caribbean; and a mail survey on priorities in research. The study identified broad agreement between researchers and stakeholders and across regions regarding research priorities. Epidemiology (burden and risk factors), health systems and social science ranked highest for type of research. Depression/anxiety, substance use disorders and psychoses; and children and adolescents, women, and people exposed to violence/trauma were prioritised among the disorders and population groups respectively. Important criteria for prioritising research were burden of disease, social justice, and availability of funds. Stakeholder groups differed in the importance they gave to the personal interest of researchers as a criterion for prioritising research. Researchers' and stakeholders' priorities were consistent with burden of disease estimates, however suicide was underprioritised compared with its burden. Researchers' and stakeholders' priorities were also largely congruent with the researchers' projects. The results of this first ever conducted survey of researchers and stakeholders regarding research priorities in mental health suggest that it should be possible to develop consensus at regional and international levels regarding the research agenda that is necessary to support health system objectives in LAMI countries.

  10. Oral health and welfare state regimes: a cross-national analysis of European countries.

    PubMed

    Guarnizo-Herreño, Carol C; Tsakos, Georgios; Sheiham, Aubrey; Watt, Richard G

    2013-06-01

    Very little is known about the potential relationship between welfare state regimes and oral health. This study assessed the oral health of adults in a range of European countries clustered by welfare regimes according to Ferrera's typology and the complementary Eastern type. We analysed data from Eurobarometer wave 72.3, a cross-sectional survey of 31 European countries carried out in 2009. We evaluated three self-reported oral health outcomes: edentulousness, no functional dentition (<20 natural teeth), and oral impacts on daily living. Age-standardized prevalence rates were estimated for each country and for each welfare state regime. The Scandinavian regime showed lower prevalence rates for all outcomes. For edentulousness and no functional dentition, there were higher prevalence rates in the Eastern regime but no significant differences between Anglo-Saxon, Bismarckian, and Southern regimes. The Southern regime presented a higher prevalence of oral impacts on daily living. Results by country indicated that Sweden had the lowest prevalences for edentulousness and no functional dentition, and Denmark had the lowest prevalence for oral impacts. The results suggest that Scandinavian welfare states, with more redistributive and universal welfare policies, had better population oral health. Future research should provide further insights about the potential mechanisms through which welfare-state regimes would influence oral health. © 2013 Eur J Oral Sci.

  11. Oral health and welfare state regimes: a cross-national analysis of European countries

    PubMed Central

    Guarnizo-Herreño, Carol C; Tsakos, Georgios; Sheiham, Aubrey; Watt, Richard G

    2013-01-01

    Very little is known about the potential relationship between welfare state regimes and oral health. This study assessed the oral health of adults in a range of European countries clustered by welfare regimes according to Ferrera's typology and the complementary Eastern type. We analysed data from Eurobarometer wave 72.3, a cross-sectional survey of 31 European countries carried out in 2009. We evaluated three self-reported oral health outcomes: edentulousness, no functional dentition (<20 natural teeth), and oral impacts on daily living. Age-standardized prevalence rates were estimated for each country and for each welfare state regime. The Scandinavian regime showed lower prevalence rates for all outcomes. For edentulousness and no functional dentition, there were higher prevalence rates in the Eastern regime but no significant differences between Anglo-Saxon, Bismarckian, and Southern regimes. The Southern regime presented a higher prevalence of oral impacts on daily living. Results by country indicated that Sweden had the lowest prevalences for edentulousness and no functional dentition, and Denmark had the lowest prevalence for oral impacts. The results suggest that Scandinavian welfare states, with more redistributive and universal welfare policies, had better population oral health. Future research should provide further insights about the potential mechanisms through which welfare-state regimes would influence oral health. PMID:23659239

  12. The role of private health providers in HIV testing: analysis of data from 18 countries.

    PubMed

    Johnson, Doug; Cheng, Xi

    2014-05-12

    HIV testing and counseling is a critical component of the overall response to the HIV epidemic in low and middle income countries. To date, little attention has been paid to the role of private for-profit providers in HIV testing. We use data from Demographic and Health Surveys and AIDS Indicators Surveys to explore the extent to which this sector provides HIV testing in 18 developing countries. We find that use of the private sector for HIV testing varies significantly by country, with private for-profit providers playing a significant role in some countries and a relatively minor one in others. At the country level, use of private providers for HIV testing is correlated with use of private providers for other health services yet, in many countries, significant differences between use of the private sector for HIV testing and other services exist. Within countries, we find that wealth is strongly associated with use of the private sector for HIV testing in most countries, but the relative socio-economic profile of clients who receive an HIV test from a private provider varies considerably across countries. On the one measure of quality to which we have access, reported adherence to antenatal care testing guidelines, there are no statistically significant differences in performance between public and private for-profit providers in most countries after controlling for wealth. These results suggest that strategies for supervising and engaging private health providers with regard to HIV testing should be country specific and take into account local context.

  13. Diaspora engagement of African migrant health workers - examples from five destination countries.

    PubMed

    Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth

    2015-01-01

    Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals.

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

    PubMed Central

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

    2014-01-01

    Objective To develop a model of the psychological factors which predict people’s intention to adopt personalised nutrition. Potential determinants of adoption included perceived risk and benefit, perceived self-efficacy, internal locus of control and health commitment. Methods A questionnaire, developed from exploratory study data and the existing theoretical literature, and including validated psychological scales was administered to N = 9381 participants from 9 European countries (Germany, Greece, Ireland, Poland, Portugal, Spain, the Netherlands, the UK, and Norway). Results Structural equation modelling indicated that the greater participants’ perceived benefits to be associated with personalised nutrition, the more positive their attitudes were towards personalised nutrition, and the greater their intention to adopt it. Higher levels of nutrition self-efficacy were related to more positive attitudes towards, and a greater expressed intention to adopt, personalised nutrition. Other constructs positively impacting attitudes towards personalised nutrition included more positive perceptions of the efficacy of regulatory control to protect consumers (e.g. in relation to personal data protection), higher self-reported internal health locus of control, and health commitment. Although higher perceived risk had a negative relationship with attitude and an inverse relationship with perceived benefit, its effects on attitude and intention to adopt personalised nutrition was less influential than perceived benefit. The model was stable across the different European countries, suggesting that psychological factors determining adoption of personalised nutrition have generic applicability across different European countries. Conclusion The results suggest that transparent provision of information about potential benefits, and protection of consumers’ personal data is important for adoption, delivery of public health benefits, and commercialisation of personalised nutrition. PMID:25334009

  15. Socio-economic effects on meeting PA guidelines: comparisons among 32 countries

    PubMed Central

    Borraccino, A; Lemma, P; Iannotti, R; Zambon, A; Dalmasso, P; Lazzeri, G; Giacchi, M; Cavallo, F

    2008-01-01

    Purpose This study examined the relationship between age and gender with physical activity (PA) and how meeting of PA guidelines (PAGL) is related to socio-economic-status. Methods Data were collected from 11-, 13-, and 15-y.o. students in 32 countries participating in the Health Behaviour in School-aged Children (HBSC) survey 2001/2002. A self-completed questionnaire assessed moderate-to-vigorous physical activity (MVPA) for the past seven days and MVPA for a typical week. Socio-economic status (SES) was assessed using the Family Affluence Scale (FAS). Results None of the countries averaged enough MVPA to meet PAGL. The pattern of MVPA across gender and age was consistent among all countries. In all countries girls were significantly less active than boys (mean hours/week of MVPA 3.52 ±1.88 vs 4.13 ±1.95) and were more likely to not meet the PAGL; older children were less active when compared to the youngest. SES was significantly associated with the amount of reported MVPA. SES and PAGL were significantly related in seven countries and a significant decrease in the influence of age was observed in these countries compared to other countries. Conclusions Levels of MVPA during adolescence showed consistent patterns across countries in relation to age, gender and social-class. The limited effect of age on PA in countries where the influence of social class was less strong, suggesting the possibility of a moderating effect of context in the development of habits acquired in childhood PMID:19276860

  16. Accreditation of undergraduate medical training programs: practices in nine developing countries as compared with the United States.

    PubMed

    Cueto, Jose; Burch, Vanessa C; Adnan, Nor Azila Mohd; Afolabi, Bosede B; Ismail, Zalina; Jafri, Wasim; Olapade-Olaopa, E Oluwabunmi; Otieno-Nyunya, Boaz; Supe, Avinash; Togoo, Altantsetseg; Vargas, Ana Lia; Wasserman, Elizabeth; Morahan, Page S; Burdick, William; Gary, Nancy

    2006-07-01

    Undergraduate medical training program accreditation is practiced in many countries, but information from developing countries is sparse. We compared medical training program accreditation systems in nine developing countries, and compared these with accreditation practices in the United States of America (USA). Medical program accreditation practices in nine developing countries were systematically analyzed using all available published documents. Findings were compared to USA accreditation practices. Accreditation systems with explicitly defined criteria, standards and procedures exist in all nine countries studied: Argentina, India, Kenya, Malaysia, Mongolia, Nigeria, Pakistan, Philippines and South Africa. Introduction of accreditation processes is relatively recent, starting in 1957 in India to 2001 in Malaysia. Accrediting agencies were set up in these countries predominantly by their respective governments as a result of legislation and acts of Parliament, involving Ministries of Education and Health. As in the USA, accreditation: (1) serves as a quality assurance mechanism promoting professional and public confidence in the quality of medical education, (2) assists medical schools in attaining desired standards, and (3) ensures that graduates' performance complies with national norms. All nine countries follow similar accreditation procedures. Where mandatory accreditation is practiced, non-compliant institutions may be placed on probation, student enrollment suspended or accreditation withdrawn. Accreditation systems in several developing countries are similar to those in the developed world. Data suggest the trend towards instituting quality assurance mechanisms in medical education is spreading to some developing countries, although generalization to other areas of the world is difficult to ascertain.

  17. Minimizing cross-cultural maladaptation: How minority status facilitates change in international acculturation.

    PubMed

    Volpone, Sabrina D; Marquardt, Dennis J; Casper, Wendy J; Avery, Derek R

    2018-03-01

    Culturally savvy organizations recognize that selecting and developing people who can be effective in a global workforce is important in today's business environment. Nevertheless, many companies struggle to identify and develop talent who are happy and successful working and living outside their home country. We examine 1 factor that may foster success in a host country-minority status in 1's home country-as a predictor of change in acculturation over time. Specifically, we draw on the conservation of resources model to suggest that international students who have been a member of more minority groups in their home country have unique experiences working with dissimilar others that offer advantages when acculturating to new cultures and novel situations. Then, change in host country acculturation is explored as a mechanism to explain how minority status in the home country relates to intentions to leave the host country and psychological well-being 6 months after entry. Two moderators (cultural intelligence, perceived diversity climate of the host institution) of these relationships are also examined. Results revealed that the relationship between minority status in the home country and change in host country acculturation was positive and stronger for those with higher cultural intelligence. Further, the relationship between change in host country acculturation and psychological well-being was positive when perceived diversity climate of the host institution was high, but was not significant when perceived diversity climate was low. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  18. Evaluation of fluoride levels in bottled water and their contribution to health and teeth problems in the United Arab Emirates.

    PubMed

    Abouleish, Mohamed Yehia Z

    2016-10-01

    Fluoride is needed for better health, yet if ingested at higher levels it may lead to health problems. Fluoride can be obtained from different sources, with drinking water being a major contributor. In the United Arab Emirates (UAE), bottled water is the major source for drinking. The aim of this research is to measure fluoride levels in different bottled water brands sold in UAE, to determine whether fluoride contributes to better health or health problems. The results were compared to international and local standards. Fluoride was present in seven out of 23 brands. One brand exhibited high fluoride levels, which exceeded all standards, suggesting it may pose health problems. Other brands were either below or above standards, suggesting either contribution to better health or health problems, depending on ingested amount. A risk assessment suggested a potential for non-cancer effects from some brands. The results were compared to fluoride levels in bottled water sold in UAE and neighboring countries (e.g. Saudi Arabia, Qatar, Kuwait, and Bahrain), over 24 years, to reflect on changes in fluoride levels in bottled water in this region. The research presents the need for creating, stricter regulations that require careful fluoride monitoring and new regulations that require listing fluoride level on the bottled water label, internationally and regionally. The research will have local and global health impact, as bottled water sold in UAE and neighboring countries, is produced locally and imported from international countries, e.g. Switzerland, the USA, France, Italy, New Zealand, and Fiji.

  19. Impact of immigration on the cost of emergency visits in Barcelona (Spain)

    PubMed Central

    Cots, Francesc; Castells, Xavier; García, Oscar; Riu, Marta; Felipe, Aida; Vall, Oriol

    2007-01-01

    Background The impact of immigration on health services utilisation has been analysed by several studies performed in countries with lower levels of immigration than Spain. These studies indicate that health services utilisation is lower among the immigrant population than among the host population and that immigrants tend to use hospital emergency services at the expense of primary care. We aimed to quantify the relative over-utilisation of emergency services in the immigrant population. Methods Emergency visits to Hospital del Mar in Barcelona in 2002 and 2003 were analysed. The country of origin, gender, age, discharge-related circumstances (hospital admission, discharge to home, or death), medical specialty, and variable cost related to medical care were registered. Immigrants were grouped into those from high-income countries (IHIC) and those from low-income countries (ILIC) and the average direct cost was compared by country of origin. A multivariate linear mixed model of direct costs was adjusted by country of origin (classified in five groups) and by the individual variables of age, gender, hospital admission, and death as a cause of discharge. Medical specialty was considered as a random effect. Results With the exception of gynaecological emergency visits, costs resulting from emergency visits by both groups of immigrants were lower than those due to visits by the Spanish-born population. This effect was especially marked for emergency visits by adults. Conclusion Immigrants tend to use the emergency department in preference to other health services. No differences were found between IHIC and ILIC, suggesting that this result was due to the ease of access to emergency services and to lack of knowledge about the country's health system rather than to poor health status resulting from immigrants' socioeconomic position. The use of costs as a variable of complexity represents an opportunistic use of a highly exhaustive registry, which is becoming ever more frequent in hospitals and which overcomes the lack of clinical information related to outpatient activity. PMID:17239236

  20. Assessing variation in tolerance in 23 Muslim-majority and Western countries.

    PubMed

    Milligan, Scott; Andersen, Robert; Brym, Robert

    2014-08-01

    Scholars disagree over whether Islam hinders the development of liberal democracy in Muslim-majority countries. We contribute to this debate by assessing the influence of Islam at the individual and national levels on ethnic, racial, and religious tolerance in 23 countries. Our analyses are based on a set of multilevel models fitted to World Values Survey data and national-level contextual information from various sources. Our findings suggest that people living in Muslim-majority countries tend to be less tolerant than are those living in Western countries. Although a significant part of this difference is attributable to variation in level of economic development and income inequality, Muslim countries remain less tolerant even after controlling for these factors. On the other hand, controlling for other individual-level factors, nonpracticing Muslims in Western countries are more tolerant than are all others in both Muslim-majority and Western countries. This finding challenges common claims about the effects of Islam as a religion on tolerance, suggesting that it is Islamic political regimes--not Islam itself--that pose problems for social tolerance.

  1. PEPFAR Funding and Reduction in HIV Infection Rates in 12 Focus Sub-Saharan African Countries: A Quantitative Analysis.

    PubMed

    Chin, Roger J; Sangmanee, Domrongphol; Piergallini, Lisa

    2015-01-01

    HIV and AIDS continue to have a calamitous effect on individuals living on the continent of Africa. U.S. President George W. Bush implemented the President's Emergency Plan for AIDS Relief (PEPFAR) with the objective of committing approximately $15 billion from 2004 through 2008 to assist with the reduction of the HIV pandemic worldwide. The majority of the PEPFAR policy and funding focused on 12 countries in sub-Saharan Africa: Botswana, Cote d'Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. The policy question this research paper seeks to analyze is whether the PEPFAR funding (as a % of Gross Domestic Product (GDP)) allocated to the 12 countries in Africa had any effect on the decrease of HIV infection rates of males and females between the ages of 15 and 49. A fixed-effects panel regression analysis was conducted to determine if this association exists. This study examined the 12 African countries that received PEPFAR funding over the years 2002 to 2010; even though PEPFAR was only active from 2004 through 2008, this research included two years prior and two years after this timeframe in order to better estimate the effect of PEPFAR funding on HIV reduction. The results illustrate that on average, ceteris paribus, for every 1 percentage point increase in PEPFAR funding per GDP a country received, the country's HIV infection rate decreased by 0.355 percentage points. While the empirical findings in this study suggested that the correlation between PEPFAR funding and HIV reduction is statistically significant, the practical significance is perhaps less obvious. Arguably, the reduction rate should be higher given the extent of funding targeted to this project. The conclusion of this research provides suggestions on future research and the policy implications of PEPFAR.

  2. HIV prevention costs and program scale: data from the PANCEA project in five low and middle-income countries.

    PubMed

    Marseille, Elliot; Dandona, Lalit; Marshall, Nell; Gaist, Paul; Bautista-Arredondo, Sergio; Rollins, Brandi; Bertozzi, Stefano M; Coovadia, Jerry; Saba, Joseph; Lioznov, Dmitry; Du Plessis, Jo-Ann; Krupitsky, Evgeny; Stanley, Nicci; Over, Mead; Peryshkina, Alena; Kumar, S G Prem; Muyingo, Sowedi; Pitter, Christian; Lundberg, Mattias; Kahn, James G

    2007-07-12

    Economic theory and limited empirical data suggest that costs per unit of HIV prevention program output (unit costs) will initially decrease as small programs expand. Unit costs may then reach a nadir and start to increase if expansion continues beyond the economically optimal size. Information on the relationship between scale and unit costs is critical to project the cost of global HIV prevention efforts and to allocate prevention resources efficiently. The "Prevent AIDS: Network for Cost-Effectiveness Analysis" (PANCEA) project collected 2003 and 2004 cost and output data from 206 HIV prevention programs of six types in five countries. The association between scale and efficiency for each intervention type was examined for each country. Our team characterized the direction, shape, and strength of this association by fitting bivariate regression lines to scatter plots of output levels and unit costs. We chose the regression forms with the highest explanatory power (R2). Efficiency increased with scale, across all countries and interventions. This association varied within intervention and within country, in terms of the range in scale and efficiency, the best fitting regression form, and the slope of the regression. The fraction of variation in efficiency explained by scale ranged from 26-96%. Doubling in scale resulted in reductions in unit costs averaging 34.2% (ranging from 2.4% to 58.0%). Two regression trends, in India, suggested an inflection point beyond which unit costs increased. Unit costs decrease with scale across a wide range of service types and volumes. These country and intervention-specific findings can inform projections of the global cost of scaling up HIV prevention efforts.

  3. The Changing Relationship Between Family Size and Educational Attainment Over the Course of Socioeconomic Development: Evidence From Indonesia

    PubMed Central

    MARALANI, VIDA

    2008-01-01

    Many studies from developed countries show a negative correlation between family size and children’s schooling, while results from developing countries show this association ranging from positive to neutral to negative, depending on the context. The body of evidence suggests that this relationship changes as a society develops, but this theory has been difficult to assess because the existing evidence requires comparisons across countries with different social structures and at different levels of development. The world’s fourth most populous nation in 2007, Indonesia has developed rapidly in recent decades. This context provides the opportunity to study these relationships within the same rapidly developing setting to see if and how these associations change. Results show that in urban areas, the association between family size and children’s schooling was positive for older cohorts but negative for more recent cohorts. Models using instrumental variables to address the potential endogeneity of fertility confirm these results. In contrast, rural areas show no significant association between family size and children’s schooling for any cohort. These findings show how the relationship between family size and children’s schooling can differ within the same country and change over time as contextual factors evolve with socioeconomic development. PMID:18939668

  4. Patient grouping for dose surveys and establishment of diagnostic reference levels in paediatric computed tomography.

    PubMed

    Vassileva, J; Rehani, M

    2015-07-01

    There has been confusion in literature on whether paediatric patients should be grouped according to age, weight or other parameters when dealing with dose surveys. The present work aims to suggest a pragmatic approach to achieve reasonable accuracy for performing patient dose surveys in countries with limited resources. The analysis is based on a subset of data collected within the IAEA survey of paediatric computed tomography (CT) doses, involving 82 CT facilities from 32 countries in Asia, Europe, Africa and Latin America. Data for 6115 patients were collected, in 34.5 % of which data for weight were available. The present study suggests that using four age groups, <1, >1-5, >5-10 and >10-15 y, is realistic and pragmatic for dose surveys in less resourced countries and for the establishment of DRLs. To ensure relevant accuracy of results, data for >30 patients in a particular age group should be collected if patient weight is not known. If a smaller sample is used, patient weight should be recorded and the median weight in the sample should be within 5-10 % from the median weight of the sample for which the DRLs were established. Comparison of results from different surveys should always be performed with caution, taking into consideration the way of grouping of paediatric patients. Dose results can be corrected for differences in patient weight/age group. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. The Caspian Sea Negotiation Support System 2.0

    NASA Astrophysics Data System (ADS)

    Rouhani, O. M.; Madani, K.

    2012-12-01

    The Caspian Sea is one of the most resourceful (both in energy and biological resources) areas of the world. The share allocation of Caspian Sea has been the subject of many disputes. Up to now, the negotiations to reach an agreement regarding the ownership status of the sea have not been completely successful. To facilitate reaching an agreement among littoral countries, research studies can provide valuable information. Researchers should examine different options for dividing the sea closely and determine the benefits of each of the options for the parties involved. Following an earlier effort, Caspian Sea Negotiation Support System is further developed in this regard. The model estimates countries' areal and utility shares under different legal methods/scenarios, attempting to minimize transportation costs of exploiting the resource. The applied model is more efficient than the earlier model and the used data includes more variables/attributes such as depth, the differentiation between gas and oil, and various fish resources than the previously employed data. Consequently, the estimates are calculated in more details than are calculated in the earlier study. The results still show a high sensitivity of outputs to the proposed division rules, suggesting a need to clarify the countries' utility and areal shares under any suggested legal regime. Compared to the previous results, the new results confirm the significant effect of the addition of the more variables/attributes to the analysis, in terms of the areal shares and allocations, valuation of resources, and asset management.

  6. Social costs of illicit financial flows in low- and middle-income countries: the case of infant vaccination coverage.

    PubMed

    Ortega, Bienvenido; Sanjuán, Jesús; Casquero, Antonio

    2018-03-01

    The liberalization of capital flows is generally associated with prospects of higher growth. However, in developing countries, opening the capital account may also facilitate the flow of capital out of the country through illicit financial flows (IFFs). Given that IFFs drain the scarce public resources available to finance the provision of public goods and services, the extent of illicit capital flows from developing countries is serious cause for concern. In this context, as a first step in analysing the social costs of IFFs in developing countries, this article studied the relationship between IFFs and infant immunization coverage rates. Data for 56 low- and middle-income countries for the period 2002-13 were used in the empirical analysis. The main result was that the relative level of IFFs to total trade negatively impacted vaccination coverage but only in the case of countries with very high levels of perceived corruption. In this case, the total effect of an annual 1 p.p. increase in the ratio of IFFs to total trade was to reduce the level of vaccination coverage rates over the coming years by 0.19 p.p. Given that there was an annual average of 18 million infants in this cluster of 25 countries, this result suggests that at least 34 000 children may not receive this basic health care intervention in the future as a consequence of this increase in IFFs in any particular year. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Changes in income inequality and the health of immigrants.

    PubMed

    Hamilton, Tod G; Kawachi, Ichiro

    2013-03-01

    Research suggests that income inequality is inversely associated with health. This association has been documented in studies that utilize variation in income inequality across countries or across time from a single country. The primary criticism of these approaches is their inability to account for potential confounders that are associated with income inequality. This paper uses variation in individual experiences of income inequality among immigrants within the United States (U.S.) to evaluate whether individuals who moved from countries with greater income inequality than the U.S. have better health than those who migrated from countries with less income in equality than the U.S. Utilizing individual-level (March Current Population Survey) and country-level data (the United Nations Human Development Reports), we show that among immigrants who have resided in the U.S. between 6 and 20 years, self-reported health is more favorable for the immigrants in the former category (i.e., greater income inequality) than those in the latter (i.e., lower income inequality). Results also show that self-reported health is better among immigrants from more developed countries and those who have more years of education, are male, and are married. Copyright © 2012. Published by Elsevier Ltd.

  8. Changes in income inequality and the health of immigrants

    PubMed Central

    Hamilton, Tod G.; Kawachi, Ichiro

    2016-01-01

    Research suggests that income inequality is inversely associated with health. This association has been documented in studies that utilize variation in income inequality across countries or across time from a single country. The primary criticism of these approaches is their inability to account for potential confounders that are associated with income inequality. This paper uses variation in individual experiences of income inequality among immigrants within the United States (U.S.) to evaluate whether individuals who moved from countries with greater income inequality than the U.S. have better health than those who migrated from countries with less income in equality than the U.S. Utilizing individual-level (March Current Population Survey) and country-level data (the United Nations Human Development Reports), we show that among immigrants who have resided in the U.S. between 6 and 20 years, self-reported health is more favorable for the immigrants in the former category (i.e., greater income inequality) than those in the latter (i.e., lower income inequality). Results also show that self-reported health is better among immigrants from more developed countries and those who have more years of education, are male, and are married. PMID:23352417

  9. Population drinking and fatal injuries in Eastern Europe: a time-series analysis of six countries.

    PubMed

    Landberg, Jonas

    2010-01-01

    To estimate to what extent injury mortality rates in 6 Eastern European countries are affected by changes in population drinking during the post-war period. The analysis included injury mortality rates and per capita alcohol consumption in Russia, Belarus, Poland, Hungary, Bulgaria and the former Czechoslovakia. Total population and gender-specific models were estimated using auto regressive integrated moving average time-series modelling. The estimates for the total population were generally positive and significant. For Russia and Belarus, a 1-litre increase in per capita consumption was associated with an increase in injury mortality of 7.5 and 5.5 per 100,000 inhabitants, respectively. The estimates for the remaining countries ranged between 1.4 and 2.0. The gender-specific estimates displayed national variations similar to the total population estimates although the estimates for males were higher than for females in all countries. The results suggest that changes in per capita consumption have a significant impact on injury mortality in these countries, but the strength of the association tends to be stronger in countries where intoxication-oriented drinking is more common. Copyright 2009 S. Karger AG, Basel.

  10. Willingness and ability to pay for physician services in six Central and Eastern European countries.

    PubMed

    Danyliv, Andriy; Groot, Wim; Gryga, Irena; Pavlova, Milena

    2014-07-01

    Patient charges for physician services are implemented in high-income countries and often are considered in the Central and Eastern Europe (CEE). However, there is no evidence on the potential consumption effects of service charges in these countries. This study provides evidence on the potential impact of patient charges on the consumption of specialized physician services in six CEE countries: Bulgaria, Hungary, Lithuania, Poland, Romania, and Ukraine. We apply a semi-parametric survival analysis to stated willingness and ability to pay (WATP) in order to identify potential demand pools and their price, income and age semi-elasticity. Data are collected through a survey held in 2010 among representative samples of about 1000 respondents in each country. Our results suggest that median WATP in the studied countries is comparable to the cost of the services. The obtained demand pools appear to be theoretically valid and externally consistent. They provide information on the shares of population that would be WATP certain fee levels, and their heterogeneity across socio-demographic groups gives an idea about the population groups that will need to be exempted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Suicide in developing countries (2): risk factors.

    PubMed

    Vijayakumar, Lakshmi; John, Sujit; Pirkis, Jane; Whiteford, Harvey

    2005-01-01

    The majority of studies on risk factors for suicide have been conducted in developed countries, and less work has been done to systematically profile risk factors in developing countries. The current paper presents a selective review of sociodemographic, clinical, and environmental/situational risk factors in developing countries. Taken together, the evidence suggests that the profiles of risk factors in developing countries demonstrate some differences from those in developed countries. In some developing countries, at least, being female, living in a rural area, and holding religious beliefs that sanction suicide may be of more relevance to suicide risk than these factors are in developed countries. Conversely, being single or having a history of mental illness may be of less relevance. Risk factors that appear to be universal include youth or old age, low socioeconomic standing, substance use, and previous suicide attempts. Recent stressful life events play a role in both developing and developed countries, although their nature may differ (e.g., social change may have more of an influence in the former). Likewise, access to means heightens risk in both, but the specific means may vary (e.g., access to pesticides is of more relevance in developing countries). These findings have clear implications for suicide prevention, suggesting that preventive efforts that have shown promise in developed countries may need to be tailored differently to address the risk factor profile of developing countries.

  12. Industry Perspective of Pediatric Drug Development in the United States: Involvement of the European Union Countries.

    PubMed

    Onishi, Taku; Tsukamoto, Katsura; Matsumaru, Naoki; Waki, Takashi

    2018-01-01

    Efforts to promote the development of pediatric pharmacotherapy include regulatory frameworks and close collaboration between the US Food and Drug Administration and the European Medicines Agency. We characterized the current status of pediatric clinical trials conducted in the United States by the pharmaceutical industry, focusing on the involvement of the European Union member countries, to clarify the industry perspective. Data on US pediatric clinical trials were obtained from ClinicalTrials.gov . Binary regression analysis was performed to identify what factors influence the likelihood of involvement of European Union countries. A total of 633 US pediatric clinical trials that met inclusion criteria were extracted and surveyed. Of these, 206 (32.5%) involved a European Union country site(s). The results of binary regression analysis indicated that attribution of industry, phase, disease area, and age of pediatric participants influenced the likelihood of the involvement of European Union countries in US pediatric clinical trials. Relatively complicated or large pediatric clinical trials, such as phase II and III trials and those that included a broad age range of participants, had a significantly greater likelihood of the involvement of European Union countries ( P < .05). Our results suggest that (1) the pharmaceutical industry utilizes regulatory frameworks in making business decisions regarding pediatric clinical trials, (2) disease area affects the involvement of European Union countries, and (3) feasibility of clinical trials is mainly concerned by pharmaceutical industry for pediatric drug development. Additional incentives for high marketability may further motivate pharmaceutical industry to develop pediatric drugs.

  13. Trends in health inequalities in 27 European countries.

    PubMed

    Mackenbach, Johan P; Valverde, José Rubio; Artnik, Barbara; Bopp, Matthias; Brønnum-Hansen, Henrik; Deboosere, Patrick; Kalediene, Ramune; Kovács, Katalin; Leinsalu, Mall; Martikainen, Pekka; Menvielle, Gwenn; Regidor, Enrique; Rychtaříková, Jitka; Rodriguez-Sanz, Maica; Vineis, Paolo; White, Chris; Wojtyniak, Bogdan; Hu, Yannan; Nusselder, Wilma J

    2018-06-19

    Unfavorable health trends among the lowly educated have recently been reported from the United States. We analyzed health trends by education in European countries, paying particular attention to the possibility of recent trend interruptions, including interruptions related to the impact of the 2008 financial crisis. We collected and harmonized data on mortality from ca 1980 to ca 2014 for 17 countries covering 9.8 million deaths and data on self-reported morbidity from ca 2002 to ca 2014 for 27 countries covering 350,000 survey respondents. We used interrupted time-series analyses to study changes over time and country-fixed effects analyses to study the impact of crisis-related economic conditions on health outcomes. Recent trends were more favorable than in previous decades, particularly in Eastern Europe, where mortality started to decline among lowly educated men and where the decline in less-than-good self-assessed health accelerated, resulting in some narrowing of health inequalities. In Western Europe, mortality has continued to decline among the lowly and highly educated, and although the decline of less-than-good self-assessed health slowed in countries severely hit by the financial crisis, this affected lowly and highly educated equally. Crisis-related economic conditions were not associated with widening health inequalities. Our results show that the unfavorable trends observed in the United States are not found in Europe. There has also been no discernible short-term impact of the crisis on health inequalities at the population level. Both findings suggest that European countries have been successful in avoiding an aggravation of health inequalities.

  14. The formal-informal patient payment mix in European countries. Governance, economics, culture or all of these?

    PubMed

    Tambor, Marzena; Pavlova, Milena; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

    2013-12-01

    Cost-sharing for health care is high on the policy agenda in many European countries that struggle with deficits in their public budget. However, such policy often meets with public opposition, which might delay or even prevent its implementation. Increased reliance on patient payments may also have adverse equity effects, especially in countries where informal patient payments are widespread. The factors which might influence the presence of both, formal and informal payments can be found in economic, governance and cultural differences between countries. The aim of this paper is to review the formal-informal payment mix in Europe and to outline factors associated with this mix. We use quantitative analyses of macro-data for 35 European countries and a qualitative description of selected country experiences. The results suggest that the presence of obligatory cost-sharing for health care services is associated with governance factors, while informal patient payments are a multi-cause phenomenon. A consensus-based policy, supported by evidence and stakeholders' engagement, might contribute to a more sustainable patient payment policy. In some European countries, the implementation of cost-sharing requires policy actions to reduce other patient payment obligations, including measures to eliminate informal payments. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Hospital waste management in developing countries: A mini review.

    PubMed

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz; Geng, Yong

    2017-06-01

    Health care activities can generate different kinds of hazardous wastes. Mismanagement of these wastes can result in environmental and occupational health risks. Developing countries are resource-constrained when it comes to safe management of hospital wastes. This study summarizes the main issues faced in hospital waste management in developing countries. A review of the existing literature suggests that regulations and legislations focusing on hospital waste management are recent accomplishments in many of these countries. Implementation of these rules varies from one hospital to another. Moreover, wide variations exist in waste generation rates within as well as across these countries. This is mainly attributable to a lack of an agreement on the definitions and the methodology among the researchers to measure such wastes. Furthermore, hospitals in these countries suffer from poor waste segregation, collection, storage, transportation and disposal practices, which can lead to occupational and environmental risks. Knowledge and awareness regarding proper waste management remain low in the absence of training for hospital staff. Moreover, hospital sanitary workers, and scavengers, operate without the provision of safety equipment or immunization. Unsegregated waste is illegally recycled, leading to further safety risks. Overall, hospital waste management in developing countries faces several challenges. Sustainable waste management practices can go a long way in reducing the harmful effects of hospital wastes.

  16. Psychotherapies for depression in low‐ and middle‐income countries: a meta‐analysis

    PubMed Central

    Cuijpers, Pim; Karyotaki, Eirini; Reijnders, Mirjam; Purgato, Marianna; Barbui, Corrado

    2018-01-01

    Most psychotherapies for depression have been developed in high‐income Western countries of North America, Europe and Australia. A growing number of randomized trials have examined the effects of these treatments in non‐Western countries. We conducted a meta‐analysis of these studies to examine whether these psychotherapies are effective and to compare their effects between studies from Western and non‐Western countries. We conducted systematic searches in bibliographical databases and included 253 randomized controlled trials, of which 32 were conducted in non‐Western countries. The effects of psychotherapies in non‐Western countries were large (g=1.10; 95% CI: 0.91‐1.30), with high heterogeneity (I2=90; 95% CI: 87‐92). After adjustment for publication bias, the effect size dropped to g=0.73 (95% CI: 0.51‐0.96). Subgroup analyses did not indicate that adaptation to the local situation was associated with the effect size. Comparisons with the studies in Western countries showed that the effects of the therapies were significantly larger in non‐Western countries, also after adjusting for characteristics of the participants, the treatments and the studies. These larger effect sizes in non‐Western countries may reflect true differences indicating that therapies are indeed more effective; or may be explained by the care‐as‐usual control conditions in non‐Western countries, often indicating that no care was available; or may be the result of the relative low quality of many trials in the field. This study suggests that psychotherapies that were developed in Western countries may or may not be more effective in non‐Western countries, but they are probably no less effective and can therefore also be used in these latter countries. PMID:29352530

  17. Exploring substance use normalization among adolescents: a multilevel study in 35 countries.

    PubMed

    Sznitman, Sharon R; Kolobov, Tanya; Bogt, Tom Ter; Kuntsche, Emmanuel; Walsh, Sophie D; Boniel-Nissim, Meyran; Harel-Fisch, Yossi

    2013-11-01

    The substance use normalization thesis predicts that adolescent substance users are less likely to report substance use risk factors in high than in low prevalence countries. This study tests whether national population-level alcohol, cigarette and cannabis prevalence rates moderate the strength of the relationship between individual level social and behavioral risk factors and individual level alcohol, cigarette and cannabis use. Data from 2009/2010 Health Behaviour in School-Aged Children Study (N = 68,045, age = 15) from 35 countries was analyzed using logistic Hierarchical Linear Modeling. As expected based on low cannabis prevalence rates in all countries studied, no evidence of normalization was found for recent cannabis use. Also in line with the normalization thesis, results show that for substance use that reaches above 40% in at least some of the countries studied (drunkenness, alcohol and cigarette use), adolescents who reported use are less likely to report social and behavioral risk factors in high prevalence countries than in low prevalence countries. However, support for the normalization thesis was only partial in that results show that in models where evidence for normalization was found, there are risk factors that predict substance use to an equal degree regardless of country level prevalence rates. The current research shows that the normalization thesis is a useful framework for understanding the contextual aspects of adolescent alcohol, tobacco, and cannabis use. The study has implications for drug prevention as it suggests that selective prevention efforts may be particularly useful in low prevalence countries where screening based on risk factors may usefully identify adolescents at most risk for developing drug use problems. This approach may be less useful in high prevalence countries where screening based on risk factors is less likely to satisfactorily identify those at risk for developing drug use problems. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Breast feeding initiation rate across Western countries: does religion matter? An ecological study

    PubMed Central

    Cohen, Emmanuel; Kramer, Michael S

    2016-01-01

    Background Breast feeding initiation rates remain below 80% in some Western countries. Many individual-level determinants are known; however, less is known regarding cultural and societal determinants, such as religion, that could explain population-level variations. We examined the correlations of the proportions of Catholics and Protestants with the breast feeding initiation rates across and within Western countries. Methods Using publicly available data, we carried out an ecological study comparing the proportions of Catholics and Protestants with the rates of breast feeding initiation. We correlated data at the country level, and additionally explored within-country data in five Western countries: France (Departments), Ireland (counties), the UK (countries), Canada (provinces) and the USA (states). Our analyses accounted for human development index, gross domestic product and population density. Results We observed a negative correlation (r=−0.30) between the proportion of Catholics and the rate of breast feeding initiation in Western countries. This correlation was consistent when using within-country data in France (r=−0.27), Ireland (r=−0.23), the UK (r=−0.79) and Canada (r=−0.62). In the USA, the positive correlation (r=0.26) between a state's proportion of Catholics and its breast feeding initiation rate was confounded by race, education and socioeconomic status (SES). After controlling for education and SES, the state proportion of non-Hispanic white Catholics was negatively correlated (r=−0.29) with the rate of breast feeding initiation. Conclusions In this ecological study, we found consistent negative correlations between Catholicism and breast feeding initiation rates. Qualitative and quantitative studies at the individual level are needed to confirm and explain our findings. Our results suggest that women living in a country or region where Catholicism has historically dominated are less likely to initiate breast feeding, and that breast feeding promotion policies should be adapted to better fit populations' cultural and religious norms. PMID:28588983

  19. Health disparities in Europe’s ageing population: the role of social network

    PubMed Central

    Olofsson, Jenny; Malmberg, Gunnar

    2018-01-01

    ABSTRACT Background: Previous research suggests that the social network may play very different roles in relation to health in countries with differing welfare regimes. Objective: The study aimed to assess the interplay between social network, socioeconomic position, and self-rated health (SRH) in European countries. Methods: The study used cross-sectional data on individuals aged 50+ from the fourth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) and includes data from 16 countries. The outcome is poor SRH. All analyses are adjusted for age and stratified by gender. Results: Low satisfaction with the social network was associated with poor SRH among women in all country groups, but predicted poor SRH among males in West/Central and Eastern Europe only. The results from the multivariable analysis showed an increased likelihood of poor SRH among those with relatively lower education, as well as among those with low satisfaction with the social network (women from all country groups and men from Western/Central and Eastern Europe). However, the results from interaction analysis show that poor SRH for those with lower relative position in educational level was greater among those with higher satisfaction with the social network among male and female participants from Northern Europe. The health of individuals who are highly satisfied with their social network is more associated with socioeconomic status in Northern Europe. Conclusions: This study highlights the significance of social network and socioeconomic gradients in health among the elderly in Europe. PMID:29553305

  20. Hidden from health: structural stigma, sexual orientation concealment, and HIV across 38 countries in the European MSM Internet Survey

    PubMed Central

    Pachankis, John E.; Hatzenbuehler, Mark L.; Hickson, Ford; Weatherburn, Peter; Berg, Rigmor C.; Marcus, Ulrich; Schmidt, Axel J.

    2016-01-01

    Objective Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however. Design Data come from the European MSM Internet Survey (EMIS), which was administered between June and August 2010 across 38 European countries (N =174 209). Methods Country-level stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of attitudes held by the citizens of each country. We also assessed concealment, HIV status, number of past 12-month male sex partners, and eight HIV-preventive services, knowledge, and behavioural outcomes. Results MSM living in countries with higher levels of stigma had reduced odds of diagnosed HIV and fewer partners but higher odds of sexual risk behaviour, unmet prevention needs, not using testing services, and not discussing their sexuality in testing services. Sexual orientation concealment mediated associations between country-level stigma and these outcomes. Conclusion Country-level stigma may have historically limited HIV transmission opportunities among MSM, but by restricting MSM’s public visibility, it also reduces MSM’s ability to access HIV-preventive services, knowledge and precautionary behaviours. These findings suggest that MSM in European countries with high levels of stigma are vulnerable to HIV infection. Although they have less opportunity to identify and contact other MSM, this might change with emerging technologies. PMID:26035323

  1. Incidence of Stomach Cancer in Oman and the Other Gulf Cooperation Council Countries

    PubMed Central

    Al-Mahrouqi, Haitham; Parkin, Lianne; Sharples, Katrina

    2011-01-01

    Objectives Stomach cancer is the most common cancer among males in Oman and the second most frequent among females from 1997 to 2007. Reports have suggested the rate is higher in Oman than in the other GCC countries. This study aims to describe the epidemiology of stomach cancer in Oman and to explore the apparent differences in the incidence of stomach cancer between Oman and the other Gulf Cooperation Council (GCC) countries. Methods Data were obtained from the Omani National Cancer Registry (1997 - 2007) and from Gulf Centre for Cancer Registration reports (1998 - 2004). Results The annual average age-adjusted incidence rates for stomach cancer in Oman were 10.1 per 100,000 for males and 5.6 per 100,000 for females between 1997 and 2007. The age-adjusted incidence varied by region within Oman, and the incidence rate was higher in Oman than in most other GCC countries between 1998 and 2004. Conclusion Further investigation of the completeness and accuracy of cancer registration is essential for exploration of variations in stomach cancer rates in the GCC countries. PMID:22043430

  2. Impact of Socio-Health Factors on Life Expectancy in the Low and Lower Middle Income Countries

    PubMed Central

    MONDAL, Md. Nazrul Islam; SHITAN, Mahendran

    2013-01-01

    Abstract Background This study is concerned with understanding the impact of demographic changes, socioeconomic inequalities, and the availability of health factors on life expectancy (LE) in the low and lower middle income countries. Methods The cross-country data were collected from 91 countries from the United Nations agencies in 2012. LE is the response variable with demographics (total fertility rate, and adolescent fertility rate), socioeconomic status (mean year of schooling, and gross national income per capita), and health factors (physician density, and HIV prevalence rate) are as the three main predictors. Stepwise multiple regression analysis is used to extract the main factors. Results The necessity of more healthcare resources and higher levels of socioeconomic advantages are more likely to increase LE. On the other hand, demographic changes and health factors are more likely to increase LE by way of de-cease fertility rates and disease prevalence. Conclusion These findings suggest that international efforts should aim at increasing LE, especially in the low income countries through the elimination of HIV prevalence, adolescent fertility, and illiteracy. PMID:26060637

  3. Characteristics of healthy weight advertisements in three countries.

    PubMed

    Pettigrew, Simone; Talati, Zenobia; Henriques, Isla; Morley, Belinda; Ball, Kylie

    2018-02-01

    High rates of population obesity have resulted in the dissemination of mass media campaigns that focus on achieving and maintaining a healthy weight. The aim of the present study was to analyse advertising techniques used in such campaigns to identify common and differential approaches in three countries with similar cultures and rates of obesity (Australia, the United Kingdom and the United States). An Internet search was conducted to identify healthy weight television advertisements aired in the three countries. Seventy-two advertisements were located and coded according to the advertising techniques employed. Despite the cultural similarity and comparable obesity rates of the three countries, there were few consistencies in advertising techniques employed. A main focus of the ads was diet, but disparate approaches were used to convey the message in each country. The identified wide variation in advertising techniques may suggest that campaign managers would benefit from greater certainty about which advertising approaches are most effective in encouraging lifestyle behaviours associated with a healthy weight. Implications for public health: A more robust evidence base would be useful to guide the development of healthy weight campaigns. © 2017 The Authors.

  4. Characterizing International Travel Behavior from Geotagged Photos: A Case Study of Flickr

    PubMed Central

    Yuan, Yihong; Medel, Monica

    2016-01-01

    Recent advances in multimedia and mobile technologies have facilitated large volumes of travel photos to be created and shared online. Although previous studies have utilized geotagged photos to model travel patterns at individual locations, there is limited research on how these datasets can model international travel behavior and inter-country travel flows—a crucial indicator to quantify the interactions between countries in tourism economics. Realizing the necessity to investigate the potential of geotagged photos in tourism geography, this research investigates international travel patterns from two perspectives: 1) We apply a series of indicators (radius of gyration (ROG), number of countries visited, and entropy) to measure the descriptive characteristics of international travel in different countries; 2) By constructing a gravity model of trade, we investigate how distance decay influences the magnitude of international travel flow between geographic entities, and whether (or how much) the popularity of a given destination (defined as the percentage of tourist income in national gross domestic product (GDP)) affects travel choices in different countries. The results provide valuable input to various commercial applications such as individual travel planning and destination suggestions. PMID:27159195

  5. Power Laws in Firm Productivity

    NASA Astrophysics Data System (ADS)

    Mizuno, T.; Ishikawa, A.; Fujimoto, S.; Watanabe, T.

    We estimate firm productivity for about 3.2 million firms from30 countries. We find that the distribution of firm productivity in each country, which is measured by total factor productivity (TFP), has a power law upper tail. However, the power law exponent of a TFP distribution in a country tends to be greater than that of a sales distribution in that country, indicating that the upper tail of a TFP distribution is less heavy compared to that of a sales distribution. We also find that the power law exponent of a TFP distribution tends to be greater than the power law exponents associated with the number of workers or tangible fixed assets. Given the idea that the sales of a firm is determined by the amount of various inputs employed by the firm (i.e., ``production function'' in the terminology of economics), these results suggest that the heavy tail of a sales distribution in a country comes not from the tail of a TFP distribution, but from the tail of the distribution of the number of workers or tangible fixed assets.

  6. Role of income in intergenerational co-residence: Evidence from selected African and Asian countries.

    PubMed

    Aziz, Nusrate; Hossain, Belayet; Emran, Masum

    2018-06-01

    The study investigates the macroeconomic determinants of co-residing arrangement between generations in selected developing countries with a focus on examining the effect of changing income level of the working generation. A reduced form model is specified for co-residence between the older generation and altruistic working generation. The fixed- and random-effects models are applied in two waves of data for 22 countries. Estimated results indicate that the income of the altruistic working generation has a negative effect on co-residence, suggesting that if the income of the working generation increases, co-residence decreases. This decrease is greater for older men compared with their female counterparts. Life expectancy, literacy and culture also have significant influences on co-residence. Co-residence is expected to fall in developing countries with economic growth over time. Consequently, a higher proportion of older citizens will be vulnerable in the future. Hence, governments of developing countries will face increasing pressure from their older people to provide appropriate planning and strategy to face this challenge. © 2018 AJA Inc.

  7. Characterizing International Travel Behavior from Geotagged Photos: A Case Study of Flickr.

    PubMed

    Yuan, Yihong; Medel, Monica

    2016-01-01

    Recent advances in multimedia and mobile technologies have facilitated large volumes of travel photos to be created and shared online. Although previous studies have utilized geotagged photos to model travel patterns at individual locations, there is limited research on how these datasets can model international travel behavior and inter-country travel flows-a crucial indicator to quantify the interactions between countries in tourism economics. Realizing the necessity to investigate the potential of geotagged photos in tourism geography, this research investigates international travel patterns from two perspectives: 1) We apply a series of indicators (radius of gyration (ROG), number of countries visited, and entropy) to measure the descriptive characteristics of international travel in different countries; 2) By constructing a gravity model of trade, we investigate how distance decay influences the magnitude of international travel flow between geographic entities, and whether (or how much) the popularity of a given destination (defined as the percentage of tourist income in national gross domestic product (GDP)) affects travel choices in different countries. The results provide valuable input to various commercial applications such as individual travel planning and destination suggestions.

  8. Maternal obesity during pregnancy and cardiovascular development and disease in the offspring.

    PubMed

    Gaillard, Romy

    2015-11-01

    Maternal obesity during pregnancy is an important public health problem in Western countries. Currently, obesity prevalence rates in pregnant women are estimated to be as high as 30%. In addition, approximately 40% of women gain an excessive amount of weight during pregnancy in Western countries. An accumulating body of evidence suggests a long-term impact of maternal obesity and excessive weight gain during pregnancy on adiposity, cardiovascular and metabolic related health outcomes in the offspring in fetal life, childhood and adulthood. In this review, we discuss results from recent studies, potential underlying mechanisms and challenges for future epidemiological studies.

  9. Exchange rate regimes, saving glut and the Feldstein Horioka puzzle: The East Asian experience

    NASA Astrophysics Data System (ADS)

    Kaya-Bahçe, Seçil; Özmen, Erdal

    2008-04-01

    This paper investigates whether the recent experience of the emerging East Asian countries with current account surpluses is consistent with the “saving glut” hypothesis and the Feldstein and Horioka puzzle. The evidence suggests that the saving retention coefficients declined substantially in most of the countries after an endogenous break date coinciding with a major exchange rate regime change with the 1997-1998 crisis. Exchange rate flexibility appears to be enhancing financial integration. The results are consistent with an “investment slump” explanation rather than the “saving glut” postulation.

  10. Do employers reward physical attractiveness in transition countries?

    PubMed

    Mavisakalyan, Astghik

    2018-02-01

    This paper studies the labour market returns to physical attractiveness using data from three transition countries of the Caucasus: Armenia, Azerbaijan and Georgia. I estimate a large positive effect of attractive looks on males' probability of employment. Results from the most comprehensive model suggest a marginal effect of 11.1 percentage points. Using a partial identification approach, I show that this relationship is likely to be causal. After accounting for covariates, particularly measures of human capital, there is no evidence for a statistically significant link between females' attractiveness and employment. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Community Connections in Health and Physical Education: A Reflection of Stakeholder Experiences

    ERIC Educational Resources Information Center

    McGrath, Georgia; Alfrey, Laura; Jeanes, Ruth

    2017-01-01

    Community development research suggests that positive partnerships and connections between groups can result in stronger, more resilient and productive communities. Despite community connections featuring increasingly at a curriculum level in countries such as Australia and New Zealand, research is only beginning to explore the nuanced processes…

  12. Colleges' Effort To Prepare for Y2K May Yield Benefits for Many Years.

    ERIC Educational Resources Information Center

    Olsen, Florence

    2000-01-01

    Suggests that the money spent ($100 billion) to fix the Y2K bug in the United States resulted in improved campus computer systems. Reports from campuses around the country indicate that both mainframe and desktop systems experienced fewer problems than expected. (DB)

  13. An Approach to the Teaching of Academic Writing.

    ERIC Educational Resources Information Center

    Johnston, Sue Ann

    1985-01-01

    Discusses solutions to problems in teaching research paper writing skills to English as a second language students in developing countries where library resources are inadequate. Suggests the use of interviews as an alternative research source and shows how an oral report on research results can help to develop synthesizing skills. (SED)

  14. Labor force participation, unemployment and occupational attainment among immigrants in West European countries

    PubMed Central

    Semyonov, Moshe

    2017-01-01

    The present paper examines modes of immigrants' labor market incorporation into European societies with specific emphasis on the role played by immigrant status (i.e. first-generation immigrants, immigrant descendants and native born without migrant background), region of origin, and gender. The data were obtained from the European Union Labour Forces Survey 2008 Ad-Hoc Module for France, Belgium, UK and Sweden. In order to supplement the results from the country-specific analysis, we replicated the analysis using pooled data from the five rounds of the European Social Survey conducted between 2002 and 2010, for nine 'old immigration' Western European countries together. The analysis centered on two aspects of incorporation: labor force status and occupation. Multinominal, binary logistic as well as linear probability regression models were estimated. The findings suggest that in all countries non-European origin is associated with greater disadvantage in finding employment not only among first-generation immigrants, but also among sons and daughters of immigrants (i.e. second-generation). Moreover, the relative employment disadvantage among immigrant men of non-European origin is especially pronounced in the second-generation. The likelihood of attaining a high-status job is influenced mostly by immigrant status, regardless of region of origin and gender. The results of the study reveal that patterns of labor force incorporation vary considerably across origin groups and across generations. The patterns do not vary as much across countries, despite cross-country differences in welfare state regimes, migration integration policy and composition of migration flows. PMID:28475632

  15. Labor force participation, unemployment and occupational attainment among immigrants in West European countries.

    PubMed

    Gorodzeisky, Anastasia; Semyonov, Moshe

    2017-01-01

    The present paper examines modes of immigrants' labor market incorporation into European societies with specific emphasis on the role played by immigrant status (i.e. first-generation immigrants, immigrant descendants and native born without migrant background), region of origin, and gender. The data were obtained from the European Union Labour Forces Survey 2008 Ad-Hoc Module for France, Belgium, UK and Sweden. In order to supplement the results from the country-specific analysis, we replicated the analysis using pooled data from the five rounds of the European Social Survey conducted between 2002 and 2010, for nine 'old immigration' Western European countries together. The analysis centered on two aspects of incorporation: labor force status and occupation. Multinominal, binary logistic as well as linear probability regression models were estimated. The findings suggest that in all countries non-European origin is associated with greater disadvantage in finding employment not only among first-generation immigrants, but also among sons and daughters of immigrants (i.e. second-generation). Moreover, the relative employment disadvantage among immigrant men of non-European origin is especially pronounced in the second-generation. The likelihood of attaining a high-status job is influenced mostly by immigrant status, regardless of region of origin and gender. The results of the study reveal that patterns of labor force incorporation vary considerably across origin groups and across generations. The patterns do not vary as much across countries, despite cross-country differences in welfare state regimes, migration integration policy and composition of migration flows.

  16. Corporal Punishment, Maternal Warmth, and Child Adjustment: A Longitudinal Study in Eight Countries

    PubMed Central

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

    2014-01-01

    Objective Two key tasks facing parents across cultures are managing children’s behaviors (and misbehaviors) and conveying love and affection. Previous research has found that corporal punishment generally is related to worse child adjustment, whereas parental warmth is related to better child adjustment. This study examined whether the association between corporal punishment and child adjustment problems (anxiety and aggression) is moderated by maternal warmth in a diverse set of countries that vary in a number of sociodemographic and psychological ways. Method Interviews were conducted with 7- to 10-year-old children (N = 1,196; 51% girls) and their mothers in eight countries: China, Colombia, Italy, Jordan, Kenya, the Philippines, Thailand, and the United States. Follow-up interviews were conducted one and two years later. Results Corporal punishment was related to increases, and maternal warmth was related to decreases, in children’s anxiety and aggression over time; however, these associations varied somewhat across groups. Maternal warmth moderated the effect of corporal punishment in some countries, with increases in anxiety over time for children whose mothers were high in both warmth and corporal punishment. Conclusions The findings illustrate the overall association between corporal punishment and child anxiety and aggression as well as patterns specific to particular countries. Results suggest that clinicians across countries should advise parents against using corporal punishment, even in the context of parent-child relationships that are otherwise warm, and should assist parents in finding other ways to manage children’s behaviors. PMID:24885184

  17. Women, Work and Early Childhood: The Nexus in Developed and Developing Countries.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Paris (France). Early Childhood and Family Education Unit.

    Most female workers in developing countries do not have wage jobs. However, the preponderance of female workers in non-wage jobs is not consistent across all developing countries. It is highly likely that the proportion of non-wage female workers in developing countries is greater than is suggested by the statistics. Consequently, mothers in the…

  18. Environment degradation, economic growth and energy consumption nexus: A wavelet-windowed cross correlation approach

    NASA Astrophysics Data System (ADS)

    Jammazi, Rania; Aloui, Chaker

    2015-10-01

    This paper analyzes the interactive linkages between carbon dioxide (CO2) emissions, energy consumption (EC) and economic growth (EG) using a novel approach namely wavelet windowed cross correlation (WWCC) for six oil-exporting countries from the GCC (Gulf Cooperation Council) region over the period 1980-2012. Our empirical results show that there exists a bidirectional causal relationship between EC and EG. However, the results support the occurrence of unidirectional causality from EC to CO2 emissions without any feedback effects, and there exists a bidirectional causal relationship between EG and CO2 emissions for the region as a whole. The study suggests that environmental and energy policies should recognize the differences in the nexus between EC and EG in order to maintain sustainable EG in the GCC region. Our findings will be useful for GCC countries to better evaluate its situation in the future climate negotiations. The overall findings will help GCC countries assess its position better in future climate change negotiations.

  19. Global assessment of human losses due to earthquakes

    USGS Publications Warehouse

    Silva, Vitor; Jaiswal, Kishor; Weatherill, Graeme; Crowley, Helen

    2014-01-01

    Current studies have demonstrated a sharp increase in human losses due to earthquakes. These alarming levels of casualties suggest the need for large-scale investment in seismic risk mitigation, which, in turn, requires an adequate understanding of the extent of the losses, and location of the most affected regions. Recent developments in global and uniform datasets such as instrumental and historical earthquake catalogues, population spatial distribution and country-based vulnerability functions, have opened an unprecedented possibility for a reliable assessment of earthquake consequences at a global scale. In this study, a uniform probabilistic seismic hazard assessment (PSHA) model was employed to derive a set of global seismic hazard curves, using the open-source software OpenQuake for seismic hazard and risk analysis. These results were combined with a collection of empirical fatality vulnerability functions and a population dataset to calculate average annual human losses at the country level. The results from this study highlight the regions/countries in the world with a higher seismic risk, and thus where risk reduction measures should be prioritized.

  20. Ageism in Belgium and Burundi: a comparative analysis

    PubMed Central

    Marquet, Manon; Missotten, Pierre; Schroyen, Sarah; Nindaba, Desiderate; Adam, Stéphane

    2016-01-01

    Background Recent cross-cultural comparisons between Asian and Western cultures have shown that ageism arises more from the lack of availability of social and economic resources for older adults than from the culture itself. We tested this assumption by conducting a survey among people living in a least developed country compared with those living in a developed country. Participants and methods Twenty-seven Belgians living in Belgium, 29 Burundians living in Belgium, and 32 Burundians living in Burundi were included in this study. Their attitudes toward older adults were assessed using several self-reported measures. Results Statistical analyses confirmed that older people are more negatively perceived by Burundians living in Burundi than by Burundians and Belgians living in Belgium, whose attitudes did not differ from each other. Conclusion Consistent with our hypothesis, our results suggest that the level of development of a country and more particularly the lack of government spending on older people (pension and health care systems) may contribute to their younger counterparts perceiving them more negatively. PMID:27601889

  1. Perceived concern about the new strain of the influenza and obtaining the vaccine in China, Japan and South Korea.

    PubMed

    Kamimura, Akiko; Armenta, Bianca A; Nourian, Maziar M; Wright, Lindsey; Rathi, Naveen; Chernenko, Alla

    This study compares the factors, which influence individuals from the countries of China, Japan and South Korea to obtain any type of influenza vaccines and their perceived concerns about the new strain of the influenza - pandemic (H1N1) 2009. The data analyzed was from the East Asian Social Survey (EASS), Cross-National Survey Data Sets: Health and Society in East Asia, 2010 (ICPSR 34608) (N=7938). The results of this study suggest that individuals who are concerned about the new strain of influenza are more likely to have obtained influenza vaccine. In these countries, perceived concerns may be directly related to vaccine-related behaviors. The results of this study also indicate that there are variations within each country regarding as to why individuals do or do not obtain the influenza vaccine. Over all, this project provides new insights about the acquisition of the influenza vaccine within China, Japan and South Korea, which will be useful for medical practice within these countries and future research. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  2. Molecular characterization and phylogenetic analysis of Explanatum explanatum in India based on nucleotide sequences of ribosomal ITS2 and the mitochondrial gene nad1.

    PubMed

    Hayashi, Kei; Mohanta, Uday K; Ohari, Yuma; Neeraja, Tambireddy; Singh, T Shantikumar; Sugiyama, Hiromu; Itagaki, Tadashi

    2016-12-01

    The aim of this study was to analyze the phylogenetic relationship between Explanatum explanatum populations in India and other countries of the Indian subcontinent. Seventy liver amphistomes collected from four localities in India were identified as E. explanatum based on the nucleotide sequences of ribosomal ITS2. The flukes were then analyzed phylogenetically based on the nucleotide sequence of the mitochondrial gene nad1 in comparison with flukes from Bangladesh and Nepal. In the resulting phylogenetic tree, the nad1 haplotypes from India were divided into four clades, and the flukes showing the haplotypes of clades A and C were predominant in India. The haplotypes of the clades A and C have also been detected in Bangladesh and Nepal, and therefore, it seems they occur commonly throughout the Indian subcontinent. The results of AMOVA suggested that gene flow was likely to occur between E. explanatum populations in these countries. These countries are geographically close and have been historically and culturally connected to each other, and therefore, the movements of host ruminants among these countries might have been involved in the migration of the flukes and their gene flow.

  3. Experiences of homophobia among gay and bisexual men: results from a cross-sectional study in seven countries.

    PubMed

    Chard, Anna N; Finneran, Catherine; Sullivan, Patrick S; Stephenson, Rob

    2015-01-01

    Experiences of homophobic discrimination are associated with an increased prevalence of psychological disorders and increased odds of reporting suicidal ideation among gay and bisexual men. We examine two domains of homophobia--external homophobic discrimination and internalised homophobia--and their associations with sexual orientation, demographic characteristics, relationships and social support among a sample of gay and bisexual men from seven countries. Sexually active gay and bisexual men aged over 18 and residing in Australia, Brazil, Canada, South Africa, Thailand, the UK and the USA were recruited through banner advertisements on Facebook. Two outcomes were examined: reporting experiences of homophobic discrimination and reporting feelings of internalised homophobia. No covariates were consistently significantly associated with experiencing external homophobic discrimination across countries. Across all countries, bisexually identifying respondents reported significantly greater feelings of internalised homophobia. Respondents in Brazil and the UK reporting a main partner, and respondents in Australia, Brazil, Canada, South Africa, Thailand and the USA reporting a larger gay/bisexual social network, reported significantly fewer feelings of internalised homophobia. Results suggest an ameliorative effect of social networks on experiencing homophobia. Additional research should focus on the mechanisms through which social networks reduce feelings of internalised homophobia.

  4. 22 countries: tax relief for vaccines, ORS, and contraceptives.

    PubMed

    Krasovec, K; Connor, C

    1999-01-01

    This article presents the implementation of tax relief of the three key public health commodities--vaccines, oral rehydration salts (ORS), and contraceptives--in 22 countries. Tax relief was provided in the form of exemptions, waivers, reductions or some combination thereof, with the goal of improving the health status of the population. Tax relief is known to aid in the achievement of policy objectives, which include reduction of buyer's administrative cost, and budget needs, reduction of consumer prices and increase of product supply. Through a global e-mail survey in 1997, information on vaccine, ORS, and contraceptive tax exemptions was gathered. Results revealed that 68% of the countries granted tax relief. It was observed that 87% of the public sector benefits from tax relief for at least one commodity, 67% of the private nonprofit sector, and 53% of the private for-profit sector. On the other hand, the use of waiver procedures for tax relief greatly differs across countries. It was noted that tax exemptions rather than waiver procedures result in the greatest benefits. This article suggests further expansion of private nonprofit and for-profit sectors with appropriate guarantees of consumer savings, as well as implementation of tax relief.

  5. 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.

  6. Enhancing the comparability of costing methods: cross-country variability in the prices of non-traded inputs to health programmes.

    PubMed

    Johns, Benjamin; Adam, Taghreed; Evans, David B

    2006-04-24

    National and international policy makers have been increasing their focus on developing strategies to enable poor countries achieve the millennium development goals. This requires information on the costs of different types of health interventions and the resources needed to scale them up, either singly or in combinations. Cost data also guides decisions about the most appropriate mix of interventions in different settings, in view of the increasing, but still limited, resources available to improve health. Many cost and cost-effectiveness studies include only the costs incurred at the point of delivery to beneficiaries, omitting those incurred at other levels of the system such as administration, media, training and overall management. The few studies that have measured them directly suggest that they can sometimes account for a substantial proportion of total costs, so that their omission can result in biased estimates of the resources needed to run a programme or the relative cost-effectiveness of different choices. However, prices of different inputs used in the production of health interventions can vary substantially within a country. Basing cost estimates on a single price observation runs the risk that the results are based on an outlier observation rather than the typical costs of the input. We first explore the determinants of the observed variation in the prices of selected "non-traded" intermediate inputs to health programmes--printed matter and media advertising, and water and electricity--accounting for variation within and across countries. We then use the estimated relationship to impute average prices for countries where limited data are available with uncertainty intervals. Prices vary across countries with GDP per capita and a number of determinants of supply and demand. Media and printing were inelastic with respect to GDP per capita, with a positive correlation, while the utilities had a surprisingly negative relationship. All equations had relatively good fits with the data. While the preferred option is to derive costs from a random sample of prices in each setting, this option is often not available to analysts. In this case, we suggest that the approach described in this paper could represent a better option than basing policy recommendations on results that are built on the basis of a single, or a few, price observations.

  7. Japanese and Korean Nursing Students' Motivation for Joining Disaster Relief Activities as Nurses in the Future.

    PubMed

    Choe, Myoung-Ae; Kuwano, Noriko; Bang, Kyung-Sook; Cho, Mi-Kyoung; Yatsushiro, Rika; Kawata, Yuki

    The purpose of this study was to identify differences in motivation for joining disaster relief activities as a nurse in the future between Japanese and Korean nursing students. A descriptive 2-group comparative study design was used. The participants were 721 first- to fourth-year nursing students (Japanese, n = 324; Korean, n = 397). From June to September 2014, data were collected through a researcher-administered questionnaire and self-reported answers. The collected data were analyzed by descriptive statistics, the χ test, and the t test.No significant difference was found between Japanese and Korean students in motivation to join domestic relief activities should a disaster occur in the area in which they lived. Compared with Korean students, Japanese students strongly agreed that it is necessary to carry out relief work across borders when disasters occur in foreign countries (p = .001). Meanwhile, Japanese students showed less motivation than Korean students to join relief activities in other domestic areas and foreign countries (p = .020).The results of this study suggest that the motivation of Japanese students to join disaster relief activities as nurses in the future should a disaster occur in other domestic areas and foreign countries needs to be increased. The results also suggest that undergraduate students should be well prepared for disasters through disaster nursing education, including practical training, disaster drills, and simulation.

  8. Daily activity patterns of 2316 men and women from five countries differing in socioeconomic development.

    PubMed

    Sani, Mamane; Refinetti, Roberto; Jean-Louis, Girardin; Pandi-Perumal, S R; Durazo-Arvizu, Ramon A; Dugas, Lara R; Kafensztok, Ruth; Bovet, Pascal; Forrester, Terrence E; Lambert, Estelle V; Plange-Rhule, Jacob; Luke, Amy

    2015-06-01

    Daily rhythmicity in the locomotor activity of laboratory animals has been studied in great detail for many decades, but the daily pattern of locomotor activity has not received as much attention in humans. We collected waist-worn accelerometer data from more than 2000 individuals from five countries differing in socioeconomic development and conducted a detailed analysis of human locomotor activity. Body mass index (BMI) was computed from height and weight. Individual activity records lasting 7 days were subjected to cosinor analysis to determine the parameters of the daily activity rhythm: mesor (mean level), amplitude (half the range of excursion), acrophase (time of the peak) and robustness (rhythm strength). The activity records of all individual participants exhibited statistically significant 24-h rhythmicity, with activity increasing noticeably a few hours after sunrise and dropping off around the time of sunset, with a peak at 1:42 pm on average. The acrophase of the daily rhythm was comparable in men and women in each country but varied by as much as 3 h from country to country. Quantification of the socioeconomic stages of the five countries yielded suggestive evidence that more developed countries have more obese residents, who are less active, and who are active later in the day than residents from less developed countries. These results provide a detailed characterization of the daily activity pattern of individual human beings and reveal similarities and differences among people from five countries differing in socioeconomic development.

  9. The global economic burden of diabetes in adults aged 20-79 years: a cost-of-illness study.

    PubMed

    Bommer, Christian; Heesemann, Esther; Sagalova, Vera; Manne-Goehler, Jennifer; Atun, Rifat; Bärnighausen, Till; Vollmer, Sebastian

    2017-06-01

    Differences in methods and data used in past studies have limited comparisons of the cost of illness of diabetes across countries. We estimate the full global economic burden of diabetes in adults aged 20-79 years in 2015, using a unified framework across all countries. Our objective was to highlight patterns of diabetes-associated costs as well as to identify the need for further research in low-income regions. Epidemiological and economic data for 184 countries were used to estimate the global economic burden of diabetes, regardless of diabetes type. Direct costs were derived using a top-down approach based on WHO general health expenditure figures and prevalence data from the 2015 International Diabetes Federation Diabetes Atlas. Indirect costs were assessed using a human-capital approach, including diabetes-associated morbidity and premature mortality. We estimate the global cost of diabetes for 2015 was US$1·31 trillion (95% CI 1·28-1·36) or 1·8% (95% CI 1·8-1·9) of global gross domestic product (GDP). Notably, indirect costs accounted for 34·7% (95% CI 34·7-35·0) of the total burden, although substantial variations existed both in the share and the composition of indirect costs across countries. North America was the most affected region relative to GDP and also the largest contributor to global absolute costs. However, on average, the economic burden as percentage of GDP was larger in middle-income countries than in high-income countries. Our results suggest a substantial global economic burden of diabetes. Although limited data were available for low-income and middle-income countries, our findings suggest that large diabetes-associated costs are not only a problem in high-income settings but also affect poorer world regions. None. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Can we determine whether physical limitations are more prevalent in the US than in countries with comparable life expectancy?

    PubMed

    Glei, Dana A; Goldman, Noreen; Ryff, Carol D; Weinstein, Maxine

    2017-12-01

    We evaluate the variability in estimates of self-reported physical limitations by age across four nationally representative surveys in the US. We consider its implications for determining whether, as previous literature suggests, the US estimates reveal limitations at an earlier age than in three countries with similar life expectancy: England, Taiwan, and Costa Rica. Based on cross-sectional data from seven population-based surveys, we use local mean smoothing to plot self-reported limitations by age for each of four physical tasks for each survey, stratified by sex. We find substantial variation in the estimates in the US across four nationally-representative surveys. For example, one US survey suggests that American women experience a walking limitation 15 years earlier than their Costa Rican counterparts, while another US survey implies that Americans have a 4-year advantage. Differences in mode of survey may account for higher prevalence of limitations in the one survey that used a self-administered mail-in questionnaire than in the other surveys that used in-person or telephone interviews. Yet, even among US surveys that used the same mode, there is still so much variability in estimates that we cannot conclude whether Americans have better or worse function than their counterparts in the other countries. Seemingly minor differences in question wording and response categories may account for the remaining inconsistency. If minor differences in question wording can result in such extensive variation in the estimates within a given population, then lack of comparability is likely to be an even greater problem when examining results across countries that do not share the same language or culture. Despite the potential utility of self-reported physical function within a survey sample, our findings imply that absolute estimates of population-level prevalence of self-reported physical limitations are unlikely to be strictly comparable across countries-or even across surveys within the same population.

  11. School Management Councils: A Lever for Mobilizing Social Capital in Rural Punjab, Pakistan?

    ERIC Educational Resources Information Center

    Khan, Faryal

    2007-01-01

    While evidence from developed countries suggests that communities may contribute to school effectiveness and efficiency, there is a need for more systematic reviews of such practice in developing countries to inform international policy. Research suggests that community participation through school councils could produce opposite outcomes: it can…

  12. Loneliness: Its Correlates and Association with Health Behaviours and Outcomes in Nine Countries of the Former Soviet Union

    PubMed Central

    Stickley, Andrew; Koyanagi, Ai; Roberts, Bayard; Richardson, Erica; Abbott, Pamela; Tumanov, Sergei; McKee, Martin

    2013-01-01

    Background Research suggests that the prevalence of loneliness varies between countries and that feeling lonely may be associated with poorer health behaviours and outcomes. The aim of the current study was to examine the factors associated with loneliness, and the relationship between feeling lonely and health behaviours and outcomes in the countries of the former Soviet Union (FSU) – a region where loneliness has been little studied to date. Methods Using data from 18,000 respondents collected during a cross-sectional survey undertaken in nine FSU countries – Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine – in 2010/11, country-wise logistic regression analysis was conducted to determine: the factors associated with feeling lonely; the association between feeling lonely and alcohol consumption, hazardous drinking and smoking; and whether feeling lonely was linked to poorer health (i.e. poor self-rated health and psychological distress). Results The prevalence of loneliness varied widely among the countries. Being divorced/widowed and low social support were associated with loneliness in all of the countries, while other factors (e.g. living alone, low locus of control) were linked to loneliness in some of the countries. Feeling lonely was connected with hazardous drinking in Armenia, Kyrgyzstan and Russia but with smoking only in Kyrgyzstan. Loneliness was associated with psychological distress in all of the countries and poor self-rated health in every country except Kazakhstan and Moldova. Conclusions Loneliness is associated with worse health behaviours and poorer health in the countries of the FSU. More individual country-level research is now needed to formulate effective interventions to mitigate the negative effects of loneliness on population well-being in the FSU. PMID:23861843

  13. Violent conflict and opiate use in low and middle-income countries: a systematic review.

    PubMed

    Jack, Helen; Masterson, Amelia Reese; Khoshnood, Kaveh

    2014-03-01

    Violent conflicts disproportionately affect populations in low and middle-income countries, and exposure to conflict is a known risk factor for mental disorders and substance use, including use of illicit opiates. Opiate use can be particularly problematic in resource-limited settings because few treatment options are available and dependence can impede economic development. In this systematic review, we explore the relationship between violent conflict and opiate use in conflict-affected populations in low and middle-income countries. We searched MEDLINE, PsychINFO, SCOPUS, PILOTS, and select grey literature databases using a defined list of key terms related to conflict and opiate use, screened the results for relevant and methodologically rigorous studies, and conducted a forward search of the bibliographies of selected results to identify additional studies. We screened 707 articles, selecting 6 articles for inclusion: 4 quantitative studies and 2 qualitative studies that examined populations in 9 different countries. All study participants were adults (aged 15-65) living in or displaced from a conflict-affected country. Data sources included death records, hospital records, and interviews with refugees, internally displaced persons, and others affected by conflict. Overall, we found a positive, but ambiguous, association between violent conflict and opiate use, with five of six studies suggesting that opiate use increases with violent conflict. Five key factors mediate the conceptual relationship between opiate use and violent conflict: (1) pre-conflict opiate presence, (2) mental disorders, (3) lack of economic opportunity, (4) changes in social norms or structure, and (5) changes in drug availability. The strength and direction of the association between opiate use and violent conflict and the proposed mediating factors may differ between contexts, necessitating country and population-specific research and interventions. Prevalence of opiate use prior to the start of conflict was common to all populations in which conflict induced a change in opiate use, suggesting that interventions to reduce opiate use and future research should focus on such populations. Population-based, longitudinal studies that use systematic measures of exposure to conflict and opiate use are needed to further explore this association and its mediating factors. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Early Evidence for Zika Virus Circulation among Aedes aegypti Mosquitoes, Rio de Janeiro, Brazil

    PubMed Central

    Ayllón, Tania; Campos, Renata de Mendonça; Brasil, Patrícia; Morone, Fernanda Cristina; Câmara, Daniel Cardoso Portela; Meira, Guilherme Louzada Silva; Tannich, Egbert; Yamamoto, Kristie Aimi; Carvalho, Marilia Sá; Pedro, Renata Saraiva; Cadar, Daniel; Ferreira, Davis Fernandes; Honório, Nildimar Alves

    2017-01-01

    During 2014–2016, we conducted mosquito-based Zika virus surveillance in Rio de Janeiro, Brazil. Results suggest that Zika virus was probably introduced into the area during May–November 2013 via multiple in-country sources. Furthermore, our results strengthen the hypothesis that Zika virus in the Americas originated in Brazil during October 2012–May 2013. PMID:28628464

  15. Transmission dynamics of schistosomiasis in Zimbabwe: A mathematical and GIS Approach

    NASA Astrophysics Data System (ADS)

    Ngarakana-Gwasira, E. T.; Bhunu, C. P.; Masocha, M.; Mashonjowa, E.

    2016-06-01

    Temperature and presence of water bodies are known to influence the transmission dynamics of schistosomiasis. In this work, effects of water bodies (taken in context of rainfall patterns) and temperature from 1950 to 2000 are considered in the model. With the aid of Geographic Information System (GIS), the reproduction number is mapped on the Zimbabwean country. Results of the mapping show high reproduction numbers along the Lowveld and the Zambezi valley catchment area. High reproduction numbers suggest high levels of schistosomiasis. This result suggests more control efforts should be targeted in these areas with high reproduction numbers.

  16. Emerging trends in informal sector recycling in developing and transition countries.

    PubMed

    Ezeah, Chukwunonye; Fazakerley, Jak A; Roberts, Clive L

    2013-11-01

    Optimistic estimates suggest that only 30-70% of waste generated in cities of developing countries is collected for disposal. As a result, uncollected waste is often disposed of into open dumps, along the streets or into water bodies. Quite often, this practice induces environmental degradation and public health risks. Notwithstanding, such practices also make waste materials readily available for itinerant waste pickers. These 'scavengers' as they are called, therefore perceive waste as a resource, for income generation. Literature suggests that Informal Sector Recycling (ISR) activity can bring other benefits such as, economic growth, litter control and resources conservation. This paper critically reviews trends in ISR activities in selected developing and transition countries. ISR often survives in very hostile social and physical environments largely because of negative Government and public attitude. Rather than being stigmatised, the sector should be recognised as an important element for achievement of sustainable waste management in developing countries. One solution to this problem could be the integration of ISR into the formal waste management system. To achieve ISR integration, this paper highlights six crucial aspects from literature: social acceptance, political will, mobilisation of cooperatives, partnerships with private enterprises, management and technical skills, as well as legal protection measures. It is important to note that not every country will have the wherewithal to achieve social inclusion and so the level of integration must be 'flexible'. In addition, the structure of the ISR should not be based on a 'universal' model but should instead take into account local contexts and conditions. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  17. Inequality of child mortality among ethnic groups in sub-Saharan Africa.

    PubMed Central

    Brockerhoff, M.; Hewett, P.

    2000-01-01

    Accounts by journalists of wars in several countries of sub-Saharan Africa in the 1990s have raised concern that ethnic cleavages and overlapping religious and racial affiliations may widen the inequalities in health and survival among ethnic groups throughout the region, particularly among children. Paradoxically, there has been no systematic examination of ethnic inequality in child survival chances across countries in the region. This paper uses survey data collected in the 1990s in 11 countries (Central African Republic, Côte d'Ivoire, Ghana, Kenya, Mali, Namibia, Niger, Rwanda, Senegal, Uganda, and Zambia) to examine whether ethnic inequality in child mortality has been present and spreading in sub-Saharan Africa since the 1980s. The focus was on one or two groups in each country which may have experienced distinct child health and survival chances, compared to the rest of the national population, as a result of their geographical location. The factors examined to explain potential child survival inequalities among ethnic groups included residence in the largest city, household economic conditions, educational attainment and nutritional status of the mothers, use of modern maternal and child health services including immunization, and patterns of fertility and migration. The results show remarkable consistency. In all 11 countries there were significant differentials between ethnic groups in the odds of dying during infancy or before the age of 5 years. Multivariate analysis shows that ethnic child mortality differences are closely linked with economic inequality in many countries, and perhaps with differential use of child health services in countries of the Sahel region. Strong and consistent results in this study support placing the notion of ethnicity at the forefront of theories and analyses of child mortality in Africa which incorporate social, and not purely epidemiological, considerations. Moreover, the typical advantage of relatively small, clearly defined ethnic groups, as compared to the majority in the national population, according to fundamental indicators of wellbeing--child survival, education, housing, and so forth--suggests that many countries in sub-Saharan Africa, despite their widespread poverty, are as marked by social inequality as are countries in other regions in the world. PMID:10686731

  18. Indoor particulate matter in developing countries: a case study in Pakistan and potential intervention strategies

    NASA Astrophysics Data System (ADS)

    Nasir, Zaheer Ahmad; Colbeck, Ian; Ali, Zulfiqar; Ahmad, Shakil

    2013-06-01

    Around three billion people, largely in low and middle income countries, rely on biomass fuels for their household energy needs. The combustion of these fuels generates a range of hazardous indoor air pollutants and is an important cause of morbidity and mortality in developing countries. Worldwide, it is responsible for four million deaths. A reduction in indoor smoke can have a significant impact on lives and can help achieve many of the Millennium Developments Goals. This letter presents details of a seasonal variation in particulate matter (PM) concentrations in kitchens using biomass fuels as a result of relocating the cooking space. During the summer, kitchens were moved outdoors and as a result the 24 h average PM10, PM2.5 and PM1 fell by 35%, 22% and 24% respectively. However, background concentrations of PM10 within the village increased by 62%. In locations where natural gas was the dominant fuel, the PM concentrations within the kitchen as well as outdoors were considerably lower than those in locations using biomass. These results highlights the importance of ventilation and fuel type for PM levels and suggest that an improved design of cooking spaces would result in enhanced indoor air quality.

  19. Fertility and Life Satisfaction in Rural Ethiopia.

    PubMed

    Conzo, Pierluigi; Fuochi, Giulia; Mencarini, Letizia

    2017-08-01

    Despite recent strong interest in the link between fertility and subjective well-being, the focus has centered on developed countries. For poorer countries, in contrast, the relationship remains rather elusive. Using a well-established panel survey-the Ethiopian Rural Household Survey (ERHS)-we investigate the empirical relationship between fertility and life satisfaction in rural Ethiopia, the largest landlocked country in Africa. Consistent with the fertility theories for developing countries and with the sociodemographic characteristics of rural Ethiopia, we hypothesize that this relationship varies by gender and across life stages, being more positive for men and for parents in old age. Indeed, our results suggest that older men benefit the most in terms of life satisfaction from having a large number of children, while the recent birth of a child is detrimental for the subjective well-being of women at reproductive ages. We address endogeneity issues by using lagged life satisfaction in ordinary least squares regressions, through fixed-effects estimation and the use of instrumental variables.

  20. Public budgets for energy RD&D and the effects on energy intensity and pollution levels.

    PubMed

    Balsalobre, Daniel; Álvarez, Agustín; Cantos, José María

    2015-04-01

    This study, based on the N-shaped cubic model of the environmental Kuznets curve, analyzes the evolution of per capita greenhouse gas emissions (GHGpc) using not just economic growth but also public budgets dedicated to energy-oriented research development and demonstration (RD&D) and energy intensity. The empirical evidence, obtained from an econometric model of fixed effects for 28 OECD countries during 1994-2010, suggests that energy innovations help reduce GHGpc levels and mitigate the negative impact of energy intensity on environmental quality. When countries develop active energy RD&D policies, they can reduce both the rates of energy intensity and the level of GHGpc emissions. This paper incorporates a moderating variable to the econometric model that emphasizes the effect that GDP has on energy intensity. It also adds a variable that reflects the difference between countries that have made a greater economic effort in energy RD&D, which in turn corrects the GHG emissions resulting from the energy intensity of each country.

  1. Bibliometric analysis of phytotechnologies for remediation: global scenario of research and applications.

    PubMed

    Koelmel, Jeremy; Prasad, M N V; Pershell, Karoline

    2015-01-01

    Phytoremediation is often a low cost alternative to conventional remediation. To assess trends, a bibliometric approach using data from SciVerse Scopus, SciVerseHub, and GoogleTM Trends was used. Globally there is a linear increase in publications containing the word phytoremediation as a percent of all published papers in SciVerse Hub, with China, India, and the Philippines concentrating relatively more research in phytoremediation. Furthermore there was an inverse correlation between a country's Human Development Index (HDI) and a country's phytoremediation research output as a percent of total research. Results show a focus on phytoremediation in countries with low HDI values. This suggests that academic experts are available for advancing phytoremediation applications in countries where the majority of the effected population do not have the education, finances, and political leverage to obtain expensive conventional remediation efforts on their land. Phytoremediation can combine expert advice with affected parties commitment and labor to help mitigate the harms of polluted landscapes.

  2. Does a wife's education influence spousal agreement on approval of family planning?: Random-effects Modeling using data from two West African Countries.

    PubMed

    Hossain, Mian; Ahmed, Saifuddin; Rogers, Laurencia

    2014-05-01

    Spousal approval of family planning is critical for contraceptive use. Both contraceptive use rates and women's education are low in many West-African countries and this study examines the role of wives' education in spousal agreement on approval of family planning in two sub-Saharan West African countries. We used couples' data from Demographic Health Surveys in Senegal and in Niger, conducted in 2005 and 2006, respectively. Multiple logistic regression results using multilevel modeling show that the odds of spousal agreement on approval of family planning were slightly over three times [OR: 3.16; 95% CI: 1.32 to 7.57] in Senegal and were about three times [OR: 3.07; 95% CI: 1.64 to 5.76] in Niger higher for women with more than primary education. Findings suggest that improvement in women's education could lead to spousal agreement on approval of family planning, which may lead to use of family planning in sub-Saharan African countries.

  3. Impact of terrorism and political instability on equity premium: Evidence from Pakistan

    NASA Astrophysics Data System (ADS)

    MengYun, Wu; Imran, Muhammad; Zakaria, Muhammad; Linrong, Zhang; Farooq, Muhammad Umer; Muhammad, Shah Khalid

    2018-02-01

    The study quantifies the impact of terrorism and political instability on firm equity premium in Pakistan using panel data for 306 non-financial firms for the period 2001 to 2014. Other variables included are law & order, government regime change and financial crisis of 2007/08. The estimated results reveal that terrorism has statistically significant negative impact on firm equity premium in Pakistan. This result is robust with alternative equation specifications. The result also remains same when terrorism variable is replaced with external and internal conflict variables. Law & order variable has significant positive effect on firm equity premium, which implies that equity premium increases with the improvement in law & order situation in the country. Equity premium also increases with government stability and when there is democratic system in the country. The result also reveals that global financial crisis of 2007/08 negatively influenced the firm equity premium. The study suggests some policy implications.

  4. Harm reduction and viral hepatitis C in European prisons: a cross-sectional survey of 25 countries.

    PubMed

    Bielen, Rob; Stumo, Samya R; Halford, Rachel; Werling, Klára; Reic, Tatjana; Stöver, Heino; Robaeys, Geert; Lazarus, Jeffrey V

    2018-05-11

    Current estimates suggest that 15% of all prisoners worldwide are chronically infected with the hepatitis C virus (HCV), and this number is even higher in regions with high rates of injecting drug use. Although harm reduction services such as opioid substitution therapy (OST) and needle and syringe programs (NSPs) are effective in preventing the further spread of HCV and HIV, the extent to which these are available in prisons varies significantly across countries. The Hep-CORE study surveyed liver patient groups from 25 European countries in 2016 and mid-2017 on national policies related to harm reduction, testing/screening, and treatment for HCV in prison settings. Results from the cross-sectional survey were compared to the data from available reports and the peer-reviewed literature to determine the overall degree to which European countries implement evidence-based HCV recommendations in prison settings. Patient groups in nine countries (36%) identified prisoners as a high-risk population target for HCV testing/screening. Twenty-one countries (84%) provide HCV treatment in prisons. However, the extent of coverage of these treatment programs varies widely. Two countries (8%) have NSPs officially available in prisons in all parts of the country. Eleven countries (44%) provide OST in prisons in all parts of the country without additional requirements. Despite the existence of evidence-based recommendations, infectious disease prevention measures such as harm reduction programs are inadequate in European prison settings. Harm reduction, HCV testing/screening, and treatment should be scaled up in prison settings in order to progress towards eliminating HCV as a public health threat.

  5. Are health inequalities really not the smallest in the Nordic welfare states? A comparison of mortality inequality in 37 countries

    PubMed Central

    Popham, Frank; Dibben, Chris; Bambra, Clare

    2013-01-01

    Background Research comparing mortality by socioeconomic status has found that inequalities are not the smallest in the Nordic countries. This is in contrast to expectations given these countries’ policy focus on equity. An alternative way of studying inequality has been little used to compare inequalities across welfare states and may yield a different conclusion. Methods We used average life expectancy lost per death as a measure of total inequality in mortality derived from death rates from the Human Mortality Database for 37 countries in 2006 that we grouped by welfare state type. We constructed a theoretical ‘lowest mortality comparator country’ to study, by age, why countries were not achieving the smallest inequality and the highest life expectancy. We also studied life expectancy as there is an important correlation between it and inequality. Results On average, Nordic countries had the highest life expectancy and smallest inequalities for men but not women. For both men and women, Nordic countries had particularly low younger age mortality contributing to smaller inequality and higher life expectancy. Although older age mortality in the Nordic countries is not the smallest. There was variation within Nordic countries with Sweden, Iceland and Norway having higher life expectancy and smaller inequalities than Denmark and Finland (for men). Conclusions Our analysis suggests that the Nordic countries do have the smallest inequalities in mortality for men and for younger age groups. However, this is not the case for women. Reducing premature mortality among older age groups would increase life expectancy and reduce inequality further in Nordic countries. PMID:23386671

  6. The role of micro health insurance in providing financial risk protection in developing countries--a systematic review.

    PubMed

    Habib, Shifa Salman; Perveen, Shagufta; Khuwaja, Hussain Maqbool Ahmed

    2016-03-22

    Out of pocket payments are the predominant method of financing healthcare in many developing countries, which can result in impoverishment and financial catastrophe for those affected. In 2010, WHO estimated that approximately 100 million people are pushed below the poverty line each year by payments for healthcare. Micro health insurance (MHI) has been used in some countries as means of risk pooling and reducing out of pocket health expenditure. A systematic review was conducted to assess the extent to which MHI has contributed to providing financial risk protection to low-income households in developing countries, and suggest how the findings can be applied in the Pakistani setting. We conducted a systematic search for published literature using the search terms "Community based health insurance AND developing countries", "Micro health insurance AND developing countries", "Mutual health insurance AND developing countries", "mutual OR micro OR community based health insurance" "Health insurance AND impact AND poor" "Health insurance AND financial protection" and "mutual health organizations" on three databases, Pubmed, Google Scholar and Science Direct (Elsevier). Only those records that were published in the last ten years, in English language with their full texts available free of cost, were considered for inclusion in this review. Hand searching was carried out on the reference lists of the retrieved articles and webpages of international organizations like World Bank, World Health Organization and International Labour Organization. Twenty-three articles were eligible for inclusion in this systematic review (14 from Asia and 9 from Africa). Our analysis shows that MHI, in the majority of cases, has been found to contribute to the financial protection of its beneficiaries, by reducing out of pocket health expenditure, catastrophic health expenditure, total health expenditure, household borrowings and poverty. MHI also had a positive safeguarding effect on household savings, assets and consumption patterns. Our review suggests that MHI, targeted at the low-income households and tailored to suit the cultural and geographical structures in the various areas of Pakistan, may contribute towards providing protection to the households from catastrophe and impoverishment resulting from health expenditures. This paper emphasizes the need for further research to fill the knowledge gap that exists about the impact of MHI, using robust study designs and impact indicators.

  7. Maternal and child mortality indicators across 187 countries of the world: converging or diverging.

    PubMed

    Goli, Srinivas; Arokiasamy, Perianayagam

    2014-01-01

    This study reassessed the progress achieved since 1990 in maternal and child mortality indicators to test whether the progress is converging or diverging across countries worldwide. The convergence process is examined using standard parametric and non-parametric econometric models of convergence. The results of absolute convergence estimates reveal that progress in maternal and child mortality indicators is diverging for the entire period of 1990-2010 [maternal mortality ratio (MMR) - β = .00033, p < .574; neonatal mortality rate (NNMR) - β = .04367, p < .000; post-neonatal mortality rate (PNMR) - β = .02677, p < .000; under-five mortality rate (U5MR) - β = .00828, p < .000)]. In the recent period, such divergence is replaced with convergence for MMR but diverged for all the child mortality indicators. The results of Kernel density estimate reveal considerable reduction in divergence of MMR for the recent period; however, the Kernel density distribution plots show more than one 'peak' which indicates the emergence of convergence clubs based on their mortality levels. For child mortality indicators, the Kernel estimates suggest that divergence is in progress across the countries worldwide but tended to converge for countries with low mortality levels. A mere progress in global averages of maternal and child mortality indicators among a global cross-section of countries does not warranty convergence unless there is a considerable reduction in variance, skewness and range of change.

  8. Influenza in workplaces: transmission, workers’ adherence to sick leave advice and European sick leave recommendations

    PubMed Central

    Tomba, Gianpaolo Scalia; de Blasio, Birgitte Freiesleben

    2016-01-01

    Background: Knowledge about influenza transmission in the workplace and whether staying home from work when experiencing influenza-like illness can reduce the spread of influenza is crucial for the design of efficient public health initiatives. Aim: This review synthesizes current literature on sickness presenteeism and influenza transmission in the workplace and provides an overview of sick leave recommendations in Europe for influenza. Methods: A search was performed on Medline, Embase, PsychINFO, Cinahl, Web of Science, Scopus and SweMed to identify studies related to workplace contacts, -transmission, -interventions and compliance with recommendations to take sick leave. A web-based survey on national recommendations and policies for sick leave during influenza was issued to 31 European countries. Results: Twenty-two articles (9 surveys; 13 modelling articles) were eligible for this review. Results from social mixing studies suggest that 20–25% of weekly contacts are made in the workplace, while modelling studies suggest that on average 16% (range 9–33%) of influenza transmission occurs in the workplace. The effectiveness of interventions to reduce workplace presenteeism is largely unknown. Finally, estimates from studies reporting expected compliance with sick leave recommendations ranged from 71 to 95%. Overall, 18 countries participated in the survey of which nine (50%) had issued recommendations encouraging sick employees to stay at home during the 2009 A(H1N1) pandemic, while only one country had official recommendations for seasonal influenza. Conclusions: During the 2009 A(H1N1) pandemic, many European countries recommended ill employees to take sick leave. Further research is warranted to quantify the effect of reduced presenteeism during influenza illness. PMID:27060594

  9. Molecular phylogenetic identification of Fasciola flukes in Nepal.

    PubMed

    Shoriki, Takuya; Ichikawa-Seki, Madoka; Devkota, Bhuminand; Rana, Hari B; Devkota, Shiva P; Humagain, Sudeep K; Itagaki, Tadashi

    2014-12-01

    Eighty-one Fasciola flukes collected from 8 districts in Nepal were analyzed for their species identification on the basis of their spermatogenic status and nuclear ribosomal internal transcribed spacer 1 (ITS1) and for their phylogenetic relation with Fasciola flukes from other Asian countries on the basis of the mitochondrial NADH dehydrogenase subunit 1 (nad1) gene. Sixty-one flukes (75.3%) were aspermic Fasciola sp., and 20 flukes (24.7%) were identified as Fasciola gigantica. All of the aspermic flukes displayed the Fh/Fg type in ITS1, which was predominant in aspermic Fasciola sp. from China, and most (60 flukes) displayed the Fsp-ND1-N1 haplotype in the nad1, which had an identical nucleotide sequence to the major haplotype (Fg-C2) of the aspermic flukes from China. These results suggest that aspermic Fasciola sp. was introduced into Nepal from China. Furthermore, the results of the diversity indices, neutrality indices, and median-joining network analysis with reference haplotypes from Asian countries suggest that aspermic Fasciola sp. rapidly expanded its distribution. In contrasts, F. gigantica displayed 10 nad1 haplotypes, which showed higher population diversity indices than the haplotypes of aspermic flukes, indicating that the F. gigantica population was clearly distributed in Nepal earlier than the aspermic Fasciola population. Although the F. gigantica haplotypes from Nepal formed a star-like phylogeny consisting of a main founder haplotype (Fg-ND1-N1), together with some F. gigantica haplotypes from Myanmar and Thailand, the Nepal population differed genetically from F. gigantica populations of neighboring countries as each country had distinct founder haplotype(s). Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Bring a gun to a gunfight: armed adversaries and violence across nations.

    PubMed

    Felson, Richard B; Berg, Mark T; Rogers, Meghan L

    2014-09-01

    We use homicide data and the International Crime Victimization Survey to examine the role of firearms in explaining cross-national variation in violence. We suggest that while gun violence begets gun violence, it inhibits the tendency to engage in violence without guns. We attribute the patterns to adversary effects-i.e., the tendency of offenders to take into account the threat posed by their adversaries. Multi-level analyses of victimization data support the hypothesis that living in countries with high rates of gun violence lowers an individual's risk of an unarmed assault and assaults with less lethal weapons. Analyses of aggregate data show that homicide rates and gun violence rates load on a separate underlying factor than other types of violence. The results suggest that a country's homicide rate reflects, to a large extent, the tendency of its offenders to use firearms. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Two cases of rickets presenting with poor growth, hypotonia, and respiratory problems.

    PubMed

    Wouters, E; Wojciechowski, M; de Vries, E

    2015-06-01

    Rickets is a rare disease in developed countries. In children, it is a disease which affects growing bone. Depending on the severity, it can present with a wide variety of symptoms. Because it is such a rare disease in developed countries, symptoms suggesting rickets are often not easily recognized. This can cause a delay in diagnosing and treating rickets. Often unnecessary and sometimes invasive investigations are performed. First leading clues to rickets on physical examination are poor growth, especially length, thickening of wrists, bow legs, and craniotabes. At further examination, special attention should be paid to osteopenia and cupping and fraying at the metaphyses on X-rays. Laboratory results suggestive for rickets are elevated alkaline phosphatase and disturbances in calcium and phosphate homeostasis. In this report, we present two cases presenting with poor growth, severe pain, and respiratory problems secondary to calcipenic rickets.

  12. Migrants, healthy worker effect, and mortality trends in the Gulf Cooperation Council countries.

    PubMed

    Chaabna, Karima; Cheema, Sohaila; Mamtani, Ravinder

    2017-01-01

    The Gulf Cooperation Council (GCC) countries namely, Bahrain, Kuwait, Oman, Qatar, United Arab Emirates (UAE), and Saudi Arabia, have experienced unique demographic changes. The major population growth contributor in these countries is young migrants, which has led to a shift in the population age pyramid. Migrants constitute the vast proportion of GCC countries' population reaching >80% in Qatar and UAE. Using Global Burden of Disease Study 2015 (GBD 2015) and United Nations data, for the GCC countries, we assessed the association between age-standardized mortality and population size trends with linear and polynomial regressions. In 1990-2015, all-cause age-standardized mortality was inversely proportional to national population size (p-values: 0.0001-0.0457). In Bahrain, Qatar, Oman, and Saudi Arabia, the highest annual decrease in mortality was observed when the annual population growth was the highest. In Qatar, all-cause age-specific mortality was inversely proportional to age-specific population size. This association was statistically significant among the 5-14 and 15-49 age groups, which have the largest population size. Cause-specific age-standardized mortality was also inversely proportional to population size. This association was statistically significant for half of the GBD 2015-defined causes of death such as "cirrhosis and other chronic liver diseases" and "HIV/AIDS and tuberculosis". Remarkably, incoming migrants to Qatar have to be negative for HIV, hepatitis B and C, and tuberculosis. These results show that decline in mortality can be partly attributed to the increase in GCC countries' population suggesting a healthy migrant effect that influences mortality rates. Consequently, benefits of health interventions and healthcare improvement are likely to be exaggerated in such countries hosting a substantial proportion of migrants compared with countries where migration is low. Researchers and policymakers should be cautious to not exclusively attribute decline in mortality within the GCC countries as a result of the positive effects of health interventions or healthcare improvement.

  13. Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data

    PubMed Central

    2011-01-01

    Background As a result of widespread chloroquine and sulphadoxine-pyrimethamine (SP) resistance, 90% of sub-Saharan African countries had adopted policies of artemisinin-based combination therapy (ACT) for treatment of uncomplicated malaria by 2007. In Malawi, cessation of chloroquine use was followed by the re-emergence of chloroquine-susceptible malaria. It was expected that introduction of ACT would lead to a return in chloroquine susceptibility throughout Africa, but this has not yet widely occurred. This observation suggests that there is continuing use of ineffective anti-malarials in Africa and that persistent chloroquine-resistant malaria is due to ongoing drug pressure despite national policy changes. Methods To estimate drug use on a national level, 2006-2007 Demographic Health Survey and Multiple Indicator Cluster Survey data from 21 African countries were analysed. Resistance data were compiled by systematic review of the published literature on the prevalence of the Plasmodium falciparum chloroquine resistance transporter polymorphism at codon 76, which causes chloroquine resistance. Results Chloroquine was the most common anti-malarial used according to surveys from 14 of 21 countries analysed, predominantly in West Africa. SP was most commonly reported in two of 21 countries. Among eight countries with longitudinal molecular resistance data, the four countries where the highest proportion of children treated for fever received chloroquine (Uganda, Burkina Faso, Guinea Bissau, and Mali) also showed no significant declines in the prevalence of chloroquine-resistant infections. The three countries with low or decreasing chloroquine use among children who reported fever treatment (Malawi, Kenya, and Tanzania) had statistically significant declines in the prevalence of chloroquine resistance. Conclusions This study demonstrates that in 2006-2007, chloroquine and SP continued to be used at high rates in many African countries. In countries reporting sustained chloroquine use, chloroquine-resistant malaria persists. In contrast, a low level of estimated chloroquine use is associated with a declining prevalence of chloroquine resistance. PMID:21554692

  14. Aggregate level beverage specific effect of alcohol sale on myocardial infarction mortality rate.

    PubMed

    Razvodovsky, Yury Evgeny

    2009-01-01

    The pronounced fluctuations in cardiovascular mortality in the countries of the former Soviet Union over the past decades have attracted considerable interest. The mounting evidence suggests that binge drinking pattern is a potentially important contributor to higher cardiovascular mortality rate in the former Soviet republics. There is assumption that if occasional heavy drinking of strong spirits increases the risk of cardiovascular mortality, countries where this is predominant drinking pattern should display positive association between spirits consumption and cardiovascular mortality at the aggregate level. To estimate the aggregate level beverage specific effect of alcohol sale on myocardial infarction mortality rate in drinking culture, which combine a higher level of spirits consumption per capita with the explosive drinking pattern. Trends in beverage specific alcohol sale per capita and myocardial infarction mortality rate from 1970 to 2005 in Belarus were analyzed employing ARIMA time series analysis. The results of time series analysis suggest positive relation between strong spirits (vodka) sale per capita and myocardial infarction mortality rate. The analysis suggests that a 1 liter increase in vodka sale per capita would result in a 7.2% increase in myocardial infarction mortality rate (8.2% increase in male mortality and 6.8% increase in female mortality). the results of the present study suggest a positive relation between vodka sale and myocardial infarction mortality rate at aggregate level and support the hypothesis that binge drinking of strong spirits is a risk factor of myocardial infarction at the individual level. Thus, from a public policy point of view, the outcome of this study suggests that cardiovascularrelated mortality prevention programs should put more focus on addressing alcohol consumption structure.

  15. Wastage in the health workforce: some perspectives from African countries.

    PubMed

    Dovlo, Delanyo

    2005-08-10

    Sub-Saharan Africa faces a human resources crisis in the health sector. Over the past two decades its population has increased substantially, with a significant rise in the disease burden due to HIV/AIDS and recurrent communicable diseases and an increased incidence of noncommunicable diseases. This increased demand for health services is met with a rather low supply of health workers, but this notwithstanding, sub-Saharan African countries also experience significant wastage of their human resources stock. This paper is a desk review to illustrate suggestions that the way human resources for health (HRH) are trained and deployed in Africa does not enhance productivity and that countries are unable to realize the full potential expected from the working life of their health workers. The paper suggests data types for use in measuring various forms of "wastage". "Direct" wastage--or avoidable increases in loss of staff through factors such as emigration and death--is on the rise, perhaps as a result of the HIV/AIDS epidemic. "Indirect" wastage--which is the result of losses in output and productivity from health professionals' misapplied skills, absenteeism, poor support and lack of supervision--is also common. HIV/AIDS represents a special cause of wastage in Africa. Deaths of health workers, fear of infection, burnout, absenteeism, heavy workloads and stress affect productivity. The paper reviews strategies that have been proposed and/or implemented. It suggests areas needing further attention, including: developing and using indicators for monitoring and managing wastage; enhancing motivation and morale of health workers; protecting and valuing the health worker with enhanced occupational safety and welfare systems; and establishing the moral leadership to effectively tackle HIV/AIDS and the brain drain.

  16. Carbon Tetrachloride Emissions from the US during 2008 - 2012 Derived from Atmospheric Data Using Bayesian and Geostatistical Inversions

    NASA Astrophysics Data System (ADS)

    Hu, L.; Montzka, S. A.; Miller, B.; Andrews, A. E.; Miller, J. B.; Lehman, S.; Sweeney, C.; Miller, S. M.; Thoning, K. W.; Siso, C.; Atlas, E. L.; Blake, D. R.; De Gouw, J. A.; Gilman, J.; Dutton, G. S.; Elkins, J. W.; Hall, B. D.; Chen, H.; Fischer, M. L.; Mountain, M. E.; Nehrkorn, T.; Biraud, S.; Tans, P. P.

    2015-12-01

    Global atmospheric observations suggest substantial ongoing emissions of carbon tetrachloride (CCl4) despite a 100% phase-out of production for dispersive uses since 1996 in developed countries and 2010 in other countries. Little progress has been made in understanding the causes of these ongoing emissions or identifying their contributing sources. In this study, we employed multiple inverse modeling techniques (i.e. Bayesian and geostatistical inversions) to assimilate CCl4 mole fractions observed from the National Oceanic and Atmospheric Administration (NOAA) flask-air sampling network over the US, and quantify its national and regional emissions during 2008 - 2012. Average national total emissions of CCl4 between 2008 and 2012 determined from these observations and an ensemble of inversions range between 2.1 and 6.1 Gg yr-1. This emission is substantially larger than the mean of 0.06 Gg/yr reported to the US EPA Toxics Release Inventory over these years, suggesting that under-reported emissions or non-reporting sources make up the bulk of CCl4 emissions from the US. But while the inventory does not account for the magnitude of observationally-derived CCl4 emissions, the regional distribution of derived and inventory emissions is similar. Furthermore, when considered relative to the distribution of uncapped landfills or population, the variability in measured mole fractions was most consistent with the distribution of industrial sources (i.e., those from the Toxics Release Inventory). Our results suggest that emissions from the US only account for a small fraction of the global on-going emissions of CCl4 (30 - 80 Gg yr-1 over this period). Finally, to ascertain the importance of the US emissions relative to the unaccounted global emission rate we considered multiple approaches to extrapolate our results to other countries and the globe.

  17. Diet, microbiota, and inflammatory bowel disease: lessons from Japanese foods

    PubMed Central

    Matsuoka, Katsuyoshi; Naganuma, Makoto; Hayashi, Atsushi; Hisamatsu, Tadakazu

    2014-01-01

    The incidence and prevalence of inflammatory bowel diseases (IBDs) including ulcerative colitis and Crohn disease are rapidly increasing in Western countries and in developed Asian countries. Although biologic agents targeting the immune system have been effective in patients with IBD, cessation of treatment leads to relapse in the majority of patients, suggesting that intrinsic immune dysregulation is an effect, not a cause, of IBD. Dramatic changes in the environment, resulting in the dysregulated composition of intestinal microbiota or dysbiosis, may be associated with the fundamental causes of IBD. Japan now has upgraded water supply and sewerage systems, as well as dietary habits and antibiotic overuse that are similar to such features found in developed Western countries. The purpose of this review article was to describe the association of diet, particularly Japanese food and microbiota, with IBD. PMID:25045286

  18. Occupational Trajectories and Immigrant Worker Health

    PubMed Central

    Crollard, Allison; de Castro, A. B.; Tsai, Jenny Hsin-Chun

    2013-01-01

    During their initial years in the receiving country, many immigrants experience occupational downgrading. Downgrading is a loss of occupational status between one’s last job in the home country and first job in the receiving country, often resulting in overeducation or overqualification. Although the extent and determinants of such occupational trajectories have been characterized, the connection to immigrant worker health has not been widely examined. However, an emerging body of knowledge indicates that negative health outcomes are associated with overeducation and overqualification in general worker populations, suggesting similar experiences by immigrant workers. This article provides an overview of the magnitude and conceptualization of occupational downgrading, overeducation, and overqualification and discusses implications for immigrant worker health. Occupational health professionals should spearhead research efforts on occupational downgrading, raise public awareness about the issue, and serve as advocates for immigrant workers’ rights. PMID:23092177

  19. Diet, microbiota, and inflammatory bowel disease: lessons from Japanese foods.

    PubMed

    Kanai, Takanori; Matsuoka, Katsuyoshi; Naganuma, Makoto; Hayashi, Atsushi; Hisamatsu, Tadakazu

    2014-07-01

    The incidence and prevalence of inflammatory bowel diseases (IBDs) including ulcerative colitis and Crohn disease are rapidly increasing in Western countries and in developed Asian countries. Although biologic agents targeting the immune system have been effective in patients with IBD, cessation of treatment leads to relapse in the majority of patients, suggesting that intrinsic immune dysregulation is an effect, not a cause, of IBD. Dramatic changes in the environment, resulting in the dysregulated composition of intestinal microbiota or dysbiosis, may be associated with the fundamental causes of IBD. Japan now has upgraded water supply and sewerage systems, as well as dietary habits and antibiotic overuse that are similar to such features found in developed Western countries. The purpose of this review article was to describe the association of diet, particularly Japanese food and microbiota, with IBD.

  20. The effectiveness of risk management: an analysis of project risk planning across industries and countries.

    PubMed

    Zwikael, Ofer; Ahn, Mark

    2011-01-01

    This article examines the effectiveness of current risk management practices to reduce project risk using a multinational, multi-industry study across different scenarios and cultures. A survey was administered to 701 project managers, and their supervisors, in seven industries and three diverse countries (New Zealand, Israel, and Japan), in multiple languages during the 2002-2007 period. Results of this study show that project context--industry and country where a project is executed--significantly impacts perceived levels of project risk, and the intensity of risk management processes. Our findings also suggest that risk management moderates the relationship between risk level and project success. Specifically, we found that even moderate levels of risk management planning are sufficient to reduce the negative effect risk levels have on project success. © 2010 Society for Risk Analysis.

  1. International migration network: Topology and modeling

    NASA Astrophysics Data System (ADS)

    Fagiolo, Giorgio; Mastrorillo, Marina

    2013-07-01

    This paper studies international migration from a complex-network perspective. We define the international migration network (IMN) as the weighted-directed graph where nodes are world countries and links account for the stock of migrants originated in a given country and living in another country at a given point in time. We characterize the binary and weighted architecture of the network and its evolution over time in the period 1960-2000. We find that the IMN is organized around a modular structure with a small-world binary pattern displaying disassortativity and high clustering, with power-law distributed weighted-network statistics. We also show that a parsimonious gravity model of migration can account for most of observed IMN topological structure. Overall, our results suggest that socioeconomic, geographical, and political factors are more important than local-network properties in shaping the structure of the IMN.

  2. International migration network: topology and modeling.

    PubMed

    Fagiolo, Giorgio; Mastrorillo, Marina

    2013-07-01

    This paper studies international migration from a complex-network perspective. We define the international migration network (IMN) as the weighted-directed graph where nodes are world countries and links account for the stock of migrants originated in a given country and living in another country at a given point in time. We characterize the binary and weighted architecture of the network and its evolution over time in the period 1960-2000. We find that the IMN is organized around a modular structure with a small-world binary pattern displaying disassortativity and high clustering, with power-law distributed weighted-network statistics. We also show that a parsimonious gravity model of migration can account for most of observed IMN topological structure. Overall, our results suggest that socioeconomic, geographical, and political factors are more important than local-network properties in shaping the structure of the IMN.

  3. The environmental Kuznets curve in the presence of corruption in developing countries.

    PubMed

    Masron, Tajul Ariffin; Subramaniam, Yogeeswari

    2018-05-01

    Environmental degradation is at an alarming level in developing economies. The present paper examines the direct and indirect impacts of corruption on environmental deterioration using the panel data of 64 developing countries. Adopting the generalized method of moments (GMM) technique, the paper finds evidence that corruption exhibits a positive impact on pollution. Subsequently, there is also evidence indicating that the level of pollution tends to be higher in countries with a higher level of corruption, eliminating the effectiveness of income effect on environmental preservation. These results also suggest that environmental degradation is monotonically increasing with higher corruption and invalidate the presence of the EKC. Hence, a policy focuses that an anti-corruption particularly in the environmental and natural resources sector needs to be emphasized and enforced in order to reduce or possibly to totally eliminate the rent for corruption.

  4. Exploring the Relationship Between Absolute and Relative Position and Late-Life Depression: Evidence From 10 European Countries

    PubMed Central

    Ladin, Keren; Daniels, Norman; Kawachi, Ichiro

    2010-01-01

    Purpose: Socioeconomic inequality has been associated with higher levels of morbidity and mortality. This study explores the role of absolute and relative deprivation in predicting late-life depression on both individual and country levels. Design and Methods: Country- and individual-level inequality indicators were used in multivariate logistic regression and in relative indexes of inequality. Data obtained from the Survey of Health, Ageing and Retirement in Europe (SHARE, Wave 1, Release 2) included 22,777 men and women (aged 50–104 years) from 10 European countries. Late-life depression was measured using the EURO-D scale and corresponding clinical cut point. Absolute deprivation was measured using gross domestic product and median household income at the country level and socioeconomic status at the individual level. Relative deprivation was measured by Gini coefficients at the country level and educational attainment at the individual level. Results: Rates of depression ranged from 18.10% in Denmark to 36.84% in Spain reflecting a clear north–south gradient. Measures of absolute and relative deprivation were significant in predicting depression at both country and individual levels. Findings suggest that the adverse impact of societal inequality cannot be overcome by increased individual-level or country-level income. Increases in individual-level income did not mitigate the effect of country-level relative deprivation. Implications: Mental health disparities persist throughout later life whereby persons exposed to higher levels of country-level inequality suffer greater morbidity compared with those in countries with less inequality. Cross-national variation in the relationship between inequality and depression illuminates the need for further research. PMID:19515635

  5. Explaining the heterogeneous scrapie surveillance figures across Europe: a meta-regression approach.

    PubMed

    Del Rio Vilas, Victor J; Hopp, Petter; Nunes, Telmo; Ru, Giuseppe; Sivam, Kumar; Ortiz-Pelaez, Angel

    2007-06-28

    Two annual surveys, the abattoir and the fallen stock, monitor the presence of scrapie across Europe. A simple comparison between the prevalence estimates in different countries reveals that, in 2003, the abattoir survey appears to detect more scrapie in some countries. This is contrary to evidence suggesting the greater ability of the fallen stock survey to detect the disease. We applied meta-analysis techniques to study this apparent heterogeneity in the behaviour of the surveys across Europe. Furthermore, we conducted a meta-regression analysis to assess the effect of country-specific characteristics on the variability. We have chosen the odds ratios between the two surveys to inform the underlying relationship between them and to allow comparisons between the countries under the meta-regression framework. Baseline risks, those of the slaughtered populations across Europe, and country-specific covariates, available from the European Commission Report, were inputted in the model to explain the heterogeneity. Our results show the presence of significant heterogeneity in the odds ratios between countries and no reduction in the variability after adjustment for the different risks in the baseline populations. Three countries contributed the most to the overall heterogeneity: Germany, Ireland and The Netherlands. The inclusion of country-specific covariates did not, in general, reduce the variability except for one variable: the proportion of the total adult sheep population sampled as fallen stock by each country. A large residual heterogeneity remained in the model indicating the presence of substantial effect variability between countries. The meta-analysis approach was useful to assess the level of heterogeneity in the implementation of the surveys and to explore the reasons for the variation between countries.

  6. Characteristics attributed to complementary foods by caregivers in four countries of Latin America and the Caribbean.

    PubMed

    Dutta, Tanushree; Sywulka, Sara M; Frongillo, Edward A; Lutter, Chessa K

    2006-12-01

    Attributes that caregivers assign to complementary foods have been primarily described in the context of illness, but attributes assigned to foods in everyday circumstances must be understood to effectively promote good complementary feeding. This study aimed to understand how mothers judge complementary foods to be appropriate by cross-cultural examination of food perceptions in four different Latin American and Caribbean countries. We used semistructured interviews to assess attributes that mothers ascribed to a list of key foods, both home-made and manufactured, and reasons for feeding or not feeding them. We elicited attributes from 79 caregivers with children 6 to 24 months of age from two urban and perirban sites each in Brazil, Jamaica, Mexico, and Panama. Textual analysis based on six home foods common to the four countries and manufactured foods resulted in six attribute categories, five of which could be positive or negative (Nutrient Content, Effects on Child, Child's Response, Availability and Accessibility, and Other Food Attributes); one (Food Quality and Safety) was only negative. Analysis of attributes of home foods (chicken, eggs, beans, carrots, bananas or plantains, and oranges) revealed many beliefs that were common within and across countries, whereas analysis of the attributes of manufactured foods revealed that these foods were less known. The consistency of the attribute categories across countries and across home and manufactured foods suggests their relevance to planning programs to improve complementary feeding in Latin America and the Caribbean and possibly other developing countries. These results can be used programmatically to assess the need for and the focus of food education programs, and to indicate which countries will be more receptive to certain foods as a means of improving complementary feeding.

  7. Icelandic for Adult Foreigners: Effects of Imposing an Icelandic Language Test

    ERIC Educational Resources Information Center

    Innes, Pamela; Skaptadóttir, Unnur Dís

    2017-01-01

    Legislation linking language course attendance and passage of a language test for residence visas and citizenship, respectively, was enacted in Iceland in the early 2000s. Curricular guidelines and the language test were developed as a result. Research in other countries suggests such structures cause teachers to create "de facto"…

  8. Scale is not an Issue : Opportunities for Collaboration among Geoscientists in Latin America and the Caribbean

    NASA Astrophysics Data System (ADS)

    Carby, B. E.

    2015-12-01

    Latin American and Caribbean (LAC) countries face multiple hazards such as earthquakes, volcanoes, accelerated erosion, landslides, drought, flooding, windstorms and the effects of climate variability and change. World Bank (2005) data indicate that seventeen of the top thirty-five countries with relatively high mortality risk from 3 or more hazards are located in LAC, El Salvador has the second highest per cent of its population at risk - 77.7% and 7 of the top 10 countries for population exposure to multiple hazards are in LAC. All LAC countries have half or more of GDP exposed to at least one hazard. The report underscores the need for better data and information on hazards and disasters to inform disaster risk reduction (DRR) and supports the view that reduction of disaster risk is essential for achieving Sustainable Development (SD). This suggests that DRR must be integrated into development planning of countries. However the Global Assessment Report notes that globally, there has been little progress in mainstreaming DRR in national development (UNISDR 2009). Without this, countries will not realise development goals. DRR efforts in LAC require an integrated approach including societal input in deciding priority DRR research themes and interdisciplinary, multi-hazard research informing DRR policy and practice. Jiminez (2015) from a study of countries across LAC reports that efforts are being made to link research to national planning through inclusion of policy makers in some university-led research projects. Research by the author in Jamaica reveals that the public sector has started to apply research on hazards to inform DRR policy, programmes and plans. As most research is done by universities, there is collaboration between the public sector and academia. Despite differences in scale among countries across the region, similarities in exposure to multiple hazards and potential hazard impacts suggest that collaboration among researchers in LAC could be beneficial. It is proposed here that this collaboration should go beyond the scientific community and should include sharing of experiences in linking DRR research to national development needs, inclusion of policy makers in research design and implementation and integration of research results in policy and programme development.

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

    PubMed Central

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

    2015-01-01

    Background To integrate immigrants into their societies, European countries have adopted different types of policies, which may influence health through both material and psychosocial determinants. Recent studies have suggested poorer health outcomes for immigrants living in countries with poorly rated integration policies. Objective To analyse mortality differences of immigrants from the same country of origin living in countries with distinct integration policy contexts. Methods From the mortality dataset collected in the Migrant Ethnic Health Observatory (MEHO) project, we chose the Netherlands (linked data from 1996-2006), France (unlinked; 2005-2007) and Denmark (linked; 1992-2001) as representatives of the inclusive, assimilationist and exclusionist policy models, respectively, based on the Migrant Integration Policy Index. We calculated for each country sex- and age-standardized mortality rates for Turkish-, Moroccan- and local-born populations aged 20-69 years. Poisson regression was used to estimate the mortality rate ratios (MRRs) for cross-country and within-country comparisons. The analyses were further stratified by age group and cause of death. Results Compared with their peers in the Netherlands, Turkish-born immigrants had higher all-cause mortality in Denmark (MRR men 1.92; 95% CI 1.74-2.13 and women 2.11; 1.80-2.47) but lower in France (men 0.64; 0.59-0.69 and women 0.58; 0.51-0.67). A similar pattern emerged for Moroccan-born immigrants. The relative differences between immigrants and the local-born population were also largest in Denmark and lowest in France (e.g., Turkish-born men MRR 1.52; 95% CI 1.38-1.67 and 0.62; 0.58-0.66, respectively). These patterns were consistent across all age groups, and more marked for cardiovascular diseases. Conclusions Although confounders and data comparability issues (e.g., French cross-sectional data) may affect the findings, this study suggests that different macro-level policy contexts may influence immigrants’ mortality. Comparable mortality registration systems across Europe along with detailed socio-demographic information on immigrants may help to better assess this association. PMID:26067249

  10. Clean birth kits to improve birth practices: development and testing of a country level decision support tool.

    PubMed

    Hundley, Vanora A; Avan, Bilal I; Ahmed, Haris; Graham, Wendy J

    2012-12-19

    Clean birth practices can prevent sepsis, one of the leading causes of both maternal and newborn mortality. Evidence suggests that clean birth kits (CBKs), as part of package that includes education, are associated with a reduction in newborn mortality, omphalitis, and puerperal sepsis. However, questions remain about how best to approach the introduction of CBKs in country. We set out to develop a practical decision support tool for programme managers of public health systems who are considering the potential role of CBKs in their strategy for care at birth. Development and testing of the decision support tool was a three-stage process involving an international expert group and country level testing. Stage 1, the development of the tool was undertaken by the Birth Kit Working Group and involved a review of the evidence, a consensus meeting, drafting of the proposed tool and expert review. In Stage 2 the tool was tested with users through interviews (9) and a focus group, with federal and provincial level decision makers in Pakistan. In Stage 3 the findings from the country level testing were reviewed by the expert group. The decision support tool comprised three separate algorithms to guide the policy maker or programme manager through the specific steps required in making the country level decision about whether to use CBKs. The algorithms were supported by a series of questions (that could be administered by interview, focus group or questionnaire) to help the decision maker identify the information needed. The country level testing revealed that the decision support tool was easy to follow and helpful in making decisions about the potential role of CBKs. Minor modifications were made and the final algorithms are presented. Testing of the tool with users in Pakistan suggests that the tool facilitates discussion and aids decision making. However, testing in other countries is needed to determine whether these results can be replicated and to identify how the tool can be adapted to meet country specific needs.

  11. Spatiotemporal Dynamics and Fitness Analysis of Global Oil Market: Based on Complex Network

    PubMed Central

    Wang, Minggang; Fang, Guochang; Shao, Shuai

    2016-01-01

    We study the overall topological structure properties of global oil trade network, such as degree, strength, cumulative distribution, information entropy and weight clustering. The structural evolution of the network is investigated as well. We find the global oil import and export networks do not show typical scale-free distribution, but display disassortative property. Furthermore, based on the monthly data of oil import values during 2005.01–2014.12, by applying random matrix theory, we investigate the complex spatiotemporal dynamic from the country level and fitness evolution of the global oil market from a demand-side analysis. Abundant information about global oil market can be obtained from deviating eigenvalues. The result shows that the oil market has experienced five different periods, which is consistent with the evolution of country clusters. Moreover, we find the changing trend of fitness function agrees with that of gross domestic product (GDP), and suggest that the fitness evolution of oil market can be predicted by forecasting GDP values. To conclude, some suggestions are provided according to the results. PMID:27706147

  12. Contracting out of health services in developing countries.

    PubMed

    McPake, B; Banda, E E

    1994-03-01

    Contracting out is emerging as a common policy issue in a number of developing countries. The theoretical case for contracting out suggests many advantages in combining public finance with private provision. However, practical difficulties such as those of ensuring that competition takes place between potential contractors, that competition leads to efficiency and that contracts and the process of contracting are effectively managed, suggest that such advantages may not always be realized. Most countries are likely only to contemplate restricted contracting of small-scale non-clinical services in the short term. Prerequisites of more extensive models appear to be the development of information systems and human resources to that end. Some urban areas of larger countries may have the existing preconditions for more successful large-scale contracting.

  13. Exploring the risk factors associated with the size and severity of roadway crashes in Riyadh.

    PubMed

    Hassan, Hany M; Al-Faleh, Hesham

    2013-12-01

    Recently, growing concern has been shifting toward the necessity of improving traffic safety in the Kingdom of Saudi Arabia (KSA). KSA has a unique traffic safety problem in that: (a) it can be classified as a developed country in terms of the magnitude and quality of the roadway networks available and its compatibility with international standards; however, (b) it can also be considered a developing country as the rate of increase in the number of road crashes is substantial compared with relevant figures of other developing countries and other countries of the Gulf region. Hence, more research efforts are still needed. This paper examines the nature and causes of fatal and serious traffic crashes in KSA so that solutions and/or future studies can be suggested. Data from 11,545 reported fatal and injury traffic crashes that occurred in Riyadh (the capital of KSA) during the period 2004-2011 were analyzed by alternative and complementary methods. A logistic regression model was estimated and the results revealed that crash reason (speeding), damages in public property, day of the week, crash location (non-intersection location), and point of collision (head-on) were the significant variables affecting the binary target variable (fatal and non-fatal crashes). Additionally, the structural equation modeling approach was developed to identify and quantify the impacts of significant variables influencing crash size (e.g., no. of injuries, no. of vehicles involved in the crash). Crash size is one of the important indices that measure the level of safety of transportation facilities. The results showed that road factor was the most significant factor affecting the size of the crash followed by the driver and environment factors. Considering the results of this study, practical suggestions on how to improve traffic safety in KSA are also presented and discussed. © 2013.

  14. Diagnosis and Management of Depression in 3 Countries: Results From a Clinical Vignette Factorial Experiment

    PubMed Central

    Link, Carol L.; Stern, Theodore A.; Piccolo, Rebecca S.; Marceau, Lisa D.; Arber, Sara; Adams, Ann; Siegrist, Johannes; von dem Knesebeck, Olaf

    2011-01-01

    Objective: International differences in disease prevalence rates are often reported and thought to reflect different lifestyles, genetics, or cultural differences in care-seeking behavior. However, they may also be produced by differences among health care systems. We sought to investigate variation in the diagnosis and management of a “patient” with exactly the same symptoms indicative of depression in 3 different health care systems (Germany, the United Kingdom, and the United States). Method: A factorial experiment was conducted between 2001 and 2006 in which 384 randomly selected primary care physicians viewed a video vignette of a patient presenting with symptoms suggestive of depression. Under the supervision of experienced clinicians, professional actors were trained to realistically portray patients who presented with 7 symptoms of depression: sleep disturbance, decreased interest, guilt, diminished energy, impaired concentration, poor appetite, and psychomotor agitation or retardation. Results: Most physicians listed depression as one of their diagnoses (89.6%), but German physicians were more likely to diagnose depression in women, while British and American physicians were more likely to diagnose depression in men (P = .0251). American physicians were almost twice as likely to prescribe an antidepressant as British physicians (P = .0241). German physicians were significantly more likely to refer the patient to a mental health professional than British or American physicians (P < .0001). German physicians wanted to see the patient in follow-up sooner than British or American physicians (P < .0001). Conclusions: Primary care physicians in different countries diagnose the exact same symptoms of depression differently depending on the patient's gender. There are also significant differences between countries in the management of a patient with symptoms suggestive of depression. International differences in prevalence rates for depression, and perhaps other diseases, may in part result from differences among health care systems in different countries. PMID:22295269

  15. Comparative assessment of analytical approaches to quantify the risk for introduction of rare animal diseases: the example of avian influenza in Spain.

    PubMed

    Sánchez-Vizcaíno, Fernando; Perez, Andrés; Martínez-López, Beatriz; Sánchez-Vizcaíno, José Manuel

    2012-08-01

    Trade of animals and animal products imposes an uncertain and variable risk for exotic animal diseases introduction into importing countries. Risk analysis provides importing countries with an objective, transparent, and internationally accepted method for assessing that risk. Over the last decades, European Union countries have conducted probabilistic risk assessments quite frequently to quantify the risk for rare animal diseases introduction into their territories. Most probabilistic animal health risk assessments have been typically classified into one-level and multilevel binomial models. One-level models are more simple than multilevel models because they assume that animals or products originate from one single population. However, it is unknown whether such simplification may result in substantially different results compared to those obtained through the use of multilevel models. Here, data used on a probabilistic multilevel binomial model formulated to assess the risk for highly pathogenic avian influenza introduction into Spain were reanalyzed using a one-level binomial model and their outcomes were compared. An alternative ordinal model is also proposed here, which makes use of simpler assumptions and less information compared to those required by traditional one-level and multilevel approaches. Results suggest that, at least under certain circumstances, results of the one-level and ordinal approaches are similar to those obtained using multilevel models. Consequently, we argue that, when data are insufficient to run traditional probabilistic models, the ordinal approach presented here may be a suitable alternative to rank exporting countries in terms of the risk that they impose for the spread of rare animal diseases into disease-free countries. © 2012 Society for Risk Analysis.

  16. The Demand for Cigarettes in Tanzania and Implications for Tobacco Taxation Policy

    PubMed Central

    Kidane, Asmerom; Mduma, John; Naho, Alexis; Ngeh, Ernest Tingum; Hu, Teh-wei

    2016-01-01

    The study attempts to estimate the demand for cigarettes in Tanzania and presents simulation results on the effect of the cigarette excise tax on smoking participation, government revenue, and related topics. After briefly summarizing the magnitude and spread of cigarette consumption in the country, the paper reviews some empirical estimates from African and other countries. The 2008 Tanzanian household budget survey was used to estimate the demand for cigarettes in Tanzania. The descriptive statistics suggest that the smoking prevalence for Tanzania is 15.35 percent with low variability across expenditure (income) groups. Smoking intensity and per capita consumption were estimated at 7.08 cigarettes and 1.33 cigarettes, respectively, a relatively low value. A two-part demand equation model was used to estimate various elasticities. For the overall equation, the price elasticities of smoking participation, smoking intensity, and total elasticity were estimated at −0.879, −0.853, and −1.732, respectively. Compared to similar results in other developing countries, the estimates appear quite high. When estimated by expenditure (income) groups, the magnitude of the elasticity appears higher among high expenditure groups than among low expenditure groups. Two simulation exercises were undertaken. First, the effect of different excise rates on smoking participation rate, cigarette consumption, tax revenue, and related responses was estimated and highlighted. Second, the same exercise was undertaken to determine the effect of a given increase in the cigarette excise tax on various expenditure groups. The overall results suggest that an increase in the excise tax on cigarettes in Tanzania would reduce cigarette consumption and increase government tax revenue. PMID:27358905

  17. Soy intake and breast cancer risk: A meta-analysis of epidemiological studies

    NASA Astrophysics Data System (ADS)

    Bahrom, Suhaila; Idris, Nik Ruzni Nik

    2016-06-01

    The impact of soy intake on breast cancer risk has been investigated extensively. However, these studies reported conflicting results. The objective of this study is to perform comprehensive review and updated meta-analysis on the association between soy intake and breast cancer risk and to identify significant factors which may contribute to the inconsistencies of results of the individual studies. Based on reviews of existing meta-analysis, we identified four main factors which contributed to the inconsistencies of results of individual studies on the association of soy intake and breast cancer risk namely; region, menopausal status of the patients, soy type and study design. Accordingly, we performed an updated meta-analysis of 57 studies grouped by the identified factors. Pooled ORs of studies carried out in Asian countries suggested that soy isoflavones consumption was inversely associated with the risk of breast cancer among both pre and postmenopausal women (OR=0.63, 95% CI: 0.54-0.74 for premenopausal women; OR=0.63, 95% CI: 0.52-0.75 for postmenopausal women). However, pooled OR of studies carried out in Western countries shows that there is no statistically significant association between soy intake and breast cancer risk (OR=0.98, 95% CI: 0.93-1.03). Our study suggests that soy food intake is associated with significantly reduced risk of breast cancer for women in Asian but not in Western countries. Further epidemiological studies need to be conducted with more comprehensive information about the dietary intake and relative exposure among the women in these two different regions.

  18. The Demand for Cigarettes in Tanzania and Implications for Tobacco Taxation Policy.

    PubMed

    Kidane, Asmerom; Mduma, John; Naho, Alexis; Ngeh, Ernest Tingum; Hu, Teh-Wei

    2015-10-01

    The study attempts to estimate the demand for cigarettes in Tanzania and presents simulation results on the effect of the cigarette excise tax on smoking participation, government revenue, and related topics. After briefly summarizing the magnitude and spread of cigarette consumption in the country, the paper reviews some empirical estimates from African and other countries. The 2008 Tanzanian household budget survey was used to estimate the demand for cigarettes in Tanzania. The descriptive statistics suggest that the smoking prevalence for Tanzania is 15.35 percent with low variability across expenditure (income) groups. Smoking intensity and per capita consumption were estimated at 7.08 cigarettes and 1.33 cigarettes, respectively, a relatively low value. A two-part demand equation model was used to estimate various elasticities. For the overall equation, the price elasticities of smoking participation, smoking intensity, and total elasticity were estimated at -0.879, -0.853, and -1.732, respectively. Compared to similar results in other developing countries, the estimates appear quite high. When estimated by expenditure (income) groups, the magnitude of the elasticity appears higher among high expenditure groups than among low expenditure groups. Two simulation exercises were undertaken. First, the effect of different excise rates on smoking participation rate, cigarette consumption, tax revenue, and related responses was estimated and highlighted. Second, the same exercise was undertaken to determine the effect of a given increase in the cigarette excise tax on various expenditure groups. The overall results suggest that an increase in the excise tax on cigarettes in Tanzania would reduce cigarette consumption and increase government tax revenue.

  19. Growth-corruption-health triaca and environmental degradation: empirical evidence from Indonesia, Malaysia, and Thailand.

    PubMed

    Azam, Muhammad; Khan, Abdul Qayyum

    2017-07-01

    This study examines the impact of economic growth, corruption, health, and poverty on environmental degradation for three countries from ASEAN, namely Indonesia, Malaysia, and Thailand using annual data over the period of 1994-2014. The relationship between environmental degradation (pollution) by carbon dioxide (CO 2 ) emissions and economic growth is examined along with some other variables, namely health expenditure, poverty, agriculture value added growth, industrial value added growth, and corruption. The ordinary least squares (OLS) method is applied as an analytical technique for parameter estimation. The empirical results reveal that almost all variables are statistically significant at the 5% level of significance, whereby test rejects the null hypotheses of non-cointegration, indicating that all variables play an important role in affecting the environment across countries. Empirical results also indicate that economic growth has significant positive impact, while health expenditures show significantly negative impact on the environment. Corruption has significant positive effect on environment in the case of Malaysia; while in the case of Indonesia and Thailand, it has insignificant results. However, for the individual analysis across countries, the regression estimate suggests that economic growth has a significant positive relationship with environment for Indonesia, while it is found insignificantly negative and positive in the case of Malaysia and Thailand, respectively, during the period under the study. Empirical findings of the study suggest that policy-makers require to make technological-friendly environment sequentially to surmount unregulated pollution, steady population transfers from rural areas to urban areas are also important, and poverty alleviation and better health provision can also help to improve the environment.

  20. Cyberbullying Definition Among Adolescents: A Comparison Across Six European Countries

    PubMed Central

    Nocentini, Annalaura; Palladino, Benedetta Emanuela; Frisén, Ann; Berne, Sofia; Ortega-Ruiz, Rosario; Calmaestra, Juan; Scheithauer, Herbert; Schultze-Krumbholz, Anja; Luik, Piret; Naruskov, Karin; Blaya, Catherine; Berthaud, Julien; Smith, Peter K.

    2012-01-01

    Abstract Several criteria have been proposed for defining cyberbullying to young people, but no studies have proved their relevance. There are also variations across different countries in the meaning and the definition of this behavior. We systematically investigated the role of five definitional criteria for cyberbullying, in six European countries. These criteria (intentionality, imbalance of power, repetition, anonymity, and public vs. private) were combined through a set of 32 scenarios, covering a range of four types of behaviors (written-verbal, visual, exclusion, and impersonation). For each scenario, participants were asked whether it was cyberbullying or not. A randomized version of the questionnaire was shown to 295 Italian, 610 Spanish, 365 German, 320 Sweden, 336 Estonian, and 331 French adolescents aged 11–17 years. Results from multidimensional scaling across country and type of behavior suggested a clear first dimension characterized by imbalance of power and a clear second dimension characterized by intentionality and, at a lower level, by anonymity. In terms of differences across types of behaviors, descriptive frequencies showed a more ambiguous role for exclusion as a form of cyberbullying, but general support was given to the relevance of the two dimensions across all the types of behavior. In terms of country differences, French participants more often perceived the scenarios as cyberbullying as compared with those in other countries, but general support was found for the relevance of the two dimensions across countries. PMID:22817693

  1. System redesign of the immunization supply chain: Experiences from Benin and Mozambique.

    PubMed

    Prosser, Wendy; Jaillard, Philippe; Assy, Emmanuelle; Brown, Shawn T; Matsinhe, Graça; Dekoun, Mawutondji; Lee, Bruce Y

    2017-04-19

    Evidence suggests that immunization supply chains are becoming outdated and unable to deliver needed vaccines due to growing populations and new vaccine introductions. Redesigning a supply chain could result in meeting current demands. The Ministries of Health in Benin in Mozambique recognized known barriers to the immunization supply chain and undertook a system redesign to address those barriers. Changes were made to introduce an informed push system while consolidating storage points, introducing transport loops, and increasing human resource capacity for distribution. Evaluations were completed in each country. Evaluation in each country indicated improved performance of the supply chain. The Effective Vaccine Management (EVM) assessment in Benin documented notable improvements in the distribution criteria of the tool, increasing from 40% to 100% at the district level. In Mozambique, results showed reduced stockouts at health facility level from 79% at baseline to less than 1% at endline. Coverage rates of DTP3 also increased from 68.9% to 92.8%. Benin and Mozambique are undertaking system redesign in order to respond to constraints identified in the vaccine supply chain. Results and learnings show improvements in supply chain performance and make a strong case for system redesign. These countries demonstrate the feasibility of system redesign for other countries considering how to address outdated supply chains. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  2. Role of the private sector in the provision of immunization services in low- and middle-income countries.

    PubMed

    Levin, Ann; Kaddar, Miloud

    2011-07-01

    The authors conducted a literature review on the role of the private sector in low- and middle-income countries. The review indicated that relatively few studies have researched the role of the private sector in immunization service delivery in these countries. The studies suggest that the private sector is playing different roles and functions according to economic development levels, the governance structure and the general presence of the private sector in the health sector. In some countries, generally low-income countries, the private for-profit sector is contributing to immunization service delivery and helping to improve access to traditional EPI vaccines. In other countries, particularly middle-income countries, the private for-profit sector often acts to facilitate early adoption of new vaccines and technologies before introduction and generalization by the public sector. The not-for-profit sector plays an important role in extending access to traditional EPI vaccines, particularly in low-income countries. Not-for-profit facilities are situated in rural as well as urban areas and are more likely to be coordinated with public services than the private for-profit sector. Although numerous studies on non-governmental organizations (NGOs) suggest that the extent of NGO provision of immunization services in low- and middle-income countries is substantial, the contribution of this sector is poorly documented, leading to a lack of recognition of its role at national and global levels. Studies on quality of immunization service provision at private health facilities suggest that it is sometimes inadequate and needs to be monitored. Although some articles on public-private collaboration exist, little was found on the extent to which governments are effectively interacting with and regulating the private sector. The review revealed many geographical and thematic gaps in the literature on the role and regulation of the private sector in the delivery of immunization services in low- and middle-income countries.

  3. Pharmacoeconomic spotlight on rotavirus vaccine RIX4414 (Rotarix™) in developed countries.

    PubMed

    Plosker, Greg L

    2012-12-01

    The most common cause of severe diarrhea in infants and young children is rotavirus gastroenteritis (RVGE), which is associated with significant morbidity, healthcare resource use, and direct and indirect costs in industrialized nations. The monovalent rotavirus vaccine RIX4414 (Rotarix™) is administered as a two-dose oral series in infants and has demonstrated protective efficacy against RVGE in clinical trials conducted in developed countries. In addition, various naturalistic studies have demonstrated 'real-world' effectiveness after the introduction of widespread rotavirus vaccination programs in the community setting. Numerous cost-effectiveness analyses have been conducted in developed countries in which a universal rotavirus vaccination program using RIX4414 was compared with no universal rotavirus vaccination program. There was a high degree of variability in base-case results across studies even when the studies were conducted in the same country, often reflecting differences in the selection of data sources or assumptions used to populate the models. In addition, results were sensitive to plausible changes in a number of key input parameters. As such, it is not possible to definitively state whether a universal rotavirus vaccination program with RIX4414 is cost effective in developed countries, although results of some analyses in some countries suggest this is the case. In addition, international guidelines advocate universal vaccination of infants and children against rotavirus. It is also difficult to draw conclusions regarding the cost effectiveness of rotavirus vaccine RIX4414 relative to that of the pentavalent rotavirus vaccine, which is administered as a three-dose oral series. Although indirect comparisons in cost-effectiveness analyses indicate that RIX4414 provided more favorable incremental cost-effectiveness ratios when each vaccine was compared with no universal rotavirus vaccination program, results were generally sensitive to vaccine costs. Actual tender prices of a full vaccination course for each vaccine were not known at the time of the analyses and therefore had to be estimated.

  4. Collective religiosity and the gender gap in attitudes towards economic redistribution in 86 countries, 1990-2008.

    PubMed

    Jaime-Castillo, Antonio M; Fernández, Juan J; Valiente, Celia; Mayrl, Damon

    2016-05-01

    What is the relationship between gender and the demand for redistribution? Because, on average, women face more economic deprivation than men, in many countries women favor redistribution more than men. However, this is not the case in a number of other countries, where women do not support redistribution more than men. To explain this cross-national paradox, we stress the role of collective religiosity. In many religions, theological principles both militate against public policies designed to redistribute income, and also promote traditionally gendered patterns of work and family involvement. Hence, we hypothesize that, in those countries where religion remains influential either through closer church-state ties or an intensely religious population, men and women should differ less in their attitudes towards redistribution. Drawing upon the World Values Survey, we estimate three-level regression models that test our religiosity-based approach and two alternative explanations in 86 countries and 175 country-years. The results are consistent with our hypothesis. Moreover, in further support of our theoretical approach, societal religiosity undermines pro-redistribution preferences more among women than men. Our findings suggest that collective religiosity matters more to the gender gap in redistributive attitudes than traditional political and labor force factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Cross-country differences in basal and stress-induced cortisol secretion in older adults.

    PubMed

    Souza-Talarico, Juliana N; Plusquellec, Pierrich; Lupien, Sonia J; Fiocco, Alexandra; Suchecki, Deborah

    2014-01-01

    Several studies have emphasized the association between socioeconomic status (SES) and inadequate response of the biological stress system. However, other factors related to SES are rarely considered, such as cultural values, social norms, organization, language and communication skills, which raises the need to investigate cross-country differences in stress response. Although some studies have shown differences in cortisol levels between immigrants and natives, there is no cross-country evidence regarding cortisol levels in country-native elders. This is particularly important given the high prevalence of stress-related disorders across nations during aging. The current study examined basal diurnal and reactive cortisol levels in healthy older adults living in two different countries. Salivary cortisol of 260 older adults from Canada and Brazil were analyzed. Diurnal cortisol was measured in saliva samples collected at home throughout two working days at awakening, 30 min after waking, 1400 h, 1600 h and before bedtime. Cortisol reactivity was assessed in response to the Trier Social Stress Test (TSST) in both populations. Our results showed that even under similar health status, psychological and cognitive characteristics, Brazilian elders exhibited higher basal and stress-induced cortisol secretion compared to the Canadian participants. These findings suggest that country context may modulate cortisol secretion and could impact the population health.

  6. Importing food damages domestic environment: Evidence from global soybean trade.

    PubMed

    Sun, Jing; Mooney, Harold; Wu, Wenbin; Tang, Huajun; Tong, Yuxin; Xu, Zhenci; Huang, Baorong; Cheng, Yeqing; Yang, Xinjun; Wei, Dan; Zhang, Fusuo; Liu, Jianguo

    2018-05-22

    Protecting the environment and enhancing food security are among the world's Sustainable Development Goals and greatest challenges. International food trade is an important mechanism to enhance food security worldwide. Nonetheless, it is widely concluded that in international food trade importing countries gain environmental benefits, while exporting countries suffer environmental problems by using land and other resources to produce food for exports. Our study shows that international food trade can also lead to environmental pollution in importing countries. At the global level, our metaanalysis indicates that there was increased nitrogen (N) pollution after much farmland for domestically cultivated N-fixing soybeans in importing countries was converted to grow high N-demanding crops (wheat, corn, rice, and vegetables). The findings were further verified by an intensive study at the regional level in China, the largest soybean-importing country, where the conversion of soybean lands to corn fields and rice paddies has also led to N pollution. Our study provides a sharp contrast to the conventional wisdom that only exports contribute substantially to environmental woes. Our results suggest the need to evaluate environmental consequences of international trade of all other major goods and products in all importing countries, which have significant implications for fundamental rethinking in global policy-making and debates on environmental responsibilities among consumers, producers, and traders across the world.

  7. A comparison of global conservation prioritization models with spatial spending patterns of conservation nongovernmental organizations.

    PubMed

    Holmes, George; Scholfield, Katherine; Brockington, Dan

    2012-08-01

    In recent decades, various conservation organizations have developed models to prioritize locations for conservation. Through a survey of the spending patterns of 281 conservation nongovernmental organizations (NGOs), we examined the relation between 2 such models and spatial patterns of spending by conservation NGOs in 44 countries in sub-Saharan Africa. We tested whether, at the country level, the proportion of a country designated as a conservation priority was correlated with where NGOs spent money. For one model (the combination of Conservation International's hotspots and High Biodiversity Wilderness Areas, which are areas of high endemism with high or low levels of vegetation loss respectively), there was no relation between the proportion of a country designated as a priority and levels of NGO spending, including by the NGO associated with the model. In the second model (Global 200), the proportion of a country designated as a priority and the amount of money spent by NGOs were significantly and positively related. Less money was spent in countries in northern and western sub-Saharan Africa than countries in southern and eastern Africa, relative to the proportion of the country designated as a conservation priority. We suggest that on the basis of our results some NGOs consider increasing their spending on the areas designated as of conservation priority which are currently relatively underfunded, although there are economic, political, cultural, historical, biological, and practical reasons why current spending patterns may not align with priority sites. ©2012 Society for Conservation Biology.

  8. Epidemiology of prostate cancer in Asian countries.

    PubMed

    Kimura, Takahiro; Egawa, Shin

    2018-06-01

    The incidence of prostate cancer has been increasing worldwide in recent years. The GLOBOCAN project showed that prostate cancer was the second most frequently diagnosed cancer and the fifth leading cause of cancer mortality among men worldwide in 2012. This trend has been growing even in Asian countries, where the incidence had previously been low. However, the accuracy of data about incidence and mortality as a result of prostate cancer in some Asian countries is limited. The cause of this increasing trend is multifactorial. One possible explanation is changes in lifestyles due to more Westernized diets. The incidence is also statistically biased by the wide implementation of early detection systems and the accuracy of national cancer registration systems, which are still immature in most Asian countries. Mortality rate decreases in Australia, New Zealand and Japan since the 1990s are possibly due to the improvements in treatment and/or early detection efforts employed. However, this rate is increasing in the majority of other Asian countries. Studies of latent and incidental prostate cancer provide less biased information. The prevalence of latent and incidental prostate cancer in contemporary Japan and Korea is similar to those in Western countries, suggesting the influence of lifestyle changes on carcinogenesis. Many studies reported evidence of both congenital and acquired risk factors for carcinogenesis of prostate cancer. Recent changes in the acquired risk factors might be associated with the increasing occurrence of prostate cancer in Asian countries. This trend could continue, especially in developing Asian countries. © 2018 The Japanese Urological Association.

  9. Comparison of the burden of illness for adults with ADHD across seven countries: a qualitative study

    PubMed Central

    2012-01-01

    Background The purpose of this study was to expand the understanding of the burden of illness experienced by adults with Attention Deficit-Hyperactivity Disorder (ADHD) living in different countries and treated through different health care systems. Methods Fourteen focus groups and five telephone interviews were conducted in seven countries in North America and Europe, comprised of adults who had received a diagnosis of ADHD. The countries included Canada, France, Germany, Italy, The Netherlands, United Kingdom, and United States (two focus groups in each country). There were 108 participants. The focus groups were designed to elicit narratives of the experience of ADHD in key domains of symptoms, daily life, and social relationships. Consonant with grounded theory, the transcripts were analyzed using descriptive coding and then themed into larger domains. Results Participants’ statements regarding the presentation of symptoms, childhood experience, impact of ADHD across the life course, addictive and risk-taking behavior, work and productivity, finances, relationships and psychological health impacts were similarly themed across all seven countries. These similarities were expressed through the domains of symptom presentation, childhood experience, medication treatment issues, impacts in adult life and across the life cycle, addictive and risk-taking behavior, work and productivity, finances, psychological and social impacts. Conclusions These data suggest that symptoms associated with adult ADHD affect individuals similarly in different countries and that the relevance of the diagnostic category for adults is not necessarily limited to certain countries and sociocultural milieus. PMID:22583562

  10. Research in Indian Country: Challenges and Changes.

    ERIC Educational Resources Information Center

    Hillabrant, Walter

    This paper describes selected settings, circumstances, problems, and barriers to research in Indian country, and suggests ways to mitigate or overcome such problems and barriers. Examples are drawn from four research projects. Distinctions are drawn among sponsors of research in Indian country (usually federal agencies); consumers of such research…

  11. International Demand for American Higher Education: An Extension.

    ERIC Educational Resources Information Center

    Mixon, J. Wilson, Jr.; Wan, Weidong

    1990-01-01

    A study of the relationship of population and income in Asian countries and Organization of Petroleum Exporting Countries (OPEC) members to their demand for American higher education found that both population and income significantly affect demand, but not proportionally. Findings suggest countries meet most change in citizens' demand with…

  12. Risk factors for men's lifetime perpetration of physical violence against intimate partners: results from the international men and gender equality survey (IMAGES) in eight countries.

    PubMed

    Fleming, Paul J; McCleary-Sills, Jennifer; Morton, Matthew; Levtov, Ruti; Heilman, Brian; Barker, Gary

    2015-01-01

    This paper examines men's lifetime physical intimate partner violence (IPV) perpetration across eight low- and middle-income countries to better understand key risk factors that interventions can target in order to promote gender equality and reduce IPV. We use data from men (n = 7806) that were collected as part of the International Men and Gender Equality Survey (IMAGES) in Bosnia and Herzegovina, Brazil, Chile, Croatia, Democratic Republic of Congo (DRC), India, Mexico, and Rwanda. Results show that there is wide variation across countries for lifetime self-reported physical violence perpetration (range: 17% in Mexico to 45% in DRC), men's support for equal roles for men and women, and acceptability of violence against women. Across the sample, 31% of men report having perpetrated physical violence against a partner in their lifetime. In multivariate analyses examining risk factors for men ever perpetrating physical violence against a partner, witnessing parental violence was the strongest risk factor, reinforcing previous research suggesting the inter-generational transmission of violence. Additionally, having been involved in fights not specifically with an intimate partner, permissive attitudes towards violence against women, having inequitable gender attitudes, and older age were associated with a higher likelihood of ever perpetrating physical IPV. In separate analyses for each country, we found different patterns of risk factors in countries with high perpetration compared to countries with low perpetration. Findings are interpreted to identify key knowledge gaps and directions for future research, public policies, evaluation, and programming.

  13. Risk Factors for Men’s Lifetime Perpetration of Physical Violence against Intimate Partners: Results from the International Men and Gender Equality Survey (IMAGES) in Eight Countries

    PubMed Central

    Fleming, Paul J.; McCleary-Sills, Jennifer; Morton, Matthew; Levtov, Ruti; Heilman, Brian; Barker, Gary

    2015-01-01

    This paper examines men’s lifetime physical intimate partner violence (IPV) perpetration across eight low- and middle-income countries to better understand key risk factors that interventions can target in order to promote gender equality and reduce IPV. We use data from men (n = 7806) that were collected as part of the International Men and Gender Equality Survey (IMAGES) in Bosnia and Herzegovina, Brazil, Chile, Croatia, Democratic Republic of Congo (DRC), India, Mexico, and Rwanda. Results show that there is wide variation across countries for lifetime self-reported physical violence perpetration (range: 17% in Mexico to 45% in DRC), men’s support for equal roles for men and women, and acceptability of violence against women. Across the sample, 31% of men report having perpetrated physical violence against a partner in their lifetime. In multivariate analyses examining risk factors for men ever perpetrating physical violence against a partner, witnessing parental violence was the strongest risk factor, reinforcing previous research suggesting the inter-generational transmission of violence. Additionally, having been involved in fights not specifically with an intimate partner, permissive attitudes towards violence against women, having inequitable gender attitudes, and older age were associated with a higher likelihood of ever perpetrating physical IPV. In separate analyses for each country, we found different patterns of risk factors in countries with high perpetration compared to countries with low perpetration. Findings are interpreted to identify key knowledge gaps and directions for future research, public policies, evaluation, and programming. PMID:25734544

  14. Understanding the value of social networks in life satisfaction of elderly people: a comparative study of 16 European countries using SHARE data.

    PubMed

    Tomini, Florian; Tomini, Sonila M; Groot, Wim

    2016-12-01

    Networks of family and friends are a source of support and are generally associated with higher life satisfaction values among older adults. On the other hand, older adults who are satisfied with their life may be more able to develop and maintain a wider social network. For this reason, the causal link between size and composition of the social networks and satisfaction with life is yet to be explored. This paper investigates the effect of the 'size', (number of family and friends, and network) and the 'composition' (the proportion of friends over total number of persons) of the social network on life satisfaction among older adults (50+). Moreover, we also investigate the patterns of this relation between different European countries. Data from the 4 th wave of Survey of Health, Ageing and Retirement in Europe and an instrumental variable approach are used to estimate the extent of the relation between life satisfaction and size and composition of social networks. Respondents in Western and Northern European (WNE) countries report larger networks than respondents in Eastern and Southern European (ESE) countries. However, the positive relationship between network size and life satisfaction is consistent across countries. On the other hand, the share of friends in the network appears to be generally negatively related to satisfaction with life, though results are not statistically significant for all countries. Apparently, a larger personal network is important for older adults (50+) to be more satisfied with life. Our results suggest that this relation is particularly positive if the network is comprised of family members.

  15. Does funding from donors displace government spending for health in developing countries?

    PubMed

    Farag, Marwa; Nandakumar, A K; Wallack, Stanley S; Gaumer, Gary; Hodgkin, Dominic

    2009-01-01

    The notable increases in funding from various donors for health over the past several years have made examining the effectiveness of aid all the more important. We examine the extent to which donor funding for health substitutes for--rather than complements--health financing by recipient governments. We find evidence of a strong substitution effect. The proportionate decrease in government spending associated with an increase in donor funding is largest in low-income countries. The results suggest that aid needs to be structured in a way that better aligns donors' and recipient governments' incentives, using innovative approaches such as performance-based aid financing.

  16. An Empirical Test of the Theory of Planned Behaviour Applied to Contraceptive Use in Rural Uganda

    PubMed Central

    Kiene, Susan M.; Hopwood, Sarah; Lule, Haruna; Wanyenze, Rhoda K.

    2013-01-01

    There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health behaviour change theories to contraceptive use amongst this population. The present study tested the Theory of Planned Behaviour’s ability to predict contraceptive use-related behaviours among postpartum women in rural Uganda. Results gave modest support to the theory’s application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries. PMID:23928989

  17. Efficiency in the European agricultural sector: environment and resources.

    PubMed

    Moutinho, Victor; Madaleno, Mara; Macedo, Pedro; Robaina, Margarita; Marques, Carlos

    2018-04-22

    This article intends to compute agriculture technical efficiency scores of 27 European countries during the period 2005-2012, using both data envelopment analysis (DEA) and stochastic frontier analysis (SFA) with a generalized cross-entropy (GCE) approach, for comparison purposes. Afterwards, by using the scores as dependent variable, we apply quantile regressions using a set of possible influencing variables within the agricultural sector able to explain technical efficiency scores. Results allow us to conclude that although DEA and SFA are quite distinguishable methodologies, and despite attained results are different in terms of technical efficiency scores, both are able to identify analogously the worst and better countries. They also suggest that it is important to include resources productivity and subsidies in determining technical efficiency due to its positive and significant exerted influence.

  18. Countries with women inequalities have higher stroke mortality.

    PubMed

    Kim, Young Dae; Jung, Yo Han; Caso, Valeria; Bushnell, Cheryl D; Saposnik, Gustavo

    2017-10-01

    Background Stroke outcomes can differ by women's legal or socioeconomic status. Aim We investigated whether differences in women's rights or gender inequalities were associated with stroke mortality at the country-level. Methods We used age-standardized stroke mortality data from 2008 obtained from the World Health Organization. We compared female-to-male stroke mortality ratio and stroke mortality rates in women and men between countries according to 50 indices of women's rights from Women, Business and the Law 2016 and Gender Inequality Index from the Human Development Report by the United Nations Development Programme. We also compared stroke mortality rate and income at the country-level. Results In our study, 176 countries with data available on stroke mortality rate in 2008 and indices of women's rights were included. There were 46 (26.1%) countries where stroke mortality in women was higher than stroke mortality in men. Among them, 29 (63%) countries were located in Sub-Saharan African region. After adjusting by country income level, higher female-to-male stroke mortality ratio was associated with 14 indices of women's rights, including differences in getting a job or opening a bank account, existence of domestic violence legislation, and inequalities in ownership right to property. Moreover, there was a higher female-to-male stroke mortality ratio among countries with higher Gender Inequality Index (r = 0.397, p < 0.001). Gender Inequality Index was more likely to be associated with stroke mortality rate in women than that in men (p < 0.001). Conclusions Our study suggested that the gender inequality status is associated with women's stroke outcomes.

  19. Why is the 'healthy immigrant effect' different between European countries?

    PubMed

    Moullan, Yasser; Jusot, Florence

    2014-08-01

    Even if health status of immigrants constitutes an important public health issue, the literature provides contradictory results on the existence of a 'healthy migrant' effect in Europe. This study proposes to explore the heterogeneity of the health gap between migrants and natives across four European countries. Based on several harmonized national health interview surveys, the association between migratory status and self-assessed health was firstly explored separately in Belgium, France, Spain and Italy. To explore whether differences in health gap between countries reflect differences in health status of immigrants between host countries or whether they are because of differences in health status of natives between host countries, the association between the host country and health was secondly analysed separately among a pooled sample of immigrants and one of natives, controlling for socio-economic status and country of origin. After controlling for socio-economic status, immigrants report a poorer health status than natives in France, Belgium and Spain, whereas they report a better health status than natives in Italy, among both women and men. A North-South gradient in immigrants' health status appears: their health status is better in Italy and in Spain than in France and Belgium. Conversely, health status of natives is poorer in Italy and in Belgium than in France and in Spain. Differences in health gap reflect differences in health status of both natives and immigrants between host countries. This suggests differences in health selection at migration and in immigrants' integration between European countries. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  20. Interactions between Financial and Environmental Networks in OECD Countries.

    PubMed

    Ruzzenenti, Franco; Joseph, Andreas; Ticci, Elisa; Vozzella, Pietro; Gabbi, Giampaolo

    2015-01-01

    We analysed a multiplex of financial and environmental networks between OECD countries from 2002 to 2010. Foreign direct investments and portfolio investment showing the flows in equity securities, short-term, long-term and total debt, these securities represent the financial layers; emissions of NOx, PM10, SO2, CO2 equivalent and the water footprint associated with international trade represent the environmental layers. We present a new measure of cross-layer correlations between flows in different layers based on reciprocity. For the assessment of results, we implement a null model for this measure based on the exponential random graph theory. We find that short-term financial flows are more correlated with environmental flows than long-term investments. Moreover, the correlations between reverse financial and environmental flows (i.e. the flows of different layers going in opposite directions) are generally stronger than correlations between synergic flows (flows going in the same direction). This suggests a trade-off between financial and environmental layers, where, more financialised countries display higher correlations between outgoing financial flows and incoming environmental flows than from lower financialised countries. Five countries are identified as hubs in this finance-environment multiplex: The United States, France, Germany, Belgium-Luxembourg and United Kingdom.

  1. Catch me if I fall! Enacted uncertainty avoidance and the social safety net as country-level moderators in the job insecurity-job attitudes link.

    PubMed

    Debus, Maike E; Probst, Tahira M; König, Cornelius J; Kleinmann, Martin

    2012-05-01

    Job insecurity is related to many detrimental outcomes, with reduced job satisfaction and affective organizational commitment being the 2 most prominent reactions. Yet, effect sizes vary greatly, suggesting the presence of moderator variables. On the basis of Lazarus's cognitive appraisal theory, we assumed that country-level enacted uncertainty avoidance and a country's social safety net would affect an individual's appraisal of job insecurity. More specifically, we hypothesized that these 2 country-level variables would buffer the negative relationships between job insecurity and the 2 aforementioned job attitudes. Combining 3 different data sources, we tested the hypotheses in a sample of 15,200 employees from 24 countries by applying multilevel modeling. The results confirmed the hypotheses that both enacted uncertainty avoidance and the social safety net act as cross-level buffer variables. Furthermore, our data revealed that the 2 cross-level interactions share variance in explaining the 2 job attitudes. Our study responds to calls to look at stress processes from a multilevel perspective and highlights the potential importance of governmental regulation when it comes to individual stress processes. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  2. National stereotypes of older people's competence are related to older adults' participation in paid and volunteer work.

    PubMed

    Bowen, Catherine E; Skirbekk, Vegard

    2013-11-01

    Why are older people perceived as more competent in some countries relative to others? In the current study, we investigate the extent to which national variation in perceptions of older people's competence is systematically related to national variation in the extent to which older people participate in paid and volunteer work. We used multilevel regression to analyze data from the European Social Survey and test the relationship between perceptions of older people's competence and older people's participation in paid and volunteer work across 28 countries. We controlled for a number of potentially confounding variables, including life expectancy as well as the gender ratio and average education of the older population in each country. We controlled for the average objective cognitive abilities of the older population in a subsample of 11 countries. Older people were perceived as more competent in countries in which more older people participated in paid or volunteer work, independent of life expectancy and the average education, gender makeup, and average cognitive abilities of the older population. The results suggest that older people's participation in paid and volunteer work is related to perceptions of older people's competence independent of older people's actual competence.

  3. Financing indicators for health care decentralization in Latin America: information and suggestions for health planning.

    PubMed

    Arredondo, A; Parada, I

    2001-01-01

    This article presents the results from an evaluative longitudinal study with before-after design. The main objective was to determine the effects of health care decentralization on changes in health financing. Taking into account feasibility, political and technical criteria, three Latin American countries were selected as study populations: Mexico, Nicaragua and Peru. The methodology had two main phases. In the first phase, the study referred to secondary sources of data and documents to obtain information about the following variables: type of decentralization implemented, source of finance, funds of financing, providers, final use of resources and mechanisms for resource allocation. In the second phase, the study referred to primary data collected in a survey of key personnel from the health sectors of each country. Taking into account the changes implemented in the three countries, as well as the strengths and weaknesses of each country in financing and decentralization, a rule for decision-making is proposed that attempts to identify the main financial changes implemented in each country and the basic indicators that can be used in future years to direct the planning, assessment, adjustment and correction of health financing and decentralization.

  4. Sleep education in medical school curriculum: a glimpse across countries.

    PubMed

    Mindell, Jodi A; Bartle, Alex; Wahab, Norrashidah Abd; Ahn, Youngmin; Ramamurthy, Mahesh Babu; Huong, Huynh Thi Duy; Kohyama, Jun; Ruangdaraganon, Nichara; Sekartini, Rini; Teng, Arthur; Goh, Daniel Y T

    2011-10-01

    The objective of this study was to assess the prevalence of education about sleep and sleep disorders in medical school education and to identify barriers to providing such education. Surveys were sent to 409 medical schools across 12 countries (Australia, India, Indonesia, Japan, Malaysia, New Zealand, Singapore, South Korea, Thailand, United States, Canada and Viet Nam). Overall, the response rate was 25.9%, ranging from 0% in some countries (India) to 100% in other countries (New Zealand and Singapore). Overall, the average amount of time spent on sleep education is just under 2.5h, with 27% responding that their medical school provides no sleep education. Three countries (Indonesia, Malaysia, and Viet Nam) provide no education, and only Australia and the United States/Canada provide more than 3h of education. Paediatric topics were covered for a mere 17 min compared to over 2h on adult-related topics. These results suggest that there continues to be very limited coverage of sleep in medical school education despite an incredible increase in acknowledgement of the importance of sleep and need for recognition of sleep disorders by physicians. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. Interactions between Financial and Environmental Networks in OECD Countries

    PubMed Central

    Ruzzenenti, Franco; Joseph, Andreas; Ticci, Elisa; Vozzella, Pietro; Gabbi, Giampaolo

    2015-01-01

    We analysed a multiplex of financial and environmental networks between OECD countries from 2002 to 2010. Foreign direct investments and portfolio investment showing the flows in equity securities, short-term, long-term and total debt, these securities represent the financial layers; emissions of NO x, PM10, SO 2, CO 2 equivalent and the water footprint associated with international trade represent the environmental layers. We present a new measure of cross-layer correlations between flows in different layers based on reciprocity. For the assessment of results, we implement a null model for this measure based on the exponential random graph theory. We find that short-term financial flows are more correlated with environmental flows than long-term investments. Moreover, the correlations between reverse financial and environmental flows (i.e. the flows of different layers going in opposite directions) are generally stronger than correlations between synergic flows (flows going in the same direction). This suggests a trade-off between financial and environmental layers, where, more financialised countries display higher correlations between outgoing financial flows and incoming environmental flows than from lower financialised countries. Five countries are identified as hubs in this finance-environment multiplex: The United States, France, Germany, Belgium-Luxembourg and United Kingdom. PMID:26375393

  6. International hospital productivity comparison: experiences from the Nordic countries.

    PubMed

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

    2013-09-01

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

  7. Impact of High Seas Closure on Food Security in Low Income Fish Dependent Countries

    PubMed Central

    Teh, Louise S. L.; Lam, Vicky W. Y.; Cheung, William W. L.; Miller, Dana; Teh, Lydia C. L.; Sumaila, U. Rashid

    2016-01-01

    We investigate how high seas closure will affect the availability of commonly consumed food fish in 46 fish reliant, and/or low income countries. Domestic consumption of straddling fish species (fish that would be affected by high seas closure) occurred in 54% of the assessed countries. The majority (70%) of countries were projected to experience net catch gains following high seas closure. However, countries with projected catch gains and that also consumed the straddling fish species domestically made up only 37% of the assessed countries. In contrast, much fewer countries (25%) were projected to incur net losses from high seas closure, and of these, straddling species were used domestically in less than half (45%) of the countries. Our findings suggest that, given the current consumption patterns of straddling species, high seas closure may only directly benefit the supply of domestically consumed food fish in a small number of fish reliant and/or low income countries. In particular, it may not have a substantial impact on improving domestic fish supply in countries with the greatest need for improved access to affordable fish, as only one third of this group used straddling fish species domestically. Also, food security in countries with projected net catch gains but where straddling fish species are not consumed domestically may still benefit indirectly via economic activities arising from the increased availability of non-domestically consumed straddling fish species following high seas closure. Consequently, this study suggests that high seas closure can potentially improve marine resource sustainability as well as contribute to human well-being in some of the poorest and most fish dependent countries worldwide. However, caution is required because high seas closure may also negatively affect fish availability in countries that are already impoverished and fish insecure. PMID:28033359

  8. Impact of High Seas Closure on Food Security in Low Income Fish Dependent Countries.

    PubMed

    Teh, Louise S L; Lam, Vicky W Y; Cheung, William W L; Miller, Dana; Teh, Lydia C L; Sumaila, U Rashid

    2016-01-01

    We investigate how high seas closure will affect the availability of commonly consumed food fish in 46 fish reliant, and/or low income countries. Domestic consumption of straddling fish species (fish that would be affected by high seas closure) occurred in 54% of the assessed countries. The majority (70%) of countries were projected to experience net catch gains following high seas closure. However, countries with projected catch gains and that also consumed the straddling fish species domestically made up only 37% of the assessed countries. In contrast, much fewer countries (25%) were projected to incur net losses from high seas closure, and of these, straddling species were used domestically in less than half (45%) of the countries. Our findings suggest that, given the current consumption patterns of straddling species, high seas closure may only directly benefit the supply of domestically consumed food fish in a small number of fish reliant and/or low income countries. In particular, it may not have a substantial impact on improving domestic fish supply in countries with the greatest need for improved access to affordable fish, as only one third of this group used straddling fish species domestically. Also, food security in countries with projected net catch gains but where straddling fish species are not consumed domestically may still benefit indirectly via economic activities arising from the increased availability of non-domestically consumed straddling fish species following high seas closure. Consequently, this study suggests that high seas closure can potentially improve marine resource sustainability as well as contribute to human well-being in some of the poorest and most fish dependent countries worldwide. However, caution is required because high seas closure may also negatively affect fish availability in countries that are already impoverished and fish insecure.

  9. The influence of country of origin on engagement in self-care behaviours following heart surgery: a descriptive correlational study.

    PubMed

    Fredericks, Suzanne

    2012-08-01

    The aim of this study was to determine whether an individual's country of origin influenced performance of self-care behaviours after heart surgery. Patients are required to perform self-care behaviours following cardiovascular surgery. Usual care encompasses a patient education initiative that addresses self-care behaviour performance. Within Canada, current heart surgery patient education efforts have been designed and evaluated using homogenous samples that self-identify their country of origin as England, Ireland or Scotland. However, approximately 42·6% of Canadian cardiovascular surgical patients self-identify their country of origin as India or China. Thus, current cardiovascular surgery patient education initiatives may not be applicable to all patients undergoing heart surgery, which may result in decreased patient outcomes such as performance of self-care behaviours. This descriptive study. A convenience sample of 90 patients who underwent heart surgery at one of two university-affiliated teaching hospitals, representing individuals of diverse backgrounds. Point-biserial correlational analysis was conducted to determine the relationship between country of origin and performance of self-care behaviours. Findings indicate individuals who self-identified their country of origin as England or Ireland were associated with a higher score on the number of self-care behaviours performed (p < 0·05) than individuals who self-identified other countries of origin. Self-care behaviours were taught using patient education materials that were designed based on feedback obtained from individuals whose country of origin was England or Ireland. This study provides preliminary evidence to suggest country of origin influences the amount of self-care behaviours individuals will perform. Patient education initiatives should incorporate the values, beliefs, attitudes and customs reflective of an individual's country of origin to enhance the likelihood of producing desired outcomes. © 2012 Blackwell Publishing Ltd.

  10. Trends in socioeconomic inequalities in self-assessed health in 10 European countries.

    PubMed

    Kunst, Anton E; Bos, Vivian; Lahelma, Eero; Bartley, Mel; Lissau, Inge; Regidor, Enrique; Mielck, Andreas; Cardano, Mario; Dalstra, Jetty A A; Geurts, José J M; Helmert, Uwe; Lennartsson, Carin; Ramm, Jorun; Spadea, Teresa; Stronegger, Willibald J; Mackenbach, Johan P

    2005-04-01

    Changes over time in inequalities in self-reported health are studied for increasingly more countries, but a comprehensive overview encompassing several countries is still lacking. The general aim of this article is to determine whether inequalities in self-assessed health in 10 European countries showed a general tendency either to increase or to decrease between the 1980s and the 1990s and whether trends varied among countries. Data were obtained from nationally representative interview surveys held in Finland, Sweden, Norway, Denmark, England, The Netherlands, West Germany, Austria, Italy, and Spain. The proportion of respondents with self-assessed health less than 'good' was measured in relation to educational level and income level. Inequalities were measured by means of age-standardized prevalence rates and odds ratios (ORs). Socioeconomic inequalities in self-assessed health showed a high degree of stability in European countries. For all countries together, the ORs comparing low with high educational levels remained stable for men (2.61 in the 1980s and 2.54 in the 1990s) but increased slightly for women (from 2.48 to 2.70). The ORs comparing extreme income quintiles increased from 3.13 to 3.37 for men and from 2.43 to 2.86 for women. Increases could be demonstrated most clearly for Italian and Spanish men and women, and for Dutch women, whereas inequalities in health in the Nordic countries showed no tendency to increase. The results underscore the persistent nature of socioeconomic inequalities in health in modern societies. The relatively favourable trends in the Nordic countries suggest that these countries' welfare states were able to buffer many of the adverse effects of economic crises on the health of disadvantaged groups.

  11. Alcohol consumption among first- and second-generation immigrant and native adolescents in 23 countries: Testing the importance of origin and receiving country alcohol prevalence rates.

    PubMed

    Barsties, Lisa S; Walsh, Sophie D; Huijts, Tim; Bendtsen, Pernille; Molcho, Michal; Buijs, Thomas; Vieno, Alessio; Elgar, Frank J; Stevens, Gonneke W J M

    2017-11-01

    This internationally comparative study examines differences in alcohol consumption between first- and second-generation immigrant and native adolescents. We also investigate to what extent origin and receiving country alcohol per capita consumption (APCC) rates and proportions of heavy episodic drinkers (HED) are associated with immigrant adolescents' alcohol consumption. We used cross-sectional survey data from the 2013/2014 Health Behaviour in School-aged Children study. Applying multilevel regression analyses, we investigated the lifetime frequency of alcohol use and drunkenness in 69 842 13- to 15-year-olds in 23 receiving countries, with immigrants from over 130 origin countries (82% natives, 6% first-generation immigrants and 12% second-generation immigrants). The lifetime frequency of alcohol use was higher among natives than among first- and second-generation immigrants, while no differences were found between the latter two. Lifetime drunkenness was more frequent among first-generation immigrants than among natives and second-generation immigrants. Higher origin country APCC and HED were associated with more frequent lifetime alcohol use and drunkenness among immigrant adolescents. Cross-level interactions revealed that for lifetime frequency of alcohol use, the origin country HED effects were stronger for first- than for second-generation immigrant adolescents. Further, especially for first-generation immigrants, a higher receiving country HED was related to lower lifetime frequencies of alcohol use and drunkenness. Our results suggest differences in lifetime frequencies of alcohol use and drunkenness between natives and first- and second-generation immigrant adolescents. Origin country APCC and HED seem to affect immigrant adolescents' alcohol consumption differently than receiving country APCC and HED. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  12. Epidemiology of antibiotic-resistant wound infections from six countries in Africa

    PubMed Central

    Bebell, Lisa M; Meney, Carron; Valeri, Linda

    2017-01-01

    Introduction Little is known about the antimicrobial susceptibility of common bacteria responsible for wound infections from many countries in sub-Saharan Africa. Methods We performed a retrospective review of microbial isolates collected based on clinical suspicion of wound infection between 2004 and 2016 from Mercy Ships, a non-governmental organisation operating a single mobile surgical unit in Benin, Congo, Liberia, Madagascar, Sierra Leone and Togo. Antimicrobial resistant organisms of interest were defined as methicillin-resistant Staphylococcus aureus (MRSA) or Enterobacteriaceae resistant to third-generation cephalosporins. Generalised mixed-effects models accounting for repeated isolates in a patient, potential clustering by case mix for each field service, age, gender and country were used to test the hypothesis that rates of antimicrobial resistance differed between countries. Results 3145 isolates from repeated field services in six countries were reviewed. In univariate analyses, the highest proportion of MRSA was found in Benin (34.6%) and Congo (31.9%), while the lowest proportion was found in Togo (14.3%) and Madagascar (14.5%); country remained a significant predictor in multivariate analyses (P=0.002). In univariate analyses, the highest proportion of third-generation cephalosporin-resistant Enterobacteriaceae was found in Benin (35.8%) and lowest in Togo (14.3%) and Madagascar (16.3%). Country remained a significant predictor for antimicrobial-resistant isolates in multivariate analyses (P=0.009). Conclusion A significant proportion of isolates from wound cultures were resistant to first-line antimicrobials in each country. Though antimicrobial resistance isolates were not verified in a reference laboratory and these data may not be representative of all regions of the countries studied, differences in the proportion of antimicrobial-resistant isolates and resistance profiles between countries suggest site-specific surveillance should be a priority and local antimicrobial resistance profiles should be used to guide empiric antibiotic selection. PMID:29588863

  13. Cysticerci-related single parenchymal brain enhancing lesions in non-endemic countries

    PubMed Central

    Del Brutto, Oscar H.; Nash, Theodore E.; Garcia, Hector H.

    2012-01-01

    Objective Review of case reports and case series of patients with single cysticercus granulomas in non-endemic countries to determine the characteristics of this form of neurocysticercosis in these regions. Methods MEDLINE and manual search of patients with single cysticercus granulomas diagnosed in non-endemic countries from 1991 to 2011. Abstracted data included: demographic profile, clinical manifestations, form of neurocysticercosis, and whether the disease occurred in immigrants, international travelers, or citizens from non-endemic countries who had never been abroad. Results A total of 77 patients were found. Of these, 61 (79%) were diagnosed since the year 2000. Thirty-four patients (44%) patients were immigrants from endemic countries, 18 (23%) were international travelers returning from disease-endemic areas, and the remaining 25 (33%) were citizens from non-endemic countries who had never been abroad. Most immigrants and international travelers became symptomatic two or more years after returning home. Countries with the most reported patients were Kuwait (n=18), UK (n=11), Australia (n=8), USA (n=7), Japan (n=6), and Israel (n=5). Conclusions A single cerebral cysticercus granuloma in a non-endemic country is not a rare event. As seen in endemic regions, these cases have a good prognosis although more surgical procedures are performed in non-endemic countries, likely reflecting a decrease of diagnostic suspicion for cysticercosis and an increased availability of surgical options. The mean age of the reported cases was 25 years, and immigrants most often developed the disease greater than two years after arrival into a non-endemic area, suggesting a significant delay between infection and symptoms. However, some may have been infected and developed the disease while residing in non-endemic countries. PMID:22658897

  14. Power Law Distributions of Patents as Indicators of Innovation

    NASA Astrophysics Data System (ADS)

    O'Neale, Dion; Hendy, Shaun

    2013-03-01

    The total number of patents produced by a country (or the number of patents produced per capita) is often used as an indicator for innovation. Such figures however give an overly simplistic measure of innovation within a country. Here we present evidence that the distribution of patents amongst applicants within many countries is well-fitted to a power law distribution with exponents that vary between 1.66 (Japan) and 2.37 (Poland). We suggest that this exponent is a useful new metric for studying innovation. Using simulations based on simple preferential attachment-type rules that generate power laws, we find we can explain some of the variation in exponents between countries, with countries that have larger numbers of patents per applicant generally exhibiting smaller exponents in both the simulated and actual data. Similarly we find that the exponents for most countries are inversely correlated with other indicators of innovation, such as research and development intensity or the ubiquity of export baskets. This suggests that in more advanced economies, which tend to have smaller values of the exponent, a greater proportion of the total number of patents are filed by large companies than in less advanced countries.

  15. The Impact of Hospital Payment Schemes on Healthcare and Mortality: Evidence from Hospital Payment Reforms in OECD Countries.

    PubMed

    Wubulihasimu, Parida; Brouwer, Werner; van Baal, Pieter

    2016-08-01

    In this study, aggregate-level panel data from 20 Organization for Economic Cooperation and Development countries over three decades (1980-2009) were used to investigate the impact of hospital payment reforms on healthcare output and mortality. Hospital payment schemes were classified as fixed-budget (i.e. not directly based on activities), fee-for-service (FFS) or patient-based payment (PBP) schemes. The data were analysed using a difference-in-difference model that allows for a structural change in outcomes due to payment reform. The results suggest that FFS schemes increase the growth rate of healthcare output, whereas PBP schemes positively affect life expectancy at age 65 years. However, these results should be interpreted with caution, as results are sensitive to model specification. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Non-urban area ownership structure. Case study of Southern Poland

    NASA Astrophysics Data System (ADS)

    Glowacka, Agnieszka; Janus, Jaroslaw; Bożek, Piotr

    2016-12-01

    The study shows a possible way of analyzing the diversity of ownership forms in non-urban areas, with particular focus on land co-ownership. The data in cadastral databases was processed with the use of the relational model which applied information on the geometry of areal spatial objects and descriptive attributes. The paper presents also the results of the analysis of Nowy Sącz District with the area of 1.550 sq.km and containing approximately 200.000 parcels. The area is representative for many countries in Central and Eastern Europe, where unfavorable land fragmentation indices and complex ownership structures complicate investing processes and development of rural areas what results in progressive degradation of agricultural and cultural landscape. The results indicate that the co-ownership phenomenon affects 13% of parcels in the study area. However, it varies greatly depending on the village and ranges from 3 to 67% of total parcels number. Suggested methods of analyzing the ownership structure are of universal character. In spite of this, when used during analyses conducted in other countries, certain modifications are required. It is mainly caused by the differences in cadastral data models used in those countries.

  17. Universal health coverage at the macro level: Synthetic control evidence from Thailand.

    PubMed

    Rieger, Matthias; Wagner, Natascha; Bedi, Arjun S

    2017-01-01

    As more and more countries are moving towards Universal Health Coverage (UHC), it is important to understand the macro level or aggregate impacts of such a policy. We use synthetic control methods to study the impact of UHC, introduced in Thailand in 2001, on various macroeconomic and health outcomes. Thailand is compared to a weighted average of control countries in terms of aggregate health financing indicators, aggregate health outcomes and economic performance, over the period 1995 to 2012. Our results suggest that UHC helps alleviate the financial consequences of illnesses. The estimated treatment effect of UHC on out-of-pocket payments as a percentage of overall health expenditures is negative 13 percentage points and its effect on annual government per capita health spending is US$ 79. We detect a smaller effect of US$ 60.8 on total health spending per capita which appears with a lag. We document positive health effects as captured by reductions in infant and child mortality. We do not find any effect on GDP and the share of the government budget devoted to health. Overall, our results complement micro evidence based on within country variation. The counterfactual design implemented here may be used to inform other countries on the macro level repercussions of UHC. Copyright © 2016. Published by Elsevier Ltd.

  18. [Socioeconomic pathology as a cause of regional differences in the prevalence of metabolic syndrome and pregnancy-induced hypertension].

    PubMed

    López-Jaramillo, Patricio; Pradilla, Lina P; Castillo, Víctor R; Lahera, Vicente

    2007-02-01

    The epidemic of cardiovascular disease being experienced by developing countries has resulted in a debate about the possible existence of regional differences in etiology and pathophysiology that could be associated with socio-economic factors. Clear demonstration of these differences is important because there may be a need for different approaches to prevention, diagnosis and treatment. There is some evidence that there are differences between populations in developed and developing countries in the pathophysiologic mechanisms underlying pregnancy-induced hypertension and metabolic syndrome, just as there are in the relative weightings of risk factors that predict the appearance of these conditions. Observations in our country suggest that increasing exposure to changes in lifestyle brought about by the consumer society (e.g., a lack of exercise, and a high-fat, high-calorie diet) results in a natural biological response (e.g., obesity, metabolic syndrome, and diabetes) that increases the risk of cardiovascular disease. We propose that the term socioeconomic pathology should be used to describe these changes associated with modern society so that they can be differentiated and considered in isolation from socioeconomic factors and other risk factors. We regard the interaction between these various factors as the most important cause of the rapidly increasing incidence of cardiovascular disease observed in developing countries in recent years.

  19. Experiences of homophobia among gay and bisexual men: results from a cross-sectional study in seven countries

    PubMed Central

    Chard, Anna N.; Finneran, Catherine; Sullivan, Patrick S.

    2016-01-01

    Experiences of homophobic discrimination are associated with an increased prevalence of psychological disorders and increased odds of reporting suicidal ideation among gay and bisexual men. We examine two domains of homophobia – external homophobic discrimination and internalised homophobia – and their associations with sexual orientation, demographic characteristics, relationships, and social support among a sample of gay and bisexual men from 7 countries. Sexually active gay and bisexual men aged over 18 and residing in Australia, Brazil, Canada, South Africa, Thailand, the United Kingdom (UK), and the United States (USA) were recruited through banner advertisements on Facebook. Two outcomes were examined: reporting experiences of homophobic discrimination and reporting feelings of internalised homophobia. No covariates were consistently significantly associated with experiencing external homophobic discrimination across countries. Across all countries, bisexually identifying respondents reported significantly greater feelings of internalised homophobia. Respondents in Brazil and the UK reporting a main partner, and respondents in Australia, Brazil, Canada, South Africa, Thailand, and the USA reporting a larger gay/bisexual social network reported significantly fewer feelings of internalised homophobia. Results suggest an ameliorative effect of social networks on experiencing homophobia. Additional research should focus on the mechanisms through which social networks reduce feelings of internalised homophobia. PMID:26096688

  20. Electric energy costs and firm productivity in the countries of the Pacific Alliance

    NASA Astrophysics Data System (ADS)

    Camacho, Anamaria

    This paper explores the relation between energy as an input of production and firm-level productivity for Chile, Colombia, Mexico and Peru, all country members of the Pacific Alliance economic bloc. The empirical literature, has explored the impact of infrastructure on productivity; however there is limited analysis on the impact of particular infrastructure variables, such as energy, on productivity at the firm level in Latin America. Therefore, this study conducts a quantitative assessment of the responsiveness of productivity to energy cost and quality for Chile, Colombia, Mexico and Peru. For this, the empirical strategy is to estimate a Cobb-Douglas production function using the World Bank's Enterprise Survey to obtain comparable measures of output and inputs of production. This approach provides estimates of input factor elasticities for all of the factors of production including energy. The results indicate that electric energy costs explain cross-country differences in firm level productivity. For the particular case of Colombia, the country exhibits the lowest capital and labor productivity of the PA, and firm output is highly responsive to changes in energy use. As a result, the evidence suggests that policies reducing electric energy costs are an efficient alternative to increase firm performance, particularly in the case of Colombia.

  1. Prevalence and Pattern of Antibiotic Resistant Strains of Helicobacter Pylori Infection in ASEAN

    PubMed

    Vilaichone, Ratha Korn; Quach, Duc Trong; Yamaoka, Yoshio; Sugano, Ken; Mahachai, Varocha

    2018-05-26

    Objective: Antibiotic resistance has significantly impact on eradication rates for H. pylori infection and remains important cause of treatment failure worldwide including ASEAN countries. The aim of this study was to survey the prevalence and antibiotic resistant pattern of H. pylori infection in ASEAN. Methods: This study was a survey among 26 experts from 9 ASEAN countries including Thailand, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore and Vietnam whom attended a meeting to develop the ASEAN consensus on H. pylori management in Bangkok in November 2015. A questionnaire was sent to each member of the consensus meeting. The detail of the questionnaire included information about prevalence of H. pylori infection, facilities to perform H. pylori culture, molecular testing for antibiotic resistance and antibiotic resistance rate in their countries. Results: H. pylori infection remain common in ASEAN ranging from 20% in Malaysia, 21-54% in Thailand and 69% in Myanmar. Most of ASEAN countries can perform H. pylori cultures and antibiotic susceptibility tests except Laos and Cambodia. In ASEAN countries, metronidazole resistant H pylori is quite common whereas amoxicillin resistance remain rare. Clarithromycin resistance results in a significant decrease in H. pylori eradication rate with clarithromycin-containing regimens. The prevalence of clarithromycin resistance varies in ASEAN countries being high in Vietnam (30%) and Cambodia (43%), moderate to high in Singapore (17%) and low in Malaysia (6.8%), Philippine (2%) and Myanmar (0%). In Thailand, clarithromycin resistance tends to higher in large cities (14%) than in rural areas (~3.7%). Conclusion: ASEAN countries should develop a standard protocol for regular susceptibility testing of H. pylori so that clinicians would be better able to choose reliably effective empiric therapies. The wide range of antibiotic resistance in ASEAN countries suggests that the preferred first line regimen should be depend on the local antibiotic resistance other than single recommendation. Creative Commons Attribution License

  2. Innovative farmers and regulatory gatekeepers: Genetically modified crops regulation and adoption in developing countries

    PubMed Central

    Sinebo, Woldeyesus; Maredia, Karim

    2016-01-01

    ABSTRACT The regulation of genetically modified (GM) crops is a topical issue in agriculture and environment over the past 2 decades. The objective of this paper is to recount regulatory and adoption practices in some developing countries that have successfully adopted GM crops so that aspiring countries may draw useful lessons and best practices for their biosafatey regulatory regimes. The first 11 mega-GM crops growing countries each with an area of more than one million hectares in 2014 were examined. Only five out of the 11 countries had smooth and orderly adoption of these crops as per the regulatory requirement of each country. In the remaining 6 countries (all developing countries), GM crops were either introduced across borders without official authorization, released prior to regulatory approval or unapproved seeds were sold along with the approved ones in violation to the existing regulations. Rapid expansion of transgenic crops over the past 2 decades in the developing world was a result of an intense desire by farmers to adopt these crops irrespective of regulatory roadblocks. Lack of workable biosafety regulatory system and political will to support GM crops encouraged unauthorized access to GM crop varieties. In certain cases, unregulated access in turn appeared to result in the adoption of substandard or spurious technology which undermined performance and productivity. An optimal interaction among the national agricultural innovation systems, biosafety regulatory bodies, biotech companies and high level policy makers is vital in making a workable regulated progress in the adoption of GM crops. Factoring forgone opportunities to farmers to benefit from GM crops arising from overregulation into biosafety risk analysis and decision making is suggested. Building functional biosafety regulatory systems that balances the needs of farmers to access and utilize the GM technology with the regulatory imperatives to ensure adequate safety to the environment and human health is recommended. PMID:26954893

  3. Centralized Negotiations of Salaries of Professional Staff in Education.

    ERIC Educational Resources Information Center

    Peterson, LeRoy J.

    This document reports on a study conducted in six European countries -- Denmark, England, France, Norway, Scotland, and Sweden -- and suggests ways to implement Statewide negotiations in the United States. The author first provides an overview of negotiations in the United States and then gives a country-by-country analysis of salary negotiations.…

  4. The Dynamics of Democracy, Development and Cultural Values

    PubMed Central

    Spaiser, Viktoria; Ranganathan, Shyam; Mann, Richard P.; Sumpter, David J. T.

    2014-01-01

    Over the past decades many countries have experienced rapid changes in their economies, their democratic institutions and the values of their citizens. Comprehensive data measuring these changes across very different countries has recently become openly available. Between country similarities suggest common underlying dynamics in how countries develop in terms of economy, democracy and cultural values. We apply a novel Bayesian dynamical systems approach to identify the model which best captures the complex, mainly non-linear dynamics that underlie these changes. We show that the level of Human Development Index (HDI) in a country drives first democracy and then higher emancipation of citizens. This change occurs once the countries pass a certain threshold in HDI. The data also suggests that there is a limit to the growth of wealth, set by higher emancipation. Having reached a high level of democracy and emancipation, societies tend towards equilibrium that does not support further economic growth. Our findings give strong empirical evidence against a popular political science theory, known as the Human Development Sequence. Contrary to this theory, we find that implementation of human-rights and democratisation precede increases in emancipative values. PMID:24905920

  5. The dynamics of democracy, development and cultural values.

    PubMed

    Spaiser, Viktoria; Ranganathan, Shyam; Mann, Richard P; Sumpter, David J T

    2014-01-01

    Over the past decades many countries have experienced rapid changes in their economies, their democratic institutions and the values of their citizens. Comprehensive data measuring these changes across very different countries has recently become openly available. Between country similarities suggest common underlying dynamics in how countries develop in terms of economy, democracy and cultural values. We apply a novel Bayesian dynamical systems approach to identify the model which best captures the complex, mainly non-linear dynamics that underlie these changes. We show that the level of Human Development Index (HDI) in a country drives first democracy and then higher emancipation of citizens. This change occurs once the countries pass a certain threshold in HDI. The data also suggests that there is a limit to the growth of wealth, set by higher emancipation. Having reached a high level of democracy and emancipation, societies tend towards equilibrium that does not support further economic growth. Our findings give strong empirical evidence against a popular political science theory, known as the Human Development Sequence. Contrary to this theory, we find that implementation of human-rights and democratisation precede increases in emancipative values.

  6. Traffic Congestion on a University Campus: A Consideration of Unconventional Remedies to Nontraditional Transportation Patterns

    ERIC Educational Resources Information Center

    Kaplan, Dave; Clapper, Thomas

    2007-01-01

    U.S. transportation data suggest that the number of vehicle miles traveled has far surpassed new capacity, resulting in increased traffic congestion in many communities throughout the country. This article reports on traffic congestion around a university campus located within a small town. The mix of trip purposes varies considerably in this…

  7. Calibration of the Wedge Prism

    Treesearch

    Charles B. Briscoe

    1957-01-01

    Since the introduction of plotless cruising in this country by Grosenbaugh and the later suggestion of using a wedge prism as an angle gauge by Bruce this method of determining basal area has been widely adopted in the South. One of the factors contributing to the occasionally unsatisfactory results obtained is failure to calibrate the prism used. As noted by Bruce the...

  8. School Autonomy and Accountability: Are They Related to Student Performance? PISA in Focus. No. 9

    ERIC Educational Resources Information Center

    OECD Publishing (NJ1), 2011

    2011-01-01

    In recent years, many schools have grown into more autonomous organisations and have become more accountable to students, parents and the public at large for their outcomes. PISA results suggest that, when autonomy and accountability are intelligently combined, they tend to be associated with better student performance. In countries where schools…

  9. Measurement Invariance of Early Development Instrument (EDI) Domain Scores across Gender and ESL Status

    ERIC Educational Resources Information Center

    Mousavi, Amin; Krishnan, Vijaya

    2016-01-01

    The Early Development Instrument (EDI) is a widely used teacher rating tool to assess kindergartners' developmental outcomes in Canada and a number of other countries. This paper examines the measurement invariance of EDI domains across ESL status and gender by means of multi-group confirmatory factor analysis. The results suggest evidence of…

  10. A Comparison of American and Chinese Students' Perceived Stress, Coping Styles, and Health Promotion Practices

    ERIC Educational Resources Information Center

    Li, Ying; Lindsey, Billie J.; Yin, Xiaoqin; Chen, William

    2012-01-01

    A cross-sectional survey utilized the Perceived Stress Scale, Brief COPE, and Health Promotion Lifestyle Profile II to ascertain similarities and differences between American (n=319) and Chinese (n=335) college students and between higher and lower stressed students in both samples. The results suggested the existence of a country difference in…

  11. Are Former "Third-Culture Kids" the Ideal Business Expatriates?

    ERIC Educational Resources Information Center

    Lam, Hon; Selmer, Jan

    2004-01-01

    Third-culture kids TCKs are adolescents who have lived at least one of their formative years in another country. This study compares survey data collected from British TCKs who were currently living in Hong Kong with those of their adolescent peers living in the UK and Hong Kong. The results unequivocally suggest that TCKs' perception of being…

  12. Roma Pupils' Identification with School in Slovenia and Serbia: Case Studies

    ERIC Educational Resources Information Center

    Macura-Milovanovic, Suncica; Munda, Milanka; Pecek, Mojca

    2013-01-01

    The research presented in this paper aims to challenge the belief held by some education professionals that Roma pupils do not value education. The research sample included groups of Roma pupils from two countries (Slovenia and Serbia) and from different socio-economic backgrounds. The results suggest that the majority of the pupils are aware of…

  13. On the positive correlation between education and fertility intentions in Europe: Individual- and country-level evidence☆

    PubMed Central

    Testa, Maria Rita

    2014-01-01

    Increasing shares of European women are making large investments in their human capital. Whether and to what extent these investments are in conflict with reproductive behaviour are issues that have repercussions for fertility levels. Using two Eurobarometer survey data (2006 and 2011) on individuals clustered in the 27 EU countries, I investigate the relationship between women's education and lifetime fertility intentions. Results suggest that a positive association between women's level of education and lifetime fertility intentions exists at both the individual and country levels, as well as in a micro–macro integrated framework. The main explanation for these findings—which remains to be proven by future research—is that, in institutional contexts allowing highly educated women to have large families, women of reproductive ages are more prone to make investments in both human capital and family size, because these choices are not seen as incompatible alternatives. PMID:26047540

  14. How does consumer knowledge affect environmentally sustainable choices? Evidence from a cross-country latent class analysis of food labels.

    PubMed

    Peschel, Anne O; Grebitus, Carola; Steiner, Bodo; Veeman, Michele

    2016-11-01

    This paper examines consumers' knowledge and lifestyle profiles and preferences regarding two environmentally labeled food staples, potatoes and ground beef. Data from online choice experiments conducted in Canada and Germany are analyzed through latent class choice modeling to identify the influence of consumer knowledge (subjective and objective knowledge as well as usage experience) on environmentally sustainable choices. We find that irrespective of product or country under investigation, high subjective and objective knowledge levels drive environmentally sustainable food choices. Subjective knowledge was found to be more important in this context. Usage experience had relatively little impact on environmentally sustainable choices. Our results suggest that about 20% of consumers in both countries are ready to adopt footprint labels in their food choices. Another 10-20% could be targeted by enhancing subjective knowledge, for example through targeted marketing campaigns. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Placing Families in Context: Challenges for Cross-National Family Research

    PubMed Central

    Yu, Wei-hsin

    2015-01-01

    Cross-national comparisons constitute a valuable strategy to assess how broader cultural, political, and institutional contexts shape family outcomes. One typical approach of cross-national family research is to use comparable data from a limited number of countries, fit similar regression models for each country, and compare results across country-specific models. Increasingly, researchers are adopting a second approach, which requires merging data from many more societies and testing multilevel models using the pooled sample. Although the second approach has the advantage of allowing direct estimates of the effects of nation-level characteristics, it is more likely to suffer from the problems of omitted-variable bias, influential cases, and measurement and construct nonequivalence. I discuss ways to improve the first approach's ability to infer macrolevel influences, as well as how to deal with challenges associated with the second one. I also suggest choosing analytical strategies according to whether the data meet multilevel models’ assumptions. PMID:25999603

  16. The limited effect of increasing educational attainment on childlessness trends in twentieth-century Europe, women born 1916-65.

    PubMed

    Beaujouan, Eva; Brzozowska, Zuzanna; Zeman, Kryštof

    2016-11-01

    During the twentieth century, trends in childlessness varied strongly across European countries while educational attainment grew continuously across them. Using census and large-scale survey data from 13 European countries, we investigated the relationship between these two factors among women born between 1916 and 1965. Up to the 1940 birth cohort, the share of women childless at age 40+ decreased universally. Afterwards, the trends diverged across countries. The results suggest that the overall trends were related mainly to changing rates of childlessness within educational groups and only marginally to changes in the educational composition of the population. Over time, childlessness levels of the medium-educated and high-educated became closer to those of the low-educated, but the difference in level between the two better educated groups remained stable in Western and Southern Europe and increased slightly in the East.

  17. Disaster Risk Reduction in Myanmar: A Need for Focus on Community Preparedness and Improved Evaluation of Initiatives.

    PubMed

    Smith, Andrew D; Chan, Emily Y Y

    2017-11-20

    Myanmar is a country in political and economic transition. Facing a wide-variety of natural hazards and ongoing conflict, the country's under-developed infrastructure has resulted in high disaster risk. Following the devastation of Cyclone Nargis in 2008 and increased global focus on disaster management and risk reduction, Myanmar has begun development of national disaster policies. Myanmar's Action Plan for Disaster Risk Reduction addressed multiple stages of disaster development and has made progress towards national projects, however, has struggled to implement community-based preparedness and response initiatives. This article analyses Myanmar's disaster strategy, though the use of a disaster development framework and suggests areas for possible improvement. In particular, the article aims to generate discussion regarding methods of supporting objective evaluation of risk reduction initiatives in developing countries. (Disaster Med Public Health Preparedness. 2017;page 1 of 5).

  18. The limited effect of increasing educational attainment on childlessness trends in twentieth-century Europe, women born 1916–65

    PubMed Central

    Beaujouan, Eva; Brzozowska, Zuzanna; Zeman, Kryštof

    2016-01-01

    During the twentieth century, trends in childlessness varied strongly across European countries while educational attainment grew continuously across them. Using census and large-scale survey data from 13 European countries, we investigated the relationship between these two factors among women born between 1916 and 1965. Up to the 1940 birth cohort, the share of women childless at age 40+ decreased universally. Afterwards, the trends diverged across countries. The results suggest that the overall trends were related mainly to changing rates of childlessness within educational groups and only marginally to changes in the educational composition of the population. Over time, childlessness levels of the medium-educated and high-educated became closer to those of the low-educated, but the difference in level between the two better educated groups remained stable in Western and Southern Europe and increased slightly in the East. PMID:27545484

  19. The relationship between pollutant emissions, renewable energy, nuclear energy and GDP: empirical evidence from 18 developed and developing countries

    NASA Astrophysics Data System (ADS)

    Ben Mbarek, Mounir; Saidi, Kais; Amamri, Mounira

    2018-07-01

    This document investigates the causal relationship between nuclear energy (NE), pollutant emissions (CO2 emissions), gross domestic product (GDP) and renewable energy (RE) using dynamic panel data models for a global panel consisting of 18 countries (developed and developing) covering the 1990-2013 period. Our results indicate that there is a co-integration between variables. The unit root test suggests that all the variables are stationary in first differences. The paper further examines the link using the Granger causality analysis of vector error correction model, which indicates a unidirectional relationship running from GDP per capita to pollutant emissions for the developed and developing countries. However, there is a unidirectional causality from GDP per capita to RE in the short and long run. This finding confirms the conservation hypothesis. Similarly, there is no causality between NE and GDP per capita.

  20. Availability of information in Public Health on the Internet: An analysis of national health authorities in the Spanish-speaking Latin American and Caribbean countries.

    PubMed

    Novillo-Ortiz, David; Hernández-Pérez, Tony; Saigí-Rubió, Francesc

    2017-04-01

    Access to reliable and quality health information and appropriate medical advice can contribute to a dramatic reduction in the mortality figures of countries. The governments of the Americas are faced with the opportunity to continue working on this challenge, and their institutional presence on their websites should play a key role in this task. In a setting where the access to information is essential to both health professionals and citizens, it is relevant to analyze the role of national health authorities. Given that search engines play such a key role in the access to health information, it is important to specifically know - in connection to national health authorities - whether health information offered is easily available to the population, and whether this information is well-ranked in search engines. Quantitative methods were used to gather data on the institutional presence of national health authorities on the web. An exploratory and descriptive research served to analyze and interpret data and information obtained quantitatively from different perspectives, including an analysis by country, and also by leading causes of death. A total of 18 web pages were analyzed. Information on leading causes of death was searched on websites of national health authorities in the week of August 10-14, 2015. The probability of finding information of national health authorities on the 10 leading causes of death in a country, among the top 10 results on Google, is 6.66%. Additionally, ten out the 18 countries under study (55%) do not have information ranked among the top results in Google when searching for the selected terms. Additionally, a total of 33 websites represent the sources of information with the highest visibility for all the search strategies in each country on Google for the ten leading causes of death in a country. Two websites, the National Library of Medicine and Wikipedia, occur as a result with visibility in the total of eighteen countries of the sample. Taking into consideration that providing reliable and quality information on these topics to the population should be one of the priorities of national health authorities, these results suggest that national health authorities need to take measures to try to better position their contents. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  1. Serosurvey of Crimean-Congo Hemorrhagic Fever Virus in Cattle, Mali, West Africa.

    PubMed

    Maiga, Ousmane; Sas, Miriam Andrada; Rosenke, Kyle; Kamissoko, Badian; Mertens, Marc; Sogoba, Nafomon; Traore, Abdallah; Sangare, Modibo; Niang, Mamadou; Schwan, Tom G; Maiga, Hamidou Moussa; Traore, Sekou F; Feldmann, Heinz; Safronetz, David; Groschup, Martin H

    2017-06-01

    AbstractCrimean-Congo hemorrhagic fever is a tick-borne disease caused by the arbovirus Crimean-Congo hemorrhagic fever virus (CCHFV, family Bunyaviridae, genus Nairovirus ). CCHFV can cause a severe hemorrhagic fever with high-case fatality rates in humans. CCHFV has a wide geographic range and has been described in around 30 countries in the Middle East, Asia, Europe, and Africa including Mali and neighboring countries. To date, little is known about the prevalence rates of CCHFV in Mali. Here, using banked bovine serum samples from across the country, we describe the results of a seroepidemiological study for CCHFV aimed at identifying regions of circulation in Mali. In total, 1,074 serum samples were tested by a modified in-house CCHFV-IgG-enzyme-linked immunosorbent assay (ELISA) with confirmatory testing by commercial ELISA and immunofluorescence assay. Overall, 66% of samples tested were positive for CCHFV-specific IgG antibodies. Regional seroprevalence rates ranged from 15% to 95% and seemed to correlate with cattle density. Our results demonstrate that CCHFV prevalence is high in many regions in Mali and suggest that CCHFV surveillance should be established.

  2. National treatment systems in global perspective.

    PubMed

    Klingemann, H

    1999-09-01

    Drug policy development is mostly viewed as emerging within the nation state. Processes of diffusion of innovative policies have been neglected to a large extent. The comparative study of public policy has demonstrated, however, that diffusion is an important predictor of early policy adaptation. Thus, the analysis asks the general question of the relative importance of endogenous and exogenous effects on the development of drug policies in various countries. Specifically it describes the Swiss debate leading to the popular initiative on 'Youth Without Drugs' as well as the international reactions regarding its liberal outcome. Results of an expert survey show two broad types of reactions. There is one set of countries where chances for the introduction of limited heroin-prescription trials during the next 5 years are considered probable and a second set of countries which seems to be strictly status quo oriented. In the concluding section a model is suggested which systematically considers endogenous as well as exogenous predictors of 'soft' or 'hard' drug policy adoption. Results of a first tentative test of the model are encouraging for future empirical research on diffusion processes of drug policies.

  3. Genetic diversity of Taenia asiatica from Thailand and other geographical locations as revealed by cytochrome c oxidase subunit 1 sequences.

    PubMed

    Anantaphruti, Malinee Thairungroj; Thaenkham, Urusa; Watthanakulpanich, Dorn; Phuphisut, Orawan; Maipanich, Wanna; Yoonuan, Tippayarat; Nuamtanong, Supaporn; Pubampen, Somjit; Sanguankiat, Surapol

    2013-02-01

    Twelve 924 bp cytochrome c oxidase subunit 1 (cox1) mitochondrial DNA sequences from Taenia asiatica isolates from Thailand were aligned and compared with multiple sequence isolates from Thailand and 6 other countries from the GenBank database. The genetic divergence of T. asiatica was also compared with Taenia saginata database sequences from 6 different countries in Asia, including Thailand, and 3 countries from other continents. The results showed that there were minor genetic variations within T. asiatica species, while high intraspecies variation was found in T. saginata. There were only 2 haplotypes and 1 polymorphic site found in T. asiatica, but 8 haplotypes and 9 polymorphic sites in T. saginata. Haplotype diversity was very low, 0.067, in T. asiatica and high, 0.700, in T. saginata. The very low genetic diversity suggested that T. asiatica may be at a risk due to the loss of potential adaptive alleles, resulting in reduced viability and decreased responses to environmental changes, which may endanger the species.

  4. Genetic Diversity of Taenia asiatica from Thailand and Other Geographical Locations as Revealed by Cytochrome c Oxidase Subunit 1 Sequences

    PubMed Central

    Thaenkham, Urusa; Watthanakulpanich, Dorn; Phuphisut, Orawan; Maipanich, Wanna; Yoonuan, Tippayarat; Nuamtanong, Supaporn; Pubampen, Somjit; Sanguankiat, Surapol

    2013-01-01

    Twelve 924 bp cytochrome c oxidase subunit 1 (cox1) mitochondrial DNA sequences from Taenia asiatica isolates from Thailand were aligned and compared with multiple sequence isolates from Thailand and 6 other countries from the GenBank database. The genetic divergence of T. asiatica was also compared with Taenia saginata database sequences from 6 different countries in Asia, including Thailand, and 3 countries from other continents. The results showed that there were minor genetic variations within T. asiatica species, while high intraspecies variation was found in T. saginata. There were only 2 haplotypes and 1 polymorphic site found in T. asiatica, but 8 haplotypes and 9 polymorphic sites in T. saginata. Haplotype diversity was very low, 0.067, in T. asiatica and high, 0.700, in T. saginata. The very low genetic diversity suggested that T. asiatica may be at a risk due to the loss of potential adaptive alleles, resulting in reduced viability and decreased responses to environmental changes, which may endanger the species. PMID:23467439

  5. Economic development and multiple air pollutant emissions from the industrial sector.

    PubMed

    Fujii, Hidemichi; Managi, Shunsuke

    2016-02-01

    This study analyzed the relationship between economic growth and emissions of eight environmental air pollutants (carbon dioxide (CO2), methane (CH4), nitrous oxide (N2O), nitrogen oxide (NOx), sulfur oxide (SOx), carbon monoxide (CO), non-methane volatile organic compound (NMVOC), and ammonia (NH3)) in 39 countries from 1995 to 2009. We tested an environmental Kuznets curve (EKC) hypothesis for 16 individual industry sectors and for the total industrial sector. The results clarified that at least ten individual industries do not have an EKC relationship in eight air pollutants even though this relationship was observed in the country and total industrial sector level data. We found that the key industries that dictated the EKC relationship in the country and the total industrial sector existed in CO2, N2O, CO, and NMVOC emissions. Finally, the EKC turning point and the relationship between economic development and trends of air pollutant emissions differ among industries according to the pollution substances. These results suggest inducing new environmental policy design such as the sectoral crediting mechanism, which focuses on the industrial characteristics of emissions.

  6. Emergence of biopharmaceutical innovators in China, India, Brazil, and South Africa as global competitors and collaborators.

    PubMed

    Rezaie, Rahim; McGahan, Anita M; Frew, Sarah E; Daar, Abdallah S; Singer, Peter A

    2012-06-06

    Biopharmaceutical innovation has had a profound health and economic impact globally. Developed countries have traditionally been the source of most innovations as well as the destination for the resulting economic and health benefits. As a result, most prior research on this sector has focused on developed countries. This paper seeks to fill the gap in research on emerging markets by analyzing factors that influence innovative activity in the indigenous biopharmaceutical sectors of China, India, Brazil, and South Africa. Using qualitative research methodologies, this paper a) shows how biopharmaceutical innovation is taking place within the entrepreneurial sectors of these emerging markets, b) identifies common challenges that indigenous entrepreneurs face, c) highlights the key role played by the state, and d) reveals that the transition to innovation by companies in the emerging markets is characterized by increased global integration. It suggests that biopharmaceutical innovators in emerging markets are capitalizing on opportunities to participate in the drug development value chain and thus developing capabilities and relationships for competing globally both with and against established companies headquartered in developed countries.

  7. Absolute and relative educational inequalities in depression in Europe.

    PubMed

    Dudal, Pieter; Bracke, Piet

    2016-09-01

    To investigate (1) the size of absolute and relative educational inequalities in depression, (2) their variation between European countries, and (3) their relationship with underlying prevalence rates. Analyses are based on the European Social Survey, rounds three and six (N = 57,419). Depression is measured using the shortened Centre of Epidemiologic Studies Depression Scale. Education is coded by use of the International Standard Classification of Education. Country-specific logistic regressions are applied. Results point to an elevated risk of depressive symptoms among the lower educated. The cross-national patterns differ between absolute and relative measurements. For men, large relative inequalities are found for countries including Denmark and Sweden, but are accompanied by small absolute inequalities. For women, large relative and absolute inequalities are found in Belgium, Bulgaria, and Hungary. Results point to an empirical association between inequalities and the underlying prevalence rates. However, the strength of the association is only moderate. This research stresses the importance of including both measurements for comparative research and suggests the inclusion of the level of population health in research into inequalities in health.

  8. Emergence of biopharmaceutical innovators in China, India, Brazil, and South Africa as global competitors and collaborators

    PubMed Central

    2012-01-01

    Biopharmaceutical innovation has had a profound health and economic impact globally. Developed countries have traditionally been the source of most innovations as well as the destination for the resulting economic and health benefits. As a result, most prior research on this sector has focused on developed countries. This paper seeks to fill the gap in research on emerging markets by analyzing factors that influence innovative activity in the indigenous biopharmaceutical sectors of China, India, Brazil, and South Africa. Using qualitative research methodologies, this paper a) shows how biopharmaceutical innovation is taking place within the entrepreneurial sectors of these emerging markets, b) identifies common challenges that indigenous entrepreneurs face, c) highlights the key role played by the state, and d) reveals that the transition to innovation by companies in the emerging markets is characterized by increased global integration. It suggests that biopharmaceutical innovators in emerging markets are capitalizing on opportunities to participate in the drug development value chain and thus developing capabilities and relationships for competing globally both with and against established companies headquartered in developed countries. PMID:22672351

  9. Is the political system really related to health?

    PubMed

    Klomp, Jeroen; de Haan, Jakob

    2009-07-01

    We analyze whether the political system and its stability are related to cross-country differences in health. We apply factor analysis on various national health indicators for a large sample of countries over the period 2000-2005 and use the outcomes of the factor analysis to construct two new health measures, i.e., the health of individuals and the quality of the health care sector. Using a cross-country structural equation model with various economic and demographic control variables, we examine the relationship between the type of regime and political stability on the one hand and health on the other. The political variables and the control variables are measured as averages over the period 1980-1999. Our results suggest that democracy has a positive relationship with the health of individuals, while regime instability has a negative relationship with the health of individuals. Government instability is negatively related to individual health via its link with the quality of the health care sector, while democracy is positively related with individual health through its link with income. Our main findings are confirmed by the results of a panel model and various sensitivity tests.

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

    PubMed Central

    Lee, Hwa-Young; Kang, Minah

    2015-01-01

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

  11. Health disparities in Europe's ageing population: the role of social network.

    PubMed

    Olofsson, Jenny; Padyab, Mojgan; Malmberg, Gunnar

    2018-01-01

    Previous research suggests that the social network may play very different roles in relation to health in countries with differing welfare regimes. The study aimed to assess the interplay between social network, socioeconomic position, and self-rated health (SRH) in European countries. The study used cross-sectional data on individuals aged 50+ from the fourth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) and includes data from 16 countries. The outcome is poor SRH. All analyses are adjusted for age and stratified by gender. Low satisfaction with the social network was associated with poor SRH among women in all country groups, but predicted poor SRH among males in West/Central and Eastern Europe only. The results from the multivariable analysis showed an increased likelihood of poor SRH among those with relatively lower education, as well as among those with low satisfaction with the social network (women from all country groups and men from Western/Central and Eastern Europe). However, the results from interaction analysis show that poor SRH for those with lower relative position in educational level was greater among those with higher satisfaction with the social network among male and female participants from Northern Europe. The health of individuals who are highly satisfied with their social network is more associated with socioeconomic status in Northern Europe. This study highlights the significance of social network and socioeconomic gradients in health among the elderly in Europe.

  12. Future trends in the prevalence of severe activity limitations among older adults in Europe: a cross-national population study using EU-SILC

    PubMed Central

    Scherbov, Sergei; Weber, Daniela

    2017-01-01

    Objective To project the proportion of population 65+ years with severe long-term activity limitations from 2017 to 2047. Design Large population study. Setting Population living in private households of the European Union (EU) and neighbouring countries. Participants Participants from the EU Statistics on Income and Living Conditions aged 55 years and older and living in one of 26 EU and neighbouring countries, who answered the health section of the questionnaire. Outcome measures Prevalence of severe long-term activity limitations of particular subpopulations (ie, 55+, 65+, 75+ and 85+ years) by sex and country. Results We find a huge variation in the prevalence of self-reported severe long-term limitations across Europe for both sexes. However, in 2017, about 20% of the female population aged 65 years and above and about 16% of their male counterparts are expected to report severe long-term activity limitations after accounting for differences in reporting. Accounting for cultural differences in reporting, we expect that European countries will have about 21% (decile 1: 19.5%; decile 9: 22.9%) of female and about 16.8% (decile 1: 15.4%; decile 9: 18.1%) of male 65+ years population with severe long-term activity limitations by 2047. Conclusions Overall, despite the expected increase of life expectancy in European countries, our results suggest almost constant shares of older adults with severe long-term activity limitations within the next 30 years. PMID:29061570

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

    PubMed

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

    2015-11-01

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

  14. Instability, investment, disasters, and demography: natural disasters and fertility in Italy (1820-1962) and Japan (1671-1965).

    PubMed

    Lin, C-Y Cynthia

    2010-03-01

    This article examines whether natural disasters affect fertility-a topic little explored but of policy importance given relevance to policies regarding disaster insurance, foreign aid, and the environment. The identification strategy uses historic regional data to exploit natural variation within each of two countries: one European country-Italy (1820-1962), and one Asian country-Japan (1671-1965). The choice of study settings allows consideration of Jones' (The European miracle, Cambridge University Press, Cambridge, 1981) theory that preindustrial differences in income and population between Asia and Europe resulted from the fertility response to different environmental risk profiles. According to the results, short-run instability, particularly that arising from the natural environment, appears to be associated with a decrease in fertility-thereby suggesting that environmental shocks and economic volatility are associated with a decrease in investment in the population size of future generations. The results also show that, contrary to Jones' (The European miracle, Cambridge University Press, Cambridge, 1981) theory, differences in fertility between Italy and Japan cannot be explained away by disaster proneness alone. Research on the effects of natural disasters may enable social scientists and environmentalists alike to better predict the potential effects of the increase in natural disasters that may result from global climate change.

  15. A sticky situation: the unexpected stability of malaria elimination

    PubMed Central

    Smith, David L.; Cohen, Justin M.; Chiyaka, Christinah; Johnston, Geoffrey; Gething, Peter W.; Gosling, Roly; Buckee, Caroline O.; Laxminarayan, Ramanan; Hay, Simon I.; Tatem, Andrew J.

    2013-01-01

    Malaria eradication involves eliminating malaria from every country where transmission occurs. Current theory suggests that the post-elimination challenges of remaining malaria-free by stopping transmission from imported malaria will have onerous operational and financial requirements. Although resurgent malaria has occurred in a majority of countries that tried but failed to eliminate malaria, a review of resurgence in countries that successfully eliminated finds only four such failures out of 50 successful programmes. Data documenting malaria importation and onwards transmission in these countries suggests malaria transmission potential has declined by more than 50-fold (i.e. more than 98%) since before elimination. These outcomes suggest that elimination is a surprisingly stable state. Elimination's ‘stickiness’ must be explained either by eliminating countries starting off qualitatively different from non-eliminating countries or becoming different once elimination was achieved. Countries that successfully eliminated were wealthier and had lower baseline endemicity than those that were unsuccessful, but our analysis shows that those same variables were at best incomplete predictors of the patterns of resurgence. Stability is reinforced by the loss of immunity to disease and by the health system's increasing capacity to control malaria transmission after elimination through routine treatment of cases with antimalarial drugs supplemented by malaria outbreak control. Human travel patterns reinforce these patterns; as malaria recedes, fewer people carry malaria from remote endemic areas to remote areas where transmission potential remains high. Establishment of an international resource with backup capacity to control large outbreaks can make elimination stickier, increase the incentives for countries to eliminate, and ensure steady progress towards global eradication. Although available evidence supports malaria elimination's stickiness at moderate-to-low transmission in areas with well-developed health systems, it is not yet clear if such patterns will hold in all areas. The sticky endpoint changes the projected costs of maintaining elimination and makes it substantially more attractive for countries acting alone, and it makes spatially progressive elimination a sensible strategy for a malaria eradication endgame. PMID:23798693

  16. JPRS Report, Near East and South Asia, Algeria.

    DTIC Science & Technology

    1992-07-30

    personnel. JPRS-NEA-92-097 30 July 1992 ECONOMIC 23 A management expert interested in sales promotion and expansion between developing countries and...facilities as those granted by other developing countries, which all appeal to other countries (Belgium, Switzerland, the Netherlands, etc.) for sales ... promotion or industrial development," a well- informed lady suggested about what is going on in our country. "In Switzerland," she said, "as in smaller

  17. The differential impact of the financial crisis on Health in Ireland and Greece: A quasi-experimental approach

    PubMed Central

    Hessel, P; Vandoros, S; Avendano, M

    2015-01-01

    Objectives Greece and Ireland suffered an economic recession of similar magnitude, but whether their health has deteriorated as a result has not yet been well established. Study design Based on five waves (2006-2010) of the European Union Statistics of Income and Living Conditions (EU-SILC) survey we implemented a difference-in-differences (DID) approach that compared trends in self-rated health in Greece and Ireland before and after the crisis with trends in a control population (Poland) that did not experience a recession and had health trends comparable to both countries before the crisis. Methods Logistic regression using a difference-in-differences (DID) approach. Results A simple examination of trends suggests that there was no significant change in health in Greece or Ireland following the onset of the financial crisis. However, DID estimates that incorporated a control population suggest an increase in the prevalence of poor-self rated health in Greece (OR=1.216; CI=1.11 - 1.32). Effects were most pronounced for older individuals and those living in high-density areas, but effects in Greece were overwhelmingly consistent in different population sub-groups. In contrast, DID estimates revealed no effect of the financial crisis in Ireland (OR=0.97; CI=0.81-1.16). Conclusions Contradicting results from a simple comparison of single-country trends, DID estimates suggest that the financial crisis has led to deterioration of population health trends in Greece but not in Ireland, where policies may have prevented a worsening of health as a result of the recent economic crisis. PMID:25369355

  18. Mapping human resources for eye health in 21 countries of sub-Saharan Africa: current progress towards VISION 2020

    PubMed Central

    2014-01-01

    Background Development of human resources for eye health (HReH) is a major focus of the Global Action Plan 2014 to 2019 to reduce the prevalence of avoidable visual impairment by 25% by the year 2019. The eye health workforce is thought to be much smaller in sub-Saharan Africa than in other regions of the world but data to support this for policy-making is scarce. We collected HReH and cataract surgeries data from 21 countries in sub-Sahara to estimate progress towards key suggested population-based VISION 2020 HReH indicators and cataract surgery rates (CSR) in 2011. Methods Routinely collected data on practitioner and surgery numbers in 2011 was requested from national eye care coordinators via electronic questionnaires. Telephone and e-mail discussions were used to determine data collection strategies that fit the national context and to verify reported data quality. Information was collected on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and ‘mid-level refractionists’ and combined with publicly available population data to calculate practitioner to population ratios and CSRs. Associations with development characteristics were conducted using Wilcoxon rank sum tests and Spearman rank correlations. Results HReH data was not easily available. A minority of countries had achieved the suggested VISION 2020 targets in 2011; five countries for ophthalmologists/cataract surgeons, four for ophthalmic nurses/clinical officers and two for CSR. All countries were below target for optometrists, even when other cadres who perform refractions as a primary duty were considered. The regional (sample) ratio for surgeons (ophthalmologists and cataract surgeons) was 2.9 per million population, 5.5 for ophthalmic clinical officers and nurses, 3.7 for optometrists and other refractionists, and 515 for CSR. A positive correlation between GDP and CSR as well as many practitioner ratios was observed (CSR P = 0.0042, ophthalmologists P = 0.0034, cataract surgeons, ophthalmic nurses and optometrists 0.1 > P > 0.05). Conclusions With only a minority of countries in our sample having reached suggested ophthalmic cadre targets and none having reached targets for refractionists in 2011, substantially more targeted investment in HReH may be needed for VISION 2020 aims to be achieved in sub-Saharan Africa. PMID:25128163

  19. Is Europe still heading to a common price level for on-patent medicines? An exploratory study among 15 Western European countries.

    PubMed

    Leopold, Christine; Mantel-Teeuwisse, Aukje Katja; Vogler, Sabine; de Joncheere, Kees; Laing, Richard Ogilvie; Leufkens, Hubert G M

    2013-10-01

    Previous studies have suggested that medicines prices in Europe converge over time as a result of policy measures such as external price referencing. To explore whether ex-factory prices of on-patented medicines in Western European countries have converged over a recent period of time. Prices of ten on-patent medicines in five years (2007, 2008, 2010, 2011, 2012) of 15 European countries were analyzed. The unit of analysis was the ex-factory price in Euro per defined daily dose (exchange rate indexed to 2007). A score (deviation from the average price) per country as well as the ranges were calculated for all medicines. The prices between countries and selected products varied to a great extent from as low as an average price of € 1.3/DDD for sitagliptin in 2010-2012 to an average of € 221.5/DDD for alemtuzumab in 2011. Between 2008 and 2012, a price divergence was seen which was fully driven by two countries, Germany (up to 27% more expensive than the average) and Greece (up to 32% cheaper than the average). All other countries had stable prices and centered around the country average. Prices of less expensive as well as expensive medicines remained relatively stable or decreased over time, while only the price of sirolimus relatively increased. Our study period included the time of the recession and several pricing policy measures may have affected the prices of medicines. Instead of the expected price convergence we observed a price divergence driven by price changes in only two of the 15 countries. All other European countries remained stable around the country average. Further research is needed to expand the study to a bigger sample size, and include prescribing data and Eastern European countries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. ENSO influences the onset of violent conflicts

    NASA Astrophysics Data System (ADS)

    Meng, K. C.; Hsiang, S. M.

    2009-12-01

    Climatic changes are frequently cited as a possible external driver of violent conflict in human societies. Qualitative studies suggest that climatic shifts may stress populations and be conducive to violent conflict. Statistical evidence has shown that anomalous local rainfall is correlated with the onset of conflict. This study finds that in addition to idiosyncratic weather events, climatic states also play a role in triggering violent conflict. El Niño Southern Oscillation (ENSO), the semi-periodic, oceanic Kelvin wave in the tropical Pacific, induces remote temperatures in the tropical free troposphere to rise. This ``ENSO teleconnection'' is not globally uniform and is felt most strongly in the tropical regions during the boreal winter. To determine the degree in which country-level climatic conditions are affected by ENSO, an absolute correlation measure between surface temperature and two ENSO indices was calculated for every country for the period 1949-2009. Countries with high levels of correlation are labeled “ENSO affected,” while countries with low correlation are labeled “ENSO unaffected”. Thus, historical variation in ENSO serves as a ``natural experiment'': if the state of ENSO influences conflict onset, it should be apparent for ENSO affected countries but not for unaffected countries. Using the UCDP/PRIO Armed Conflict Dataset, we find evidence of a large and statistically significant influence of ENSO on the onset of violent conflict. Between 1949-2009, the average probability of a conflict beginning in any country was 0.03. For the ENSO affected countries, we find that a 1°C rise in either NINO12 or NINO34 is associated with an increased probability of conflict onset by 0.015 (or 50% of the global country average). A relationship was not detected for the ENSO unaffected group of countries. This result is robust to a range of statistical models. Nonparametric methods (see figure) also indicate a marked difference in the response of ENSO affected and unaffected country groups. These results show that the ENSO cycle plays a role in the timing of violent conflicts for a portion of the world. Should anthropogenic climate forcing influence the frequency or intensity of El Niño events, it may have significant implications for the future security of ENSO affected countries. Non-parametric estimates (Nadaraya-Watson) of the probability of conflict onset, conditional on the annual mean ENSO indices NINO12 (solid) and NINO34 (dashed). The countries exhibiting surface temperatures most highly correlated with ENSO are the "affected" group (black). The countries least correlated with ENSO are the "unaffected" group (gray).

  1. Different trends in euthanasia acceptance across Europe. A study of 13 western and 10 central and eastern European countries, 1981-2008.

    PubMed

    Cohen, Joachim; Van Landeghem, Paul; Carpentier, Nico; Deliens, Luc

    2013-06-01

    We examined how acceptance of euthanasia among the general public has changed between 1981 and 2008 in western and central and eastern European (CEE) countries using data of the European Values Surveys. Data were collected in 1981, 1990, 1999 and 2008 for 13 western European countries and in 1990, 1999 and 2008 for 10 CEE countries. Euthanasia acceptance increased each decade up until 2008 in 11 of 13 western European countries; in CEE countries, it decreased or did not increase between 1999-2008 in 8 of 10 countries. A number of explanations for and implications of this apparent east-west polarization are suggested.

  2. Cross-cultural validity of the Self-Stigma of Seeking Help (SSOSH) scale: examination across six nations.

    PubMed

    Vogel, David L; Armstrong, Patrick Ian; Tsai, Pei-Chun; Wade, Nathaniel G; Hammer, Joseph H; Efstathiou, Georgios; Holtham, Elizabeth; Kouvaraki, Elli; Liao, Hsin-Ya; Shechtman, Zipora; Topkaya, Nursel

    2013-04-01

    Researchers have found that the stigma associated with seeking therapy--particularly self-stigma--can inhibit the use of psychological services. Yet, most of the research on self-stigma has been conducted in the United States. This is a considerable limitation, as the role of self-stigma in the help-seeking process may vary across cultural groups. However, to examine cross-cultural variations, researchers must first develop culturally valid scales. Therefore, this study examined scale validity and reliability of the widely used Self-Stigma of Seeking Help scale (SSOSH; Vogel, Wade, & Haake, 2006) across samples from 6 different countries (England, Greece, Israel, Taiwan, Turkey, and the United States). Specifically, we used a confirmatory factor analysis framework to conduct measurement invariance analysis and latent mean comparisons of the SSOSH across the 6 sampled countries. Overall, the results suggested that the SSOSH has a similar univariate structure across countries and is sufficiently invariant across countries to be used to explore cultural differences in the way that self-stigma relates to help-seeking behavior.

  3. Public acceptance of euthanasia in Europe: a survey study in 47 countries.

    PubMed

    Cohen, Joachim; Van Landeghem, Paul; Carpentier, Nico; Deliens, Luc

    2014-02-01

    In recent years, the European euthanasia debate has become more intense, and the practice was legalized in the Netherlands, Belgium, and Luxembourg. We aimed to determine the current degree of public acceptance of euthanasia across Europe and investigate what factors explain differences. Data were derived from the 2008 wave of the European Values Survey (EVS), conducted in 47 European countries (N = 67,786, response rate = 69 %). Acceptance of euthanasia was rated on a 1-10 scale. Relatively high acceptance was found in a small cluster of Western European countries, including the three countries that have legalized euthanasia and Denmark, France, Sweden and Spain. In a large part of Europe public acceptance was relatively low to moderate. Comparison with the results of the previous EVS wave (1999) suggests a tendency towards a polarization in Europe, with most of Western Europe becoming more permissive and most of Eastern Europe becoming less permissive. There is roughly a West-East division in euthanasia acceptance among the European public, making a pan-European policy approach to the issue difficult.

  4. Reproductive rights approach to reproductive health in developing countries

    PubMed Central

    Pillai, Vijayan K.; Gupta, Rashmi

    2011-01-01

    Background Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between. Objective This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women's reproductive health in developing countries. The empowerment strategy for improving reproductive health is theoretically situated on a number of background factors such as economic and social development. Design Cross-national socioeconomic and demographic data from a number of international organizations on 142 developing countries are used to test a model of reproductive rights and reproductive health. Results The findings suggest that both economic and democratic development have significant positive effects on levels of gender equality. The level of social development plays a prominent role in promoting reproductive rights. It is found that reproductive rights channel the influences of social structural factors and gender equality on reproductive health. PMID:22184501

  5. Walking, cycling, and obesity rates in Europe, North America, and Australia.

    PubMed

    Bassett, David R; Pucher, John; Buehler, Ralph; Thompson, Dixie L; Crouter, Scott E

    2008-11-01

    This study was designed to examine the relationship between active transportation (defined as the percentage of trips taken by walking, bicycling, and public transit) and obesity rates (BMI > or = 30 kg . m-2) in different countries. National surveys of travel behavior and health indicators in Europe, North America, and Australia were used in this study; the surveys were conducted in 1994 to 2006. In some cases raw data were obtained from national or federal agencies and then analyzed, and in other cases summary data were obtained from published reports. Countries with the highest levels of active transportation generally had the lowest obesity rates. Europeans walked more than United States residents (382 versus 140 km per person per year) and bicycled more (188 versus 40 km per person per year) in 2000. Walking and bicycling are far more common in European countries than in the United States, Australia, and Canada. Active transportation is inversely related to obesity in these countries. Although the results do not prove causality, they suggest that active transportation could be one of the factors that explain international differences in obesity rates.

  6. Cross-cultural similarities and differences in the experience of awe.

    PubMed

    Razavi, Pooya; Zhang, Jia Wei; Hekiert, Daniela; Yoo, Seung Hee; Howell, Ryan T

    2016-12-01

    Current research on awe is limited to Western cultures. Thus, whether the measurement, frequency, and consequences of awe will replicate across non-Western cultures remains unanswered. To address this gap, we validated the dispositional awe scale (Shiota, Keltner, & John, 2006) in 4 countries (United States, Iran, Malaysia, and Poland; N = 1,173) with extensive variations in cultural values (i.e., power distance) and personality profiles (i.e., extraversion and openness). Multigroup factor analyses demonstrated that, across all cultures, a 3-factor model that treats awe, amusement, and pride as 3 unique emotions is superior to a single-factor model that clusters all 3 emotions together. Structurally, the scales of awe, amusement and pride were invariant across all countries. Furthermore, we found significant country-level differences in dispositional awe, with the largest discrepancy between the United States and Iran (d = 0.79); these differences are not likely due to cultural response biases. Results are discussed in terms of possible explanations for country-level differences and suggestions for future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  7. Language, culture, and task shifting--an emerging challenge for global mental health.

    PubMed

    Swartz, Leslie; Kilian, Sanja; Twesigye, Justus; Attah, Dzifa; Chiliza, Bonginkosi

    2014-01-01

    Language is at the heart of mental health care. Many high-income countries have sophisticated interpreter services, but in low- and middle-income countries there are not sufficient professional services, let alone interpreter services, and task shifting is used. In this article, we discuss this neglected issue in the context of low- and middle-income countries, where task shifting has been suggested as a solution to the problem of scarce mental health resources. The large diversity of languages in low- and middle-income countries, exacerbated by wide-scale migration, has implications for the scale-up of services. We suggest that it would be useful for those who are working innovatively to develop locally delivered mental health programmes in low- and middle-income countries to explore and report on issues of language and how these have been addressed. We need to know more about local challenges, but also about local solutions which seem to work, and for this we need more information from the field than is currently available.

  8. Are movies with tobacco, alcohol, drugs, sex, and violence rated for youth?: A comparison of rating systems in Argentina, Brazil, Mexico, and the United States

    PubMed Central

    Thrasher, James F.; Sargent, James D.; Vargas, Rosa; Braun, Sandra; Barrientos-Gutierrez, Tonatiuh; Sevigny, Eric L.; Billings, Deborah L.; Arillo-Santillán, Edna; Navarro, Ashley; Hardin, James

    2014-01-01

    Background This study aimed to determine between-country differences and changes over time in the portrayal of youth risk behaviors in films rated for youth in Argentina, Brazil, Mexico and the United States. Methods Content and ratings were analyzed for 362 films that were popular across all four countries from 2002–2009. Country-specific ratings were classified as either youth or adult, and Generalized Estimating Equations were used to determine between-country differences in the presence of tobacco, alcohol, drugs, sexual content, and violence in youth-rated films. Within-country differences in this content over time were also assessed, comparing films released from 2002–2005 with those released from 2006–2009. Results In the US, films rated for youth were less likely to contain all five risk behaviors than in youth-rated films in Argentina, Brazil, and, when the “15 and older” rating was considered a youth rating, in Mexico. All three Latin American countries “downrated” films that received an adult rating in the US. Nevertheless, tobacco and drug use in youth-rated films declined over time in all countries, whereas moderate to extreme alcohol use and violence involving children or youth increased in all countries. Conclusions Tobacco and drug use have declined in popular US films, but these behaviors are still prevalent in films rated for youth across the Americas. The apparent success of advocacy efforts to reduce tobacco and other drugs in films suggests that similar efforts be directed to reduce alcohol portrayals. PMID:24316001

  9. Disparity in Dental Attendance Among Older Adult Populations: A Comparative Analysis Across Selected European Countries and the United States

    PubMed Central

    Manski, Richard; Moeller, John; Chen, Haiyan; Widström, Eeva; Listl, Stefan

    2015-01-01

    Background The current study addresses the extent to which diversity in dental attendance across population subgroups exists within and between the United States and selected European countries. Method The analyses relied on 2006/2007 data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) and 2004–2006 data from of the Health and Retirement Study (HRS) in the United States for respondents aged 51 years and older. Logistic regression models were estimated to identify impacts of dental care coverage and oral as well as general health status on dental care use. Results We were unable to discern significant differences in dental attendance across population subgroups in countries with and without social health insurance, between the USA and European countries, and between European countries classified by social welfare regime. Patterns of diverse dental use were found, but they did not appear predominately in countries classified by welfare state regime or by presence or absence of social health insurance. Conclusions Findings of this study suggest that income and education have stronger and more persistent correlation with dental use than the correlation between dental insurance and dental use across European countries. We conclude that (1) higher overall rates of coverage in most European countries, compared to relatively lower rates in the USA, contribute to this finding and that (2) policies targeted to improving the income of older persons and their awareness of the importance of oral health care in both Europe and the USA can contribute to improving the use of dental services. PMID:26465093

  10. Prediction of adaptation difficulties by country of origin, cumulate psychosocial stressors and attitude toward integrating: A Swedish study of first-generation immigrants from Somalia, Vietnam and China

    PubMed Central

    Zolkowska, Krystyna; McNeil, Thomas F

    2015-01-01

    Background: Different types of accumulated stress have been found to have negative consequences for immigrants’ capacity to adapt to the new environment. It remains unclear which factors have the greatest influence. Aims: The study investigated whether immigrants’ experience of great difficulty in adapting to a new country could best be explained by (1) country of origin, (2) exposure to accumulated stressors before arrival or (3) after arrival in the new country and/or (4) reserved attitude toward integrating into the new society. Methods: The 119 first-generation immigrants from Somalia, Vietnam and China, living in Malmö, Sweden, were interviewed in a standardized manner. Results: Experiencing great difficulty in adapting to Sweden was independent of length of residence, but significantly related to all four influences, studied one at a time. Country of origin was also related to stressors and attitude. When the effects of the other influences were mutually controlled for, only exposure to accumulated stressors in Sweden (and especially experiencing discrimination/xenophobia/racism) accounted for great adaptation difficulty. Stressors in Sweden had a greater effect if the immigrant had been exposed to stressors earlier. Conclusions: Immigrants’ long-term experiences of great difficulty in adapting to a new country were explained primarily by exposure to accumulated stressors while moving to and living in the new country, rather than by their backgrounds or attitudes toward integrating. This suggests promoting strategies to avoid discrimination and other stressors in the host country. PMID:24927925

  11. State of rare disease management in Southeast Asia.

    PubMed

    Shafie, Asrul Akmal; Chaiyakunapruk, Nathorn; Supian, Azuwana; Lim, Jeremy; Zafra, Matt; Hassali, Mohamed Azmi Ahmad

    2016-08-02

    Rare diseases, also referred to as orphan diseases, are characterised by their low prevalence with majority of them are chronically debilitating and life threatening. Given the low prevalence and the widely dispersed but very small patient base for each disease, there may often be a disproportion in the availability of treatments and resources to manage patients, spur research and train experts. This is especially true in Southeast Asian countries that are currently in the process of implementing or revising their universal health coverage schemes. This paper aims to examine the status of rare disease management in Southeast Asian countries. It will serve as the basis for a more active discussion on how countries in the region can address an under-recognised rare disease burden and enhance national and regional capacities. The study consists of literature reviews and key stakeholders interviews in six focus countries, including the Philippines, Singapore, Malaysia, Indonesia, Vietnam, and Thailand and five countries as best practice, comprising of France, Canada, Australia, Taiwan, and South Korea. Rare disease management initiatives across each country were examined based on the World Health Organization's framework for action in strengthening health systems. The results suggest rare disease management remains challenging across Southeast Asia, as many of the focus countries face fundamental issues from basic healthcare systems to funding. Nonetheless, there are substantial improvement opportunities, including leveraging best practices from around the world and organising a multi-stakeholder and regional approach and strategy. Southeast Asian countries have made significant progress in the management of rare disease, but there remain key areas for substantial development opportunities.

  12. Does it payoff to research economics-A tale of citation, knowledge and economic growth in transition countries

    NASA Astrophysics Data System (ADS)

    Kovac, Dejan; Scrbec, Nikol; Podobnik, Boris

    2018-09-01

    There are many economic theories that promote human capital as a key driver of a country's economic growth, but it is challenging to test this theory empirically on a country level and causally interpret the coefficients due to several identification problems. We tried to answer this particular question by using a quasi-natural experiment that happened quarter century ago - the fall of communist block in Eastern Europe. We use a shock to a particular scientific field - economics, to test whether the future investment into that particular field resulted in increased welfare and economic growth. The economics paradigm that was governing all of the communist block ceased to exist. Human capital depreciated over night and all communist countries had to transit from planned economy to a market economy. In the following years countries had to adapt to market economy through additional investment in human capital and research. We find that countries which lack both of the two fourth mentioned components had 25 years later a relatively lower economic growth and wealth. Unlike economics, other fields such as physics and medicine did not go through the same process so we use them as a placebo effect for our study. We find that the relative ratio of citations between economics and physics in post-communist countries is increasing only 15 years after the "paradigm" shock which gives a suggestive evidence that timing of investment into particular scientific field matters the most.

  13. Metal spectra as indicators of development.

    PubMed

    Graedel, T E; Cao, J

    2010-12-07

    We have assembled extensive information on the cycles of seven industrial metals in 49 countries, territories, or groups of countries, drawn from a database of some 200,000 material flows, and have devised analytical approaches to treat the suite of metals as composing an approach to a national "materials metabolism." We demonstrate that in some of the more developed countries, per capita metal use is more than 10 times the global average. Additionally, countries that use more than the per capita world average of any metal do so for all metals, and vice versa, and countries that are above global average rates of use are very likely to be above global average rates at all stages of metal life cycles from fabrication onward. We show that all countries are strongly dependent on international trade to supply the spectrum of nonrenewable resources that modern technology requires, regardless of their level of development. We also find that the rate of use of the spectrum of metals stock is highly correlated to per capita gross domestic product, as well as to the Human Development Index and the Global Competitiveness Innovation Index. The implication is that as wealth and technology increase in developing countries, strong demand will be created not for a few key resources, but across the entire spectrum of the industrial metals. Long-term metal demand can be estimated given gross domestic product projections; the results suggest overall metal flow into use in 2050 of 5-10 times today's level should supplies permit.

  14. Metal spectra as indicators of development

    PubMed Central

    Graedel, T. E.; Cao, J.

    2010-01-01

    We have assembled extensive information on the cycles of seven industrial metals in 49 countries, territories, or groups of countries, drawn from a database of some 200,000 material flows, and have devised analytical approaches to treat the suite of metals as composing an approach to a national “materials metabolism.” We demonstrate that in some of the more developed countries, per capita metal use is more than 10 times the global average. Additionally, countries that use more than the per capita world average of any metal do so for all metals, and vice versa, and countries that are above global average rates of use are very likely to be above global average rates at all stages of metal life cycles from fabrication onward. We show that all countries are strongly dependent on international trade to supply the spectrum of nonrenewable resources that modern technology requires, regardless of their level of development. We also find that the rate of use of the spectrum of metals stock is highly correlated to per capita gross domestic product, as well as to the Human Development Index and the Global Competitiveness Innovation Index. The implication is that as wealth and technology increase in developing countries, strong demand will be created not for a few key resources, but across the entire spectrum of the industrial metals. Long-term metal demand can be estimated given gross domestic product projections; the results suggest overall metal flow into use in 2050 of 5–10 times today’s level should supplies permit. PMID:21098309

  15. Presence, characteristics and equity of access to breast cancer screening programmes in 27 European countries in 2010 and 2014. Results from an international survey.

    PubMed

    Deandrea, S; Molina-Barceló, A; Uluturk, A; Moreno, J; Neamtiu, L; Peiró-Pérez, R; Saz-Parkinson, Z; Lopez-Alcalde, J; Lerda, D; Salas, D

    2016-10-01

    The European Union Council Recommendation of 2 December 2003 on cancer screening suggests the implementation of organised, population-based breast cancer screening programmes based on mammography every other year for women aged 50 to 69years, ensuring equal access to screening, taking into account potential needs for targeting particular socioeconomic groups. A European survey on coverage and participation, and key organisational and policy characteristics of the programmes, targeting years 2010 and 2014, was undertaken in 2014. Overall, 27 countries contributed to this survey, 26 of the 28 European Union member states (92.9%) plus Norway. In 2014, 25 countries reported an ongoing population-based programme, one country reported a pilot programme and another was planning a pilot. In eight countries, the target age range was broader than that proposed by the Council Recommendation, and in three countries the full range was not covered. Fifteen countries reported not reaching some vulnerable populations, such as immigrants, prisoners and people without health insurance, while 22 reported that participation was periodically monitored by socioeconomic variables (e.g. age and territory). Organised, population-based breast cancer screening programmes based on routine mammograms are in place in most EU member states. However, there are still differences in the way screening programmes are implemented, and participation by vulnerable populations should be encouraged. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Human epidermal growth factor receptor 2 status of breast cancer patients in Asia: Results from a large, multicountry study.

    PubMed

    Pathmanathan, Nirmala; Geng, Jing-Shu; Li, Wencai; Nie, Xiu; Veloso, Januario; Hill, Julie; McCloud, Philip; Bilous, Michael

    2016-12-01

    Current estimates of the human epidermal growth factor receptor 2 (HER2)-positivity rate in breast cancer are largely based on studies from the United States, Europe and Australia, and might not reflect the rate among breast cancer patients in Asia. The primary aim of this study was to conduct a clinical audit of laboratories across eight countries in Asia to determine the incidence of HER2-positive breast cancer in this region. Pathology laboratories submitted data on breast cancers consecutively tested for HER2 over a two-year period. The proportion of HER2-positive, -equivocal and -negative tumors was determined for each country and overall. HER2-positivity rate by age and histological grade was also determined. HER2 results from 30 179 breast cancers were submitted by 96 laboratories. The overall HER2-positivity rate was 23.5%; the rate between countries ranged from 19.7% to 44.2%, and from 4.4% to 51.6% between laboratories. An equivocal HER2 result was recorded in 18.2% of cases. Discrepancies between laboratories suggest that testing expertise contributes to variations seen in HER2 status across laboratories, as well as the generally higher rate of HER2-positivity that was recorded. In this study, the incidence of HER2-positive breast cancer diagnosed in Asian women was higher than published studies on women from Western countries. In addition, the study found that women in Asian countries presented with breast cancer at an earlier age, with a higher histological grade. This study serves to highlight the challenges with HER2 testing and data collection in a large multicenter Asian cohort. © 2016 The Authors. Asia-Pacific Journal of Clinical Oncology Published by John Wiley & Sons Australia, Ltd.

  17. The demographics, treatment characteristics and quality of life of adult people with haemophilia in China - results from the HERO study.

    PubMed

    Sun, J; Zhao, Y; Yang, R; Guan, T; Iorio, A

    2017-01-01

    Haemophilia management in China needs to be further developed. To further improve the quality of life (QoL) of people with haemophilia (PWH) in China, it is important to investigate the peculiarities of China as compared to other countries. The primary objective of the Haemophilia Experiences, Results and Opportunities (HERO) project was to quantify the impact of key psychosocial factors affecting PWH. This article presents the demographics, treatment characteristics, and QoL of adult PWH in China as compared with the results of the other nine countries participating in the HERO study. This was a web- (except in Algeria) and questionnaire-based survey conducted in 10 countries. A total of 110 adult PWH from China and 565 from other countries completed the questionnaire. Compared with other countries, respondents in China reported: lower rate of employment (45.6% vs. 63.1%); lower percentages of being treated by prophylaxis (4.1% vs. 36.8%), being treated always at home (27.8% vs. 54.3%) and following treatment recommendation as instructed (6.2% vs. 40.5%); greater difficulty in obtaining replacement factor products (97.3% vs. 29.6%) and visiting their treatment centre (60.9% vs. 26.4%); more annual bleeds requiring treatment (mean: 29.4/year vs. 15.4/year); lower mean self-evaluated disease control score (5.5 vs. 7.7), EQ-5D index (0.71 vs. 0.75) and visual analogue scale (7.1 vs. 7.5) scores. Employed PWH in China had a better self-reported generic QoL than those unemployed. The study suggests that there is a major need for further improvement of both medical care and ongoing psychosocial support for PWH in China. © 2016 John Wiley & Sons Ltd.

  18. Artemisinin-based combination therapy availability and use in the private sector of five AMFm phase 1 countries

    PubMed Central

    2013-01-01

    Background In 2009, the Global Fund to Fight AIDS, Tuberculosis and Malaria established the Affordable Medicines Facility-malaria (AMFm) in order to increase access to quality-assured artemisinin combination therapy (QAACT). AMFm Phase 1, which includes nine pilot programmes in eight countries, was launched in 2009. The objective of this study was to assess anti-malarial stock and purchase patterns at private outlets in five AMFm Phase 1 countries in regard to three of the core AMFm goals: increase the affordability of QAACT, increase the availability of QAACT, and crowd out artemisinin monotherapies and other substandard therapies. Methods The study was conducted between April and May 2012 and included interviews with personnel in 598 private pharmaceutical outlets in Ghana, Kenya, Nigeria, Tanzania, and Uganda. Questionnaires were administered at private retail outlets and the data were analyzed to assess within- and between-country differences in QAACT price, availability, and popularity. Results AMFm medications were less expensive than their non-AMFm counterparts, yet prices for both types were above country-specific suggested retail prices. Market penetration of AMFm QAACT in both urban and rural areas was high, although stock-outs of both AMFm and non-AMFm products were more common in rural compared with urban outlets in Ghana and Kenya (p = 0.0013). Government recommendation was the most significant factor influencing anti-malarial stock choices in urban (41.5%) and rural (31.9%) outlets. The three top-selling anti-malarials reported for both urban and rural areas in each country were, with the exception of rural Uganda and urban Nigeria, combination therapies. Conclusions Results from this study indicate that the AMFm has not fully achieved its affordability and crowd-out objectives. Still, the final purchase price of AMFm QAACT was substantially lower than non-AMFm equivalents. Moreover, for both urban and rural areas, AMFm QAACT availability was found to be high, and the various forms of QAACT were the best-selling products among all anti-malarials. These findings suggest a continued need for initiatives like the AMFm that improve the affordability and accessibility of QAACT. Similar programmes may be especially effective if employed in combination with rapid diagnostic testing to ensure the appropriate use of these products. PMID:23607504

  19. Crowding related norms in outdoor recreation: U.S. versus international visitors

    Treesearch

    Megha Budruk; Robert Manning

    2003-01-01

    Research on crowding-related norms has begun to explore differences across settings, time, activities, and visitor characteristics such as age, economic status, and country of origin. The literature examining visitors' country of origin suggests a mixed pattern. While there is some evidence of differences across country of origin, other studies have not indicated...

  20. Sexual risk among orphaned adolescents: is country-level HIV prevalence an important factor?

    PubMed Central

    Robertson, Laura; Gregson, Simon; Garnett, Geoff P.

    2010-01-01

    Previous studies from sub-Saharan Africa have found that orphans experience increased sexual risk compared to non-orphans. We developed a theoretical framework for the investigation of determinants of HIV risk and used it to generate specific hypotheses regarding the effect of country-level HIV prevalence on the sexual risk experience of orphans. We expected that countries with high HIV prevalence would experience a higher prevalence of orphanhood. We further hypothesised that orphans in countries with high HIV prevalence would experience increased sexual risk, compared to non-orphans, due to pressure on the extended family network, which is primarily responsible for the care of orphans in sub-Saharan Africa, resulting in poorer standards of care and guidance. We used hierarchical logistic regression models to investigate this hypothesis using cross-sectional, Demographic and Health Survey data from 10 sub-Saharan African countries. We found that countries with high HIV prevalence did indeed have higher prevalence of orphanhood. We also found that, amongst female adolescents, maternal and double orphans were significantly more likely to have started sex than non-orphans in countries with high HIV prevalence but were not at increased risk in low HIV prevalence countries. This effect of country-level HIV prevalence on the sexual risk of orphans was not explained by household level factors such as wealth, overcrowding or age of the household head. The same pattern of risk was not observed for male adolescents — male orphans were not more likely to have started sex than non-orphans. This suggests that orphaned adolescent women are an important target group for HIV prevention and that efforts should be made to integrate prevention messages into existing support programmes for orphans and vulnerable children. PMID:20552462

  1. Progress towards malaria control targets in relation to national malaria programme funding

    PubMed Central

    2013-01-01

    Background Malaria control has been dramatically scaled up the past decade, mainly thanks to increasing international donor financing since 2003. This study assessed progress up to 2010 towards global malaria impact targets, in relation to Global Fund, other donor and domestic malaria programme financing over 2003 to 2009. Methods Assessments used domestic malaria financing reported by national programmes, and Global Fund/OECD data on donor financing for 90 endemic low- and middle-income countries, WHO estimates of households owning one or more insecticide-treated mosquito net (ITN) for countries in sub-Saharan Africa, and WHO-estimated malaria case incidence and deaths in countries outside sub-Saharan Africa. Results Global Fund and other donor funding is concentrated in a subset of the highest endemic African countries. Outside Africa, donor funding is concentrated in those countries with highest malaria mortality and case incidence rates over the years 2000 to 2003. ITN coverage in 2010 in Africa, and declines in case and death rates per person at risk over 2004 to 2010 outside Africa, were greatest in countries with highest donor funding per person at risk, and smallest in countries with lowest donor malaria funding per person at risk. Outside Africa, all-source malaria programme funding over 2003 to 2009 per case averted ($56-5,749) or per death averted ($58,000-3,900,000) over 2004 to 2010 tended to be lower (more favourable) in countries with higher donor malaria funding per person at risk. Conclusions Increases in malaria programme funding are associated with accelerated progress towards malaria control targets. Associations between programme funding per person at risk and ITN coverage increases and declines in case and death rates suggest opportunities to maximize the impact of donor funding, by strategic re-allocation to countries with highest continued need. PMID:23317000

  2. General parenting styles are not strongly associated with fruit and vegetable intake and social-environmental correlates among 11-year-old children in four countries in Europe.

    PubMed

    De Bourdeaudhuij, I; Te Velde, S J; Maes, L; Pérez-Rodrigo, C; de Almeida, M D V; Brug, J

    2009-02-01

    To investigate whether fruit and vegetable (F&V) intake in 11-year-olds, and social-environmental correlates of F&V intake such as parental modelling and encouragement, family food rules and home availability, differ according to general parenting styles in Belgium, The Netherlands, Portugal and Spain. Cross-sectional study. Primary schools in four countries. Pupils and one of their parents completed questionnaires to measure F&V intake, related social-environmental correlates and general parenting styles. The sample size was 4555 (49.3 % boys); 1180 for Belgium, 883 for The Netherlands, 1515 for Portugal and 977 for Spain. Parenting styles were divided into authoritative, authoritarian, indulgent and neglectful. No differences were found in F&V intake across parenting styles and only very few significant differences in social-environmental correlates. The authoritarian (more parental encouragement and more demands to eat fruit) and the authoritative (more availability of fruit and vegetables) parenting styles resulted in more favourable correlates. Despite earlier studies suggesting that general parenting styles are associated with health behaviours in children, the present study suggests that this association is weak to non-existent for F&V intakes in four different European countries.

  3. Effect Analysis of U.S. Military Aid to the Republic of Korea.

    DTIC Science & Technology

    1989-06-01

    general opinion of the Korean people toward U.S. forces in Korea at the point of their withdrawal. Finally, Chapter VIII suggests some ideas for a...about the status of the relations between two countries. In this concluding chapter, we’d like to suggest a few ideas to enhance harmony and cooperation...after the division fell to about 15 percent of that in 1944. The war in 1950 resulted in a "coup de grace" effect on the already weak and unbalanced

  4. Healthy and happy in Europe? On the association between happiness and life expectancy over time.

    PubMed

    Bjørnskov, Christian

    2008-04-01

    This paper revisits the standard finding in individual-level studies that happiness leads to longevity. It does so in a cross-country time-series analysis in which the use of a random effects estimator controls for most relevant time-invariant factors. The findings suggest that happiness is negatively associated with longevity at the national level, and suggests a potential indirect transmission channel, as national happiness is negatively associated with public health expenditures. The paper concludes by discussing the implications of the results for public policy and future research.

  5. Exploring the impact of foreign direct investment on tobacco consumption in the former Soviet Union

    PubMed Central

    Gilmore, A; McKee, M

    2005-01-01

    Background: Tobacco is the single largest cause of morbidity and mortality in the developed world; in the former socialist bloc tobacco kills twice as many men as in the west. Although evidence shows that liberalisation of the cigarette trade through the elimination of import barriers leads to significant increases in consumption, far less is known about the impact of foreign direct investment on cigarette consumption. This paper seeks to explore the impact that the substantial transnational tobacco company investments have had on patterns of tobacco trade and consumption in the former Soviet Union. Design: Routine data were used to explore trends in cigarette trade and consumption in the 15 countries of the former Soviet Union from the 1960s to the present day. Comparisons were made between trends in countries that have received substantial investment from the tobacco transnationals and countries that have not. Results: Between 1991 and 2000 cigarette production increased by 96% in countries receiving industry investment and by 11% in countries that did not. Over the same period cigarette consumption increased by 40%; the increase was concentrated in countries receiving investments. Despite these investments, cigarette imports still outweigh exports and no trade surplus has yet to result. Conclusions: The findings suggest that liberalisation of inward investment has a significant and positive impact on cigarette consumption and that without appropriate safeguards, market liberalisation may have long term negative impacts on health. Specific trade rules are needed to govern trade and investment in this uniquely harmful product. Implementation of effective tobacco control policies should precede tobacco industry privatisation. International financial organisations pressing for privatisation should ensure this occurs. PMID:15735295

  6. Financing mental health services in low- and middle-income countries.

    PubMed

    Dixon, Anna; McDaid, David; Knapp, Martin; Curran, Claire

    2006-05-01

    Mental disorders account for a significant and growing proportion of the global burden of disease and yet remain a low priority for public financing in health systems globally. In many low-income countries, formal mental health services are paid for directly by patients out-of-pocket and in middle-income countries undergoing transition there has been a decline in coverage. The paper explores the impact of health care financing arrangements on the efficient and equitable utilization of mental health services. Through a review of the literature and a number of country case studies, the paper examines the impact of financing mental health services from out-of-pocket payments, private health insurance, social health insurance and taxation. The implications for the development of financing systems in low- and middle-income countries are discussed. International evidence suggests that charging patients for mental health services results in levels of use which are below socially efficient levels as the benefits of the services are distributed according to ability to pay, resulting in inequitable access to care. Private health insurance poses three main problems for mental health service users: exclusion of mental health benefits, limited access to those without employment and refusal to insure pre-existing conditions. Social health insurance may offer protection to those with mental health problems. However, in many low- and middle-income countries, eligibility is based on contributions and limited to those in formal employment (therefore excluding many with mental health problems). Tax-funded systems provide universal coverage in theory. However, the quality and distribution of publicly financed health care services makes access difficult in practice, particularly for rural poor communities.

  7. Distributions of the vectors of heartwater, Amblyomma hebraeum and Amblyomma variegatum (Acari: Ixodidae), in Zimbabwe.

    PubMed

    Peter, T F; Perry, B D; O'Callaghan, C J; Medley, G F; Shumba, W; Madzima, W; Burridge, M J; Mahan, S M

    1998-12-01

    The tick vectors of heartwater (Cowdria ruminantium infection) in Zimbabwe, Amblyomma hebraeum and Amblyomma variegatum, historically were believed to be confined to the low-lying regions of the south and north-west of the country. However, country-wide surveys performed in 1975-1980 and 1988-1991 demonstrated that both species were also established in western parts of the highveld plateau and had started to encroach on the predominantly heartwater-free central and eastern highveld regions. To determine the current distributions of both the vectors and evaluate the potential threat of heartwater to animals in the highveld, a survey of ticks infesting cattle was performed in 1996 at 2994 locations in small-holder and large-scale commercial farming areas throughout Zimbabwe. Amblyomma hebraeum was collected at 1329 locations, A. variegatum at 72 locations and both A. hebraeum and A. variegatum at 13 locations. The results demonstrated that A. hebraeum was present, as previously recorded, throughout the southern half of the country and appeared to have undergone further limited spread into the central and eastern highveld regions. Only the northern-most region of the country appeared to be free of this species. Amblyomma variegatum was collected mainly in the north-west, as previously recorded, but was also found at isolated locations across the central highveld region and along the eastern border with Mozambique. This species was, however, still absent from the southern half and the northern-most regions of the country. An overlap of the distributions of the two species existed within a zone along the southern and eastern regions of the distribution of A. variegatum. These results suggest that the vectors of heartwater are spreading and threaten to introduce heartwater into intensive livestock-producing regions of the country.

  8. Forecasting imbalances in the global health labor market and devising policy responses.

    PubMed

    Scheffler, Richard M; Campbell, James; Cometto, Giorgio; Maeda, Akiko; Liu, Jenny; Bruckner, Tim A; Arnold, Daniel R; Evans, Tim

    2018-01-11

    The High-Level Commission on Health Employment and Economic Growth released its report to the United Nations Secretary-General in September 2016. It makes important recommendations that are based on estimates of over 40 million new health sector jobs by 2030 in mostly high- and middle-income countries and a needs-based shortage of 18 million, mostly in low- and middle-income countries. This paper shows how these key findings were developed, the global policy dilemmas they raise, and relevant policy solutions. Regression analysis is used to produce estimates of health worker need, demand, and supply. Projections of health worker need, demand, and supply in 2030 are made under the assumption that historical trends continue into the future. To deliver essential health services required for the universal health coverage target of the Sustainable Development Goal 3, there will be a need for almost 45 million health workers in 2013 which is projected to reach almost 53 million in 2030 (across 165 countries). This results in a needs-based shortage of almost 17 million in 2013. The demand-based results suggest a projected demand of 80 million health workers by 2030. Demand-based analysis shows that high- and middle-income countries will have the economic capacity to employ tens of millions additional health workers, but they could face shortages due to supply not keeping up with demand. By contrast, low-income countries will face both low demand for and supply of health workers. This means that even if countries are able to produce additional workers to meet the need threshold, they may not be able to employ and retain these workers without considerably higher economic growth, especially in the health sector.

  9. Has decentralisation affected child immunisation status in Indonesia?

    PubMed Central

    Maharani, Asri; Tampubolon, Gindo

    2014-01-01

    Background The past two decades have seen many countries, including a number in Southeast Asia, decentralising their health system with the expectation that this reform will improve their citizens’ health. However, the consequences of this reform remain largely unknown. Objective This study analyses the effects of fiscal decentralisation on child immunisation status in Indonesia. Design We used multilevel logistic regression analysis to estimate these effects, and multilevel multiple imputation to manage missing data. The 2011 publication of Indonesia's national socio-economic survey (Susenas) is the source of household data, while the Podes village census survey from the same year provides village-level data. We supplement these with local government fiscal data from the Ministry of Finance. Results The findings show that decentralising the fiscal allocation of responsibilities to local governments has a lack of association with child immunisation status and the results are robust. The results also suggest that increasing the number of village health centres (posyandu) per 1,000 population improves probability of children to receive full immunisation significantly, while increasing that of hospitals and health centres (puskesmas) has no significant effect. Conclusion These findings suggest that merely decentralising the health system does not guarantee improvement in a country's immunisation coverage. Any successful decentralisation demands good capacity and capability of local governments. PMID:25160515

  10. Smoking-related deaths averted due to three years of policy progress

    PubMed Central

    Ellis, Jennifer A; Mays, Darren; Huang, An-Tsun

    2013-01-01

    Abstract Objective To evaluate the global impact of adopting highest-level MPOWER tobacco control policies in different countries and territories from 2007 to 2010. Methods Policy effect sizes based on previously-validated SimSmoke models were applied to determine the reduction in the number of smokers as a result of policy adoption during this period. Based on previous research suggesting that half of all smokers die from smoking, we also derived the estimated smoking-attributable deaths (SADs) averted due to MPOWER policy implementation. The results from use of this simple yet powerful method are consistent with those predicted by using previously validated SimSmoke models. Findings In total, 41 countries adopted at least one highest-level MPOWER policy between 2007 and 2010. As a result of all policies adopted during this period, the number of smokers is estimated to have dropped by 14.8 million, with a total of 7.4 million SADs averted. The largest number of SADs was averted as a result of increased cigarette taxes (3.5 million), smoke-free air laws (2.5 million), health warnings (700 000), cessation treatments (380 000), and bans on tobacco marketing (306 000). Conclusion From 2007 to 2010, 41 countries and territories took action that will collectively prevent nearly 7.5 million smoking-related deaths globally. These findings demonstrate the magnitude of the actions already taken by countries and underscore the potential for millions of additional lives to be saved with continued adoption of MPOWER policies. PMID:23825878

  11. Is astronomical research appropriate for developing countries?

    NASA Astrophysics Data System (ADS)

    Snowden, Michael S.

    An unproductive 45-cm astronomical telescope, given by JICA (Japan) to Sri Lanka, raises general questions as to the reasons for unproductive pure science in developing countries. Before installation, site, maintenance, and scientific objectives were discussed. The facility was launched with a conference organised by the UN Office for Outer Space Affairs. Unfortunately, no research or significant education has resulted after four years. The annual operating cost is U.S. $5000 per year, including salary for a trainee, maintenance, and a modest promotional programme. Comparison with a similar installation in Auckland suggests lack of funding or technical competence do not explain the failure in Sri Lanka. The facility in New Zealand, on the roof of Auckland University's Physics Department, has a slightly smaller budget but has led to modest but useful research and teaching. Lack of financial backing and expertise are often blamed for weak science in developing countries, but examination shows most of these countries have adequately skilled people, and plenty of resources for religion and military. General lack of motivation for science appears to be the principal reason. This lack of interest and highly inefficient bureaucracies are common to scientifically unproductive countries. They mostly lack the cultural and philosophical base of the European Renaissance that motivate the pursuit of modern science, an activity that violates human preferences. There are excellent facilities (ESO, SAAO, Cerro Tololo, and GONG) in some of these same countries, when administered from the West.

  12. Export-oriented deforestation in Mato Grosso: harbinger or exception for other tropical forests?

    PubMed

    DeFries, Ruth; Herold, Martin; Verchot, Louis; Macedo, Marcia N; Shimabukuro, Yosio

    2013-06-05

    The Brazilian state of Mato Grosso was a global deforestation hotspot in the early 2000s. Deforested land is used predominantly to produce meat for distal consumption either through cattle ranching or soya bean for livestock feed. Deforestation declined dramatically in the latter part of the decade through a combination of market forces, policies, enforcement and improved monitoring. This study assesses how representative the national-level drivers underlying Mato Grosso's export-oriented deforestation are in other tropical forest countries based on agricultural exports, commercial agriculture and urbanization. We also assess how pervasive the governance and technical monitoring capacity that enabled Mato Grosso's decline in deforestation is in other countries. We find that between 41 and 54 per cent of 2000-2005 deforestation in tropical forest countries (other than Brazil) occurred in countries with drivers similar to Brazil. Very few countries had national-level governance and capacity similar to Brazil. Results suggest that the ecological, hydrological and social consequences of land-use change for export-oriented agriculture as discussed in this Theme Issue were applicable in about one-third of all tropical forest countries in 2000-2005. However, the feasibility of replicating Mato Grosso's success with controlling deforestation is more limited. Production landscapes to support distal consumption similar to Mato Grosso are likely to become more prevalent and are unlikely to follow a land-use transition model with increasing forest cover.

  13. Social network analysis of international scientific collaboration on psychiatry research.

    PubMed

    Wu, Ying; Duan, Zhiguang

    2015-01-01

    Mental disorder is harmful to human health, effects social life seriously and still brings a heavy burden for countries all over the world. Scientific collaboration has become the indispensable choice for progress in the field of biomedicine. However, there have been few scientific publications on scientific collaboration in psychiatry research so far. The aim of this study was to measure the activities of scientific collaboration in psychiatry research at the level of authors, institutions and countries. We retrieved 36557 papers about psychiatry from Science Ciation Index Expanded (SCI-Expanded) in web of science. Additionally, some methods such as social network analysis (SNA), K-plex analysis and Core-Periphery were used in this study. Collaboration has been increasing at the level of authors, institutions and countries in psychiatry in the last ten years. We selected the top 100 prolific authors, institutions and 30 countries to construct collaborative map respectively. Freedman, R and Seidman, LJ were the central authors, Harvard university was the central institution and the USA was the central country of the whole network. Notably, the rate of economic development of countries affected collaborative behavior. The results show that we should encourage multiple collaboration types in psychiatry research as they not only help researchers to master the current research hotspots but also provide scientific basis for clinical research on psychiatry and suggest policies to promote the development of this area.

  14. The political economy of the public-private mix in heath expenditure: an empirical review of thirteen OECD countries.

    PubMed

    Mou, Haizhen

    2013-12-01

    This study investigates the factors that may have influenced the public-private mix of health expenditure in 13 OECD countries from 1981 to 2007. The degree to which health services are socialized is regarded as the product of a trade-off between the desire to redistribute income through the fiscal system and the losses some citizens will incur when the public health care system expands. The estimation results show that, greater income inequality and population aging are associated with a smaller share of public health expenditure in total health expenditure. The more ideologically left-leaning the electorate is, the larger the share of public health expenditure. Private health insurance tends to erode the political support for the public health care systems in countries with private duplicate health insurance, but not in countries with private primary health insurance. The findings suggest that the role of private sources of funding for health care is likely to grow in developed countries. The expansion of public coverage to include pharmaceuticals and long-term care in some countries may (theoretically) encounter less opposition if the current insurance holders have no duplicate coverage, if the voters as a whole share more left-leaning political ideology, and if low-income voters are more politically mobilized. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Export-oriented deforestation in Mato Grosso: harbinger or exception for other tropical forests?

    PubMed Central

    DeFries, Ruth; Herold, Martin; Verchot, Louis; Macedo, Marcia N.; Shimabukuro, Yosio

    2013-01-01

    The Brazilian state of Mato Grosso was a global deforestation hotspot in the early 2000s. Deforested land is used predominantly to produce meat for distal consumption either through cattle ranching or soya bean for livestock feed. Deforestation declined dramatically in the latter part of the decade through a combination of market forces, policies, enforcement and improved monitoring. This study assesses how representative the national-level drivers underlying Mato Grosso's export-oriented deforestation are in other tropical forest countries based on agricultural exports, commercial agriculture and urbanization. We also assess how pervasive the governance and technical monitoring capacity that enabled Mato Grosso's decline in deforestation is in other countries. We find that between 41 and 54 per cent of 2000–2005 deforestation in tropical forest countries (other than Brazil) occurred in countries with drivers similar to Brazil. Very few countries had national-level governance and capacity similar to Brazil. Results suggest that the ecological, hydrological and social consequences of land-use change for export-oriented agriculture as discussed in this Theme Issue were applicable in about one-third of all tropical forest countries in 2000–2005. However, the feasibility of replicating Mato Grosso's success with controlling deforestation is more limited. Production landscapes to support distal consumption similar to Mato Grosso are likely to become more prevalent and are unlikely to follow a land-use transition model with increasing forest cover. PMID:23610176

  16. Case Report: Severe Imported Influenza Infections Developed during Travel in Reunion Island.

    PubMed

    Allyn, Jérôme; Brottet, Elise; Antok, Emmanuel; Dangers, Laurence; Persichini, Romain; Coolen-Allou, Nathalie; Roquebert, Bénédicte; Allou, Nicolas; Vandroux, David

    2017-12-01

    We report two cases of severe influenza infection imported by tourist patients from their country of origin and developed during travel. While studies have reported cases of influenza infections acquired during travel, here we examine two cases of severe influenza infection contracted in the country of origin that led to diagnosis and therapeutic problems in the destination country. No international recommendation exists concerning influenza vaccination before travel, and few countries recommend it for all travelers. Our study suggests that travel should be canceled when infectious signs are observed before departure. Influenza is a very common infection that is often benign, but sometimes very severe. The most severe cases include shock, acute respiratory distress syndrome (ARDS), myocarditis, rhabdomyolysis, and multiple organ failure. Management can require exceptional therapies, such as extracorporeal membrane oxygenation. A number of studies have focused on influenza infection in travelers. Cases of influenza acquired during travel have been reported in this literature, but no study has examined cases of influenza imported from the country of origin and developed while abroad. The latter situation may lead to 1) diagnostic problems during the nonepidemic season or in places where diagnostic techniques are lacking and 2) therapeutic difficulties resulting from the unavailability of techniques for the management of severe influenza infection in tourist areas. Here, we report two cases of extremely severe influenza infection imported by tourists from their country of origin and developed during travel.

  17. Changing sero-epidemiology of hepatitis A in Asia Pacific countries: A systematic review.

    PubMed

    Gripenberg, Marissa; Aloysia D'Cor, Naveena; L'Azou, Maïna; Marsh, Grenville; Druelles, Sophie; Nealon, Joshua

    2018-03-01

    Hepatitis A is a viral liver disease whose prevalence is associated with low socio-economic and hygiene levels due to its faecal-oral transmission. Severity increases with age, and immunity is life-long. Decreased endemicity could result in increased age and severity of cases. A literature review was conducted to describe changes in age-stratified hepatitis A seroprevalence in Asia Pacific countries from 1980 to 2016, and to identify gaps in the literature. The PRISMA guidelines were followed. The PubMed database was searched for studies on age-specific hepatitis A seroprevalence in 17 Asia Pacific countries. All studies published in the English language, reporting human hepatitis A seroprevalence levels in any age group, were included. Seventy-three publications from 11 countries were identified. A trend of increasing age at first exposure over time was observed, particularly in developed countries such as Japan, Taiwan, Thailand, and Korea, suggesting a transition in terms of endemicity. Extensive gaps in the literature were identified between countries and year of publication, indicating the need for further research. Decreasing hepatitis A exposure and thus immunity conferred during childhood, may render older populations susceptible to infection. The public health and economic value of vaccination against hepatitis A should be assessed within this changing epidemiological context. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. An analysis of perceived access to health care in Europe: How universal is universal coverage?

    PubMed

    Cylus, Jonathan; Papanicolas, Irene

    2015-09-01

    The objective of this paper is to examine variations in perceptions of access to health care across and within 29 European countries. Using data from the 2008 round of the European Social Survey, we investigate the likelihood of an individual perceiving that they will experience difficulties accessing health care in the next 12 months, should they need it (N=51,835). We find that despite most European countries having mandates for universal health coverage, individuals who are low income, in poor health, lack citizenship in the country where they reside, 20-30 years old, unemployed and/or female have systematically greater odds of feeling unable to access care. Focusing on the role of income, we find that while there is a strong association between low income and perceived access barriers across countries, within many countries, perceptions of difficulties accessing care are not concentrated uniquely among low-income groups. This implies that factors that affect all income groups, such as poor quality care and long waiting times may serve as important barriers to access in these countries. Despite commitments to move towards universal health coverage in Europe, our results suggest that there is still significant heterogeneity among individuals' perceptions of access and important barriers to accessing health care. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  19. 'Time is costly': modelling the macroeconomic impact of scaling-up antiretroviral treatment in sub-Saharan Africa.

    PubMed

    Ventelou, Bruno; Moatti, Jean-Paul; Videau, Yann; Kazatchkine, Michel

    2008-01-02

    Macroeconomic policy requirements may limit the capacity of national and international policy-makers to allocate sufficient resources for scaling-up access to HIV care and treatment in developing countries. An endogenous growth model, which takes into account the evolution of society's human capital, was used to assess the macroeconomic impact of policies aimed at scaling-up access to HIV/AIDS treatment in six African countries (Angola, Benin, Cameroon, Central African Republic, Ivory Coast and Zimbabwe). The model results showed that scaling-up access to treatment in the affected population would limit gross domestic product losses due to AIDS although differently from country to country. In our simulated scenarios of access to antiretroviral therapy, only 10.3% of the AIDS shock is counterbalanced in Zimbabwe, against 85.2% in Angola and even 100.0% in Benin (a total recovery). For four out of the six countries (Angola, Benin, Cameroon, Ivory Coast), the macro-economic gains of scaling-up would become potentially superior to its associated costs in 2010. Despite the variability of HIV prevalence rates between countries, macro-economic estimates strongly suggest that a massive investment in scaling-up access to HIV treatment may efficiently counteract the detrimental long-term impact of the HIV pandemic on economic growth, to the extent that the AIDS shock has not already driven the economy beyond an irreversible 'no-development epidemiological trap'.

  20. A wavelet analysis of co-movements in Asian gold markets

    NASA Astrophysics Data System (ADS)

    Das, Debojyoti; Kannadhasan, M.; Al-Yahyaee, Khamis Hamed; Yoon, Seong-Min

    2018-02-01

    This study assesses the cross-country co-movements of gold spot returns among the major gold consuming countries in Asia using wavelet-based analysis for a dataset spanning over 26 years. Wavelet-based analysis is used since it allows measuring co-movements in a time-frequency space. The results suggest intense and positive co-movements in Asia after the Asian financial crisis of 1997 at all frequencies. In addition, the Asian gold spot markets depict a state of impending perfect market integration. Finally, Thailand emerges as the potential market leader in all wavelet scales except one, which is led by India. The study has important implications for international diversification of a single-asset (gold) portfolio.

  1. An empirical test of the Theory of Planned Behaviour applied to contraceptive use in rural Uganda.

    PubMed

    Kiene, Susan M; Hopwood, Sarah; Lule, Haruna; Wanyenze, Rhoda K

    2014-12-01

    There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health-behaviour-change theories to contraceptive use among this population. This study tested the Theory of Planned Behaviour's ability to predict contraceptive-use-related behaviours among post-partum women in rural Uganda. Results gave modest support to the theory's application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries. © The Author(s) 2013.

  2. Social Representation of "Loud Music" in Young Adults: A Cross-Cultural Study.

    PubMed

    Manchaiah, Vinaya; Zhao, Fei; Widen, Stephen; Auzenne, Jasmin; Beukes, Eldré W; Ahmadi, Tayebeh; Tomé, David; Mahadeva, Deepthi; Krishna, Rajalakshmi; Germundsson, Per

    2017-06-01

    Exposure to recreational noise, particularly music exposure, is considered one of the biggest public health hazards of our time. Some important influencing factors such as socioeconomic status, educational background, and cross-cultural perspectives have previously been found to be associated with attitudes toward loud music and the use of hearing protection. Although culture seems to play an important role, there is relatively little known about how it influences perceptions regarding loud music exposure in young adults. The present study was aimed to explore cross-cultural perceptions of and reactions to loud music in young adults (18-25 yr) using the theory of social representations. The study used a cross-sectional survey design. The study sample included young adults (n = 534) from five different countries (India, Iran, Portugal, the United States, and the United Kingdom) who were recruited using convenience sampling. Data were collected using a questionnaire. Data were analyzed using a content analysis, co-occurrence analysis, and also χ² analysis. Fairly equal numbers of positive and negative connotations (∼40%) were noted in all countries. However, the χ² analysis showed significant differences between the countries (most positive connotations were found in India and Iran, whereas the most negative connotations were found in the United Kingdom and Portugal) regarding the informants' perception of loud music. The co-occurrence analysis results generally indicate that the category "negative emotions and actions" occurred most frequently, immediately followed by the category "positive emotions and actions." The other most frequently occurring categories included "acoustics," "physical aliment," "location," and "ear and hearing problems." These six categories formed the central nodes of the social representation of loud music exposure in the global index. Although some similarities and differences were noted among the social representations toward loud music among countries, it is noteworthy that more similarities than differences were noted among countries. The study results suggest that "loud music" is perceived to have both positive and negative aspects within society and culture. We suggest that the health promotion strategies should focus on changing societal norms and regulations to be more effective in decreasing the noise- and/or music-induced auditory symptoms among young adults. American Academy of Audiology

  3. Comparative Study on Migration, Urbanization and Development in the ESCAP Region (RAS/P13/79). Rev. version.

    PubMed

    1982-01-01

    Development of a study project by the UN Economic and Social Commission for Asia and the Pacific (ESCAP) on migration, urbanization, and development in the following countries is described: Indonesia, Malaysia, Pakistan, Philippines, Republic of Korea, Sri Lanka, and Thailand. The project's immediate goal is to assist decision makers in formulating population redistribution policies. It was recommended that ESCAP develop and test a migration questionnaire to assist member countries in undertaking surveys to study the interrelationships of migration and development. Upon completion of survey manuals to assist in the survey implementation, it was suggested that ESCAP run a series of in-country workshops to discuss the applications of survey results for policy formulation. A national migration survey will be taken in each country in the early 1980s in order to discern pattern and type of population mobility, factors that cause people to move or not to move, and the consequences of migration on places of origin and destination. A sample of 14,000 households in each country will be selected and 1 person of age 15-64 will be chosen as the respondent for each household. the following are some items which will be studied: 1) volume of migration streams within and between metropolitan areas and urban-rural areas; 2) decision making factors; 3) interactions between population movement and family structure, chages in fertility levels, employment, and education; 4) impact of agricultural systems on seasonal movements; 5) contributions of migrants to the cities; and 6) implications of international migration to and from the country. Leading family planning agencies will use these results to develop policy relating to population distribution, industry location, migration laws, regional economic planning, modern technology, and rural education. The management framework of the project is presented. After these results are published, government agencies can utilize them by incorporating direct questions on population movement into the national census, conducting demonstration projects to assess the impact of population movement programs, and training personnel.

  4. Acculturation and obesity among migrant populations in high income countries – a systematic review

    PubMed Central

    2013-01-01

    Background There is evidence to suggest that immigrant populations from low or medium-income countries to high income countries show a significant change in obesogenic behaviors in the host society, and that these changes are associated with acculturation. However, the results of studies vary depending on how acculturation is measured. The objective of this study is to systematically review the evidence on the relationship between acculturation - as measured with a standardized acculturation scale - and overweight/obesity among adult migrants from low/middle countries to high income countries. Methods A systematic review of relevant studies was undertaken using six EBSCOhost databases and following the Centre for Reviews and Dissemination’s Guidance for Undertaking Reviews in Health Care. Results The initial search identified 1135 potentially relevant publications, of which only nine studies met the selection criteria. All of the studies were from the US with migrant populations from eight different countries. Six studies employed bi-directional acculturation scales and three used uni-directional scales. Six studies indicated positive general associations between higher acculturation and body mass index (BMI), and three studies reported that higher acculturation was associated with lower BMI, as mainly among women. Conclusion Despite the small number of studies, a number of potential explanatory hypotheses were developed for these emerging patterns. The ‘Healthy Migrant Effect’ may diminish with greater acculturation as the host culture potentially promotes more unhealthy weight gain than heritage cultures. This appears particularly so for men and a rapid form of nutrition transition represents a likely contributor. The inconsistent results observed for women may be due to the interplay of cultural influences on body image, food choices and physical activity. That is, the Western ideal of a slim female body and higher values placed on physical activity and fitness may counteract the obesogenic food environment for female migrants. PMID:23663279

  5. Health policy and systems research agendas in developing countries.

    PubMed

    Gonzalez-Block, Miguel A

    2004-08-05

    BACKGROUND: Health policy and systems research (HPSR) is an international public good with potential to orient investments and performance at national level. Identifying research trends and priorities at international level is therefore important. This paper offers a conceptual framework and defines the HPSR portfolio as a set of research projects under implementation. The research portfolio is influenced by factors external to the research system as well as internal to it. These last include the capacity of research institutions, the momentum of research programs, funding opportunities and the influence of stakeholder priorities and public opinion. These dimensions can vary in their degree of coordination, leading to a complementary or a fragmented research portfolio. OBJECTIVE: The main objective is to identify the themes currently being pursued in the research portfolio and agendas within developing countries and to quantify their frequency in an effort to identify current research topics and their underlying influences. METHODS: HPSR topics being pursued by developing country producer institutions and their perceived priorities were identified through a survey between 2000 and 2002. The response to a call for letters of intent issued by the Alliance in 2000 for a broad range of topics was also analyzed. The institutions that were the universe of this study consisted of the 176 institutional partners of the Alliance for Health Policy and Systems Research producing research in low and middle income countries outside Europe. HPSR topics as well as the beneficiaries or issues and the health problems addressed were content analyzed. Topics were classified into 19 categories and their frequency analyzed across groups of countries with similar per capita income. Agendas were identified by analyzing the source of funding and of project initiation for projects under implementation. RESULTS: The highest ranking topic at the aggregate level is "Sector analysis", followed by "Disease burden" and "Management and organization". Categories at the bottom of this ranking are "Equity", "Policy process", "Economic policy and health" and "Information systems". "Disease burden" is more often funded than other topics for which there is more demand or perceived priority. Analysis suggests few although important differences across priorities, demand for funding and actual project funding. The donors' agenda coincides most with the ranking of research topics overall.Ranking across country income groups shows important differences. Topics that gain prominence in low income countries are "Disease burden" and "Accessibility". In lower middle income countries "Insurance" gains prominence. In upper middle income countries "Decentralization/local health systems", "Equity" and "Policy process" are more prominent. "Program evaluation" is the most consistently ranked topic across income regions, showing a neutral influence by donors, governments or researchers. CONCLUSIONS: The framework proposed offers a basis to identify and contrast research needs, projects and products at the international level and to identify the actor agendas and their influence. Research gaps are suggested when comparing topic ranking against the challenges to health system strengthening and scaling up of disease control programs. Differences across per capita income groups suggests the need for differentiated priority setting mechanisms guiding international support. Data suggests that stakeholders have different agendas, and that donors predominate in determining the research portfolio. High-level consensus building at the national and international levels is necessary to ensure that the diverse agendas play a complementary role in support of health system objectives.The Ministerial Summit for Health Research to be held in Mexico in November 2004 should be an opportunity to analyze further data and to commit funding for priorities identified through sharing and discussion of agendas.

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

    PubMed

    Jou, Judy; Techakehakij, Win

    2012-09-01

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

  7. Is Writing Performance Related to Keyboard Type? An Investigation from Examinees' Perspectives on the TOEFL IBT

    ERIC Educational Resources Information Center

    Ling, Guangming

    2017-01-01

    To investigate whether the type of keyboard used in exams introduces any construct-irrelevant variance to the TOEFL iBT Writing scores, we surveyed 17,040 TOEFL iBT examinees from 24 countries on their keyboard-related perceptions and preferences and analyzed the survey responses together with their test scores. Results suggest that controlling…

  8. Is It Safe? Injury Prevention for Young Children. Suggestions for Teachers, Parents and Other Care Providers of Children to Age 10.

    ERIC Educational Resources Information Center

    Smith, Becky J.

    The United States has a higher child mortality rate than most other industrialized countries, but most childhood injuries, although called "accidents," are the result of predictable and preventable behavior. This book demonstrates how teachers, parents, and caregivers can provide and maintain safe environments while teaching children how to avoid…

  9. Genetic markers and population history: Finland revisited.

    PubMed

    Palo, Jukka U; Ulmanen, Ismo; Lukka, Matti; Ellonen, Pekka; Sajantila, Antti

    2009-10-01

    The Finnish population in Northern Europe has been a target of extensive genetic studies during the last decades. The population is considered as a homogeneous isolate, well suited for gene mapping studies because of its reduced diversity and homogeneity. However, several studies have shown substantial differences between the eastern and western parts of the country, especially in the male-mediated Y chromosome. This divergence is evident in non-neutral genetic variation also and it is usually explained to stem from founder effects occurring in the settlement of eastern Finland as late as in the 16th century. Here, we have reassessed this population historical scenario using Y-chromosomal, mitochondrial and autosomal markers and geographical sampling covering entire Finland. The obtained results suggest substantial Scandinavian gene flow into south-western, but not into the eastern, Finland. Male-biased Scandinavian gene flow into the south-western parts of the country would plausibly explain the large inter-regional differences observed in the Y-chromosome, and the relative homogeneity in the mitochondrial and autosomal data. On the basis of these results, we suggest that the expression of 'Finnish Disease Heritage' illnesses, more common in the eastern/north-eastern Finland, stems from long-term drift, rather than from relatively recent founder effects.

  10. Ethnic differences in self reported health in Malmö in southern Sweden

    PubMed Central

    Lindstrom, M; Sundquist, J; Ostergren, P

    2001-01-01

    STUDY OBJECTIVE—The aim of this study was to investigate ethnic differences in self reported health in the city of Malmö, Sweden, and whether these differences could be explained by psychosocial and economic conditions.
DESIGN/SETTING/PARTICIPANTS—The public health survey in Malmö 1994 was a cross sectional study. A total of 5600 people aged 20-80 years completed a postal questionnaire. The participation rate was 71%. The population was categorised according to country of origin: born in Sweden, other Western countries, Yugoslavia, Poland, Arabic speaking countries and all other countries. The multivariate analysis was performed using a logistic regression model in order to investigate the importance of possible confounders on the differences by country of origin in self reported health. Finally, variables measuring psychosocial and economic conditions were introduced into the model.
MAIN RESULTS—The odds ratios of having poor self reported health were significantly higher among men born in other Western countries, Yugoslavia, Arabic speaking countries and in the category all other countries, as well as among women born in Yugoslavia, Poland and all other countries, compared with men and women born in Sweden. The multivariate analysis including age and education did not change these results. A huge reduction of the odds ratios was observed for men and women born in Yugoslavia, Arabic speaking countries and all other countries, and for women born in Poland after the introduction of the social network, social support and economic factors into the multivariate model.
CONCLUSIONS—There were significant ethnic group differences in self reported health. These differences were greatly reduced by psychosocial and economic factors, which suggest that these factors may be important determinants of self rated health in certain minority groups.


Keywords: self reported health; social network; social support PMID:11154248

  11. The Geography of Sexual Orientation: Structural Stigma and Sexual Attraction, Behavior, and Identity Among Men Who Have Sex with Men Across 38 European Countries.

    PubMed

    Pachankis, John E; Hatzenbuehler, Mark L; Mirandola, Massimo; Weatherburn, Peter; Berg, Rigmor C; Marcus, Ulrich; Schmidt, Axel J

    2017-07-01

    While the prevalence of sexual identities and behaviors of men who have sex with men (MSM) varies across countries, no study has examined country-level structural stigma toward sexual minorities as a correlate of this variation. Drawing on emerging support for the context-dependent nature of MSM's open sexual self-identification cross-nationally, we examined country-level structural stigma as a key correlate of the geographic variation in MSM's sexual attraction, behavior, and identity, and concordance across these factors. Data come from the European MSM Internet Survey, a multi-national dataset containing a multi-component assessment of sexual orientation administered across 38 European countries (N = 174,209). Country-level stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of attitudes toward sexual minorities held by the citizens of each country. Results demonstrate that in more stigmatizing countries, MSM were significantly more likely to report bisexual/heterosexual attractions, behaviors, and identities, and significantly less likely to report concordance across these factors, than in less stigmatizing countries. Settlement size moderated associations between country-level structural stigma and odds of bisexual/heterosexual attraction and behavior, such that MSM living in sparsely populated locales within high-structural stigma countries were the most likely to report bisexual or heterosexual behaviors and attractions. While previous research has demonstrated associations between structural stigma and adverse physical and mental health outcomes among sexual minorities, this study was the first to show that structural stigma was also a key correlate not only of sexual orientation identification, but also of MSM's sexual behavior and even attraction. Findings have implications for understanding the ontology of MSM's sexuality and suggest that a comprehensive picture of MSM's sexuality will come from attending to the local contexts surrounding this important segment of the global population.

  12. Do less populous countries receive more development assistance for health per capita? Longitudinal evidence for 143 countries, 1990-2014.

    PubMed

    Martinsen, Lene; Ottersen, Trygve; Dieleman, Joseph L; Hessel, Philipp; Kinge, Jonas Minet; Skirbekk, Vegard

    2018-01-01

    Per capita allocation of overall development assistance has been shown to be biased towards countries with lower population size, meaning funders tend to provide proportionally less development assistance to countries with large populations. Individuals that happen to be part of large populations therefore tend to receive less assistance. However, no study has investigated whether this is also true regarding development assistance for health. We examined whether this so-called 'small-country bias' exists in the health aid sector. We analysed the effect of a country's population size on the receipt of development assistance for health per capita (in 2015 US$) among 143 countries over the period 1990-2014. Explanatory variables shown to be associated with receipt of development assistance for health were included: gross domestic product per capita, burden of disease, under-5 mortality rate, maternal mortality ratio, vaccination coverage (diphtheria, tetanus and pertussis) and fertility rate. We used the within-between regression analysis, popularised by Mundluck, as well as a number of robustness tests, including ordinary least squares, random-effects and fixed-effects regressions. Our results suggest there exists significant negative effect of population size on the amount of development assistance for health per capita countries received. According to the within-between estimator, a 1% larger population size is associated with a 0.4% lower per capita development assistance for health between countries (-0.37, 95% CI -0.45 to -0.28), and 2.3% lower per capita development assistance for health within countries (-2.29, 95% CI -3.86 to -0.72). Our findings support the hypothesis that small-country bias exists within international health aid, as has been previously documented for aid in general. In a rapidly changing landscape of global health and development, the inclusion of population size in allocation decisions should be challenged on the basis of equitable access to healthcare and health aid effectiveness.

  13. Post-traumatic stress symptoms and structure among orphan and vulnerable children and adolescents in Zambia

    PubMed Central

    Familiar, Itziar; Murray, Laura; Gross, Alden; Skavenski, Stephanie; Jere, Elizabeth; Bass, Judith

    2014-01-01

    Background Scant information exists on PTSD symptoms and structure in youth from developing countries. Methods We describe the symptom profile and exposure to trauma experiences among 343 orphan and vulnerable children and adolescents from Zambia. We distinguished profiles of post-traumatic stress symptoms using latent class analysis. Results Average number of trauma-related symptoms (21.6; range 0-38) was similar across sex and age. Latent class model suggested 3 classes varying by level of severity: low (31% of the sample), medium (45% of the sample), and high (24% of the sample) symptomatology. Conclusions Results suggest that PTSD is a continuously distributed latent trait. PMID:25382359

  14. Trends in Characteristics and Country of Origin Among Foreign-Trained Nurses in the United States, 1990 and 2000

    PubMed Central

    Polsky, Daniel; Ross, Sara J.; Brush, Barbara L.; Sochalski, Julie

    2007-01-01

    Objectives. We describe long-term trends in the characteristics of foreign-trained new entrants to the registered nurse (RN) workforce in the United States. Methods. Using the 1990 and 2000 US Census 5% Public Use Microdata Sample files, we compared trends in characteristics of US- and foreign-trained new entrants to the RN labor force (n=40827) and identified trends in the country of origin of the foreign-trained new entrants. Results. Foreign-trained RNs grew as a percentage of new entrants to the RN workforce, from 8.8% in 1990 to 15.2% in 2000. Compared with US-trained RNs, foreign-trained RNs were 3 times as likely to work in nursing homes and were more likely to have earned a bachelor’s degree. In 2000, 21% of foreign-trained RNs originated from low-income countries, a doubling of the rate since 1990. Conclusions. Foreign-trained RNs now account for a substantial and growing proportion of the US RN workforce. Our findings suggest foreign-trained RNs entering the United States are not of lower quality than US-trained RNs. However, growth in the proportion of RNs from low-income countries may have negative consequences in those countries. PMID:17395844

  15. Fighting terrorism in Africa: Benchmarking policy harmonization

    NASA Astrophysics Data System (ADS)

    Asongu, Simplice A.; Tchamyou, Vanessa S.; Minkoua N., Jules R.; Asongu, Ndemaze; Tchamyou, Nina P.

    2018-02-01

    This study assesses the feasibility of policy harmonization in the fight against terrorism in 53 African countries with data for the period 1980-2012. Four terrorism variables are used, namely: domestic, transnational, unclear and total terrorism dynamics. The empirical evidence is based on absolute beta catch-up and sigma convergence estimation techniques. There is substantial absence of catch-up. The lowest rate of convergence in terrorism is in landlocked countries for regressions pertaining to unclear terrorism (3.43% per annum for 174.9 years) while the highest rate of convergence is in upper-middle-income countries in domestic terrorism regressions (15.33% per annum for 39.13 years). After comparing results from the two estimation techniques, it is apparent that in the contemporary era, countries with low levels of terrorism are not catching-up their counterparts with high levels of terrorism. As a policy implication, whereas some common policies may be feasibly adopted for the fight against terrorism, the findings based on the last periodic phase (2004-2012) are indicative that country-specific policies would better pay-off in the fight against terrorism than blanket common policies. Some suggestions of measures in fighting transnational terrorism have been discussed in the light of an anticipated surge in cross-national terrorism incidences in the coming years.

  16. Bioeconomic analysis of child-targeted subsidies for artemisinin combination therapies: a cost-effectiveness analysis

    PubMed Central

    Klein, Eili Y.; Smith, David L.; Cohen, Justin M.; Laxminarayan, Ramanan

    2015-01-01

    The Affordable Medicines Facility for malaria (AMFm) was conceived as a global market-based mechanism to increase access to effective malaria treatment and prolong effectiveness of artemisinin. Although results from a pilot implementation suggested that the subsidy was effective in increasing access to high-quality artemisinin combination therapies (ACTs), the Global Fund has converted AMFm into a country-driven mechanism whereby individual countries could choose to fund the subsidy from within their country envelopes. Because the initial costs of the subsidy in the pilot countries was higher than expected, countries are also exploring alternatives to a universal subsidy, such as subsidizing only child doses. We examined the incremental cost-effectiveness of a child-targeted policy using an age-structured bioeconomic model of malaria from the provider perspective. Because the vast majority of malaria deaths occur in children, targeting children could potentially improve the cost-effectiveness of the subsidy, though it would avert significantly fewer deaths. However, the benefits of a child-targeted subsidy (i.e. deaths averted) are eroded as leakage (i.e. older individuals taking young child-targeted doses) increases, with few of the benefits of a universal subsidy gained (i.e. reductions in overall prevalence). Although potentially more cost-effective, a child-targeted subsidy must contain measures to reduce the possibility of leakage. PMID:25994293

  17. Project analysis procedures for an OPEC country: case study of Qatar's Northwest Dome Gas Project

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

    Ali, A.B.; Khalifah, H.

    1986-01-01

    The discovery of oil in most OPEC countries in the 1940s changed the economies of these countries from a state of capital shortage and stagnation to a state of capital surplus and economic growth. This growth, however, is lopsided. Oil production and export dominate the gross domestic products (GDPs) of those economies. Concern arising during the 1970s about overdependence on crude oil export as the main source of national income has resulted in the initiation of various industrial development programs in OPEC states aiming to diversify their economies. This study was conducted with two primary objectives: (1) to identify andmore » understand the features of selected OPEC countries' development problems, strategies and plans, focusing on the role of oil and gas resources and opportunities for diversification, and (2) to suggest an appropriate development strategy, with project evaluation implications, for capital-abundant, labor-scarce OPEC countries in the Gulf region such as Qatar. This proposed approach is designed to evaluate the project from its contribution to the national income, people's welfare, the expansion of the economy's absorptive capacity, and relief of the economy's dependence on nonrenewable resources. The Northwest Dome Gas Project in Qatar was selected as an illustrative case study for this approach.« less

  18. Economic impacts of policies affecting crop biotechnology and trade.

    PubMed

    Anderson, Kym

    2010-11-30

    Agricultural biotechnologies, and especially transgenic crops, have the potential to boost food security in developing countries by offering higher incomes for farmers and lower priced and better quality food for consumers. That potential is being heavily compromised, however, because the European Union and some other countries have implemented strict regulatory systems to govern their production and consumption of genetically modified (GM) food and feed crops, and to prevent imports of foods and feedstuffs that do not meet these strict standards. This paper analyses empirically the potential economic effects of adopting transgenic crops in Asia and Sub-Saharan Africa. It does so using a multi-country, multi-product model of the global economy. The results suggest the economic welfare gains from crop biotechnology adoption are potentially very large, and that those benefits are diminished only very slightly by the presence of the European Union's restriction on imports of GM foods. That is, if developing countries retain bans on GM crop production in an attempt to maintain access to EU markets for non-GM products, the loss to their food consumers as well as to farmers in those developing countries is huge relative to the slight loss that could be incurred from not retaining EU market access. Copyright © 2010 Elsevier B.V. All rights reserved.

  19. A Comparison of Japan and U.K. SF-6D Health-State Valuations Using a Non-Parametric Bayesian Method.

    PubMed

    Kharroubi, Samer A

    2015-08-01

    There is interest in the extent to which valuations of health may differ between different countries and cultures, but few studies have compared preference values of health states obtained in different countries. We sought to estimate and compare two directly elicited valuations for SF-6D health states between the Japan and U.K. general adult populations using Bayesian methods. We analysed data from two SF-6D valuation studies where, using similar standard gamble protocols, values for 241 and 249 states were elicited from representative samples of the Japan and U.K. general adult populations, respectively. We estimate a function applicable across both countries that explicitly accounts for the differences between them, and is estimated using data from both countries. The results suggest that differences in SF-6D health-state valuations between the Japan and U.K. general populations are potentially important. The magnitude of these country-specific differences in health-state valuation depended, however, in a complex way on the levels of individual dimensions. The new Bayesian non-parametric method is a powerful approach for analysing data from multiple nationalities or ethnic groups, to understand the differences between them and potentially to estimate the underlying utility functions more efficiently.

  20. Income inequality and obesity prevalence among OECD countries.

    PubMed

    Su, Dejun; Esqueda, Omar A; Li, Lifeng; Pagán, José A

    2012-07-01

    Using recent pooled data from the World Health Organization Global Infobase and the World Factbook compiled by the Central Intelligence Agency of the United States, this study assesses the relation between income inequality and obesity prevalence among 31 OECD countries through a series of bivariate and multivariate linear regressions. The United States and Mexico well lead OECD countries in both obesity prevalence and income inequality. A sensitivity analysis suggests that the inclusion or exclusion of these two extreme cases can fundamentally change the findings. When the two countries are included, the results reveal a positive correlation between income inequality and obesity prevalence. This correlation is more salient among females than among males. Income inequality alone is associated with 16% and 35% of the variations in male and female obesity rates, respectively, across OECD countries in 2010. Higher levels of income inequality in the 2005-2010 period were associated with a more rapid increase in obesity prevalence from 2002 to 2010. These associations, however, virtually disappear when the US and Mexico have been excluded from the analysis. Findings from this study underscore the importance of assessing the impact of extreme cases on the relation between income inequality and health outcomes. The potential pathways from income inequality to the alarmingly high rates of obesity in the cases of the US and Mexico warrant further research.

  1. Quality of claims, references and the presentation of risk results in medical journal advertising: a comparative study in Australia, Malaysia and the United States

    PubMed Central

    2010-01-01

    Background Journal advertising is used by pharmaceutical companies to disseminate medicine information to doctors. The quality of claims, references and the presentation of risk results in Australia and the US has been questioned in several studies. No recent evidence is available on the quality of claims, references and the presentation of risk results in journal advertising in Australia and the US and no Malaysian data have been published. The aim of this study was to compare the quality of claims, references and the presentation of risk results in journal advertising in these three countries. Methods A consecutive sample of 85 unique advertisements from each country was selected from journal advertising published between January 2004 to December 2006. Claims, references and the presentation of risk results in medical journal advertising were compared between the three countries. Results Less than one-third of the claims were unambiguous claims (Australia, 30%, Malaysia 17%, US, 23%). In Malaysia significantly less unambiguous claims were provided than in Australia and the US (P < 0.001). However, the unambiguous claims were supported by more references than other claims (80%). Most evidence was obtained from at least one randomized controlled trial, a systematic review or meta-analysis (Australia, 84%, Malaysia, 81%, US, 76%) with journal articles being the most commonly cited references in all countries. Data on file were significantly more likely to be cited in the US (17%) than in Australia (2%) and Malaysia (4%) (P < 0.001). Advertisements that provided quantitative information reported risk results exclusively as a relative risk reduction Conclusions The majority of claims were vague suggesting poor quality of claims in journal advertising in these three countries. Evidence from a randomized controlled trial, systematic review or meta- analysis was commonly cited to support claims. However, the more frequent use of data that have not been published and independently reviewed in the US compared to Australia and Malaysia raises questions on the quality of references in the US. The use of relative rather than absolute benefits may overemphasize the benefit of medicines which may leave doctors susceptible to misinterpreting information. PMID:20509953

  2. International scientific collaboration in HIV and HPV: a network analysis.

    PubMed

    Vanni, Tazio; Mesa-Frias, Marco; Sanchez-Garcia, Ruben; Roesler, Rafael; Schwartsmann, Gilberto; Goldani, Marcelo Z; Foss, Anna M

    2014-01-01

    Research endeavours require the collaborative effort of an increasing number of individuals. International scientific collaborations are particularly important for HIV and HPV co-infection studies, since the burden of disease is rising in developing countries, but most experts and research funds are found in developed countries, where the prevalence of HIV is low. The objective of our study was to investigate patterns of international scientific collaboration in HIV and HPV research using social network analysis. Through a systematic review of the literature, we obtained epidemiological data, as well as data on countries and authors involved in co-infection studies. The collaboration network was analysed in respect to the following: centrality, density, modularity, connected components, distance, clustering and spectral clustering. We observed that for many low- and middle-income countries there were no epidemiological estimates of HPV infection of the cervix among HIV-infected individuals. Most studies found only involved researchers from the same country (64%). Studies derived from international collaborations including high-income countries and either low- or middle-income countries had on average three times larger sample sizes than those including only high-income countries or low-income countries. The high global clustering coefficient (0.9) coupled with a short average distance between researchers (4.34) suggests a "small-world phenomenon." Researchers from high-income countries seem to have higher degree centrality and tend to cluster together in densely connected communities. We found a large well-connected community, which encompasses 70% of researchers, and 49 other small isolated communities. Our findings suggest that in the field of HIV and HPV, there seems to be both room and incentives for researchers to engage in collaborations between countries of different income-level. Through international collaboration resources available to researchers in high-income countries can be efficiently used to enroll more participants in low- and middle-income countries.

  3. Resource needs and gap analysis in achieving universal access to HIV/AIDS services: a data envelopment analysis of 45 countries.

    PubMed

    Zeng, Wu; Shepard, Donald S; Avila-Figueroa, Carlos; Ahn, Haksoon

    2016-06-01

    -To manage the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) epidemic, international donors have pledged unprecedented commitments for needed services. The Joint United Nations Programme on HIV/AIDS (UNAIDS) projected that low- and middle-income countries needed $25 billion to meet the 2010 HIV/AIDS goal of universal access to AIDS prevention and care, using the resource needs model (RNM). -Drawing from the results from its sister study, which used a data envelopment analysis (DEA) and a Tobit model to evaluate and adjust the technical efficiency of 61 countries in delivering HIV/AIDS services from 2002 to 2007, this study extended the DEA and developed an approach to estimate resource needs and decompose the performance gap into efficiency gap and resource gap. In the DEA, we considered national HIV/AIDS spending as the input and volume of voluntary counseling and testing (VCT), prevention of mother to child transmission (PMTCT) and antiretroviral treatment (ART) as the outputs. An input-oriented DEA model was constructed to project resource needs in achieving 2010 HIV/AIDS goal for 45 countries using the data in 2006, assuming that all study countries maximized efficiency. -The DEA approach demonstrated the potential to include efficiency of national HIV/AIDS programmes in resource needs estimation, using macro-level data. Under maximal efficiency, the annual projected resource needs for the 45 countries was $6.3 billion, ∼47% of their UNAIDS estimate of $13.5 billion. Given study countries' spending of $3.9 billion, improving efficiency could narrow the gap from $9.6 to $2.4 billion. The results suggest that along with continued financial commitment to HIV/AIDS, improving the efficiency of HIV/AIDS programmes would accelerate the pace to reach 2010 HIV/AIDS goals. The DEA approach provides a supplement to the AIDS RNM to inform policy making. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  4. Assessment of the potential REDD+ as a new international support measure for GHG reduction

    NASA Astrophysics Data System (ADS)

    Kim, Y.; Ahn, J.; Kim, H.

    2016-12-01

    As part of the Paris Agreement, the mechanism for reducing emissions from deforestation and forest degradation in developing countries (REDD+) has high potential to simultaneously contribute to greenhouse gas (GHG) mitigation through forest conservation and poverty alleviation. Some of 162 Intended Nationally Determined Contributions (INDCs) submitted by 189 countries representing approximately 98.8% of global GHG emissions include not only unconditional mitigation goals but also conditional goals based on the condition of the provision of international support such as finance, technology transfer and capacity building. Considering REDD+ as one of the main mechanisms to support such work, this study selected ten countries from among Korea's 24 ODA priority partners, taking into consideration their conditional INDC targets alongside sectoral quantified targets such as land use, land-use change and forestry (LULUCF). The ten selected countries are Indonesia, Cambodia, Vietnam, Bangladesh, Sri Lanka, Ghana, Senegal, Colombia, Peru and Paraguay. Of these countries, most REDD+ projects have been conducted in Indonesia mainly due to the fact that 85% of the country's total GHG emissions are caused by forest conversion and peatland degradation. Therefore, GHG reduction rates and associated projected costs of the Indonesia's REDD+ projects were analyzed in order to offer guidance on the potential of REDD+ to contribute to other INDCs' conditional goals. The result showed that about 0.9 t CO2 ha-1 could be reduced at a cost of USD 23 per year. Applying this estimation to the Cambodian case, which has submitted a conditional INDC target of increasing its forest coverage by 60% (currently 57%) by 2030, suggests that financial support of USD 12.8 million would reduce CO2 emissions by about 5.1 million tones by increasing forest coverage. As there is currently no consideration of LULUCF in Cambodia's INDC, this result represents the opportunity for an additional contribution to achieving the country's conditional mitigation goals.

  5. Determination of trace metal concentrations in ginseng (Panax Quinquefolius (American)) roots for forensic comparison using Inductively Coupled Plasma Mass-Spectrometry.

    PubMed

    Peake, Barrie M; Tong, Alfred Y C; Wells, William J; Harraway, John A; Niven, Brian E; Weege, Butch; LaFollette, Douglas J

    2015-06-01

    The trace metal content of roots of samples of the American ginseng natural herbal plant species (Panax quinquefolius) was investigated as a means of differentiating between this species grown on Wisconsin and New Zealand farms, and from Canadian and Chinese sources. ICP-MS measurements were undertaken by ashing samples of the roots and then digestion with conc. HNO3 and H2O2. There was considerable variation in the concentrations of 28 detectable elements along the length of a root, between different roots, between different farms/sources and between different countries. Statistical processing of the log-transformed concentration data was undertaken using principal component analysis (PCA) and discriminant function analysis (DFA). Although PCA showed some differentiation between samples, a much clearer discrimination of the Panax quinquefolius species of ginseng from the four countries was observed using DFA. 88% of the variation between countries could be accounted for by only using discriminant function 1 while 80% of the remaining 12% of the variation between countries is accounted for by discriminant function 2. The Fisher Classification Functions classify 98% of the 87 samples to the correct country of origin with 97% of the cross-validated cases correctly classified. The predictive ability of this DFA model was further tested by constructing 100 discriminant models each using a random selection of the data for two thirds of the 87 sampled ginseng root tops, and then using the resulting classification functions to determine correctly the country of origin of the remaining third of the cases. The mean success rate of the 100 classifications was 92%. These results suggest that measurement and statistical analysis of just the trace metal content of the roots of Panax quinquefolius promises to be an excellent predictor of the country of origin of this ginseng species. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Migrants, healthy worker effect, and mortality trends in the Gulf Cooperation Council countries

    PubMed Central

    Cheema, Sohaila; Mamtani, Ravinder

    2017-01-01

    The Gulf Cooperation Council (GCC) countries namely, Bahrain, Kuwait, Oman, Qatar, United Arab Emirates (UAE), and Saudi Arabia, have experienced unique demographic changes. The major population growth contributor in these countries is young migrants, which has led to a shift in the population age pyramid. Migrants constitute the vast proportion of GCC countries’ population reaching >80% in Qatar and UAE. Using Global Burden of Disease Study 2015 (GBD 2015) and United Nations data, for the GCC countries, we assessed the association between age-standardized mortality and population size trends with linear and polynomial regressions. In 1990–2015, all-cause age-standardized mortality was inversely proportional to national population size (p-values: 0.0001–0.0457). In Bahrain, Qatar, Oman, and Saudi Arabia, the highest annual decrease in mortality was observed when the annual population growth was the highest. In Qatar, all-cause age-specific mortality was inversely proportional to age-specific population size. This association was statistically significant among the 5–14 and 15–49 age groups, which have the largest population size. Cause-specific age-standardized mortality was also inversely proportional to population size. This association was statistically significant for half of the GBD 2015-defined causes of death such as “cirrhosis and other chronic liver diseases” and “HIV/AIDS and tuberculosis”. Remarkably, incoming migrants to Qatar have to be negative for HIV, hepatitis B and C, and tuberculosis. These results show that decline in mortality can be partly attributed to the increase in GCC countries’ population suggesting a healthy migrant effect that influences mortality rates. Consequently, benefits of health interventions and healthcare improvement are likely to be exaggerated in such countries hosting a substantial proportion of migrants compared with countries where migration is low. Researchers and policymakers should be cautious to not exclusively attribute decline in mortality within the GCC countries as a result of the positive effects of health interventions or healthcare improvement. PMID:28632794

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

    PubMed

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

    2014-01-01

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

  8. To what extent do potential conservation donors value community-aspects of conservation projects in low income countries?

    PubMed Central

    Young, Richard P.; Gibbons, James M.; Jones, Julia P. G.

    2018-01-01

    There is a major gap in funding required for conservation, especially in low income countries. Given the significant contribution of taxpayers in industrialized countries to funding conservation overseas, and donations from membership organisation, understanding the preferences of ordinary people in a high income country for different attributes of conservation projects is valuable for future marketing of conservation. We conducted a discrete choice experiment with visitors to a UK zoo, while simultaneously conducting a revealed preference study through a real donation campaign on the same sample. Respondents showed the highest willingness to pay for projects that have local community involvement in management (95% confidence interval £9.82 to £15.83), and for improvement in threatened species populations (£2.97 - £13.87). Both of these were significantly larger than the willingness to pay for projects involving provision of alternative livelihoods, or improving the condition of conservation sites. Results of the simultaneous donation campaign showed that respondents were very willing to donate the suggested £1 or above donation (88% made a donation, n = 1798); there was no effect of which of the two campaigns they were exposed to (threatened species management or community involvement in management). The small number of people who did not make a donation had a higher stated willingness to pay within the choice experiment, which may suggest hypothetical bias. Conservationists increasingly argue that conservation should include local communities in management (for both pragmatic and moral reasons). It is heartening that potential conservation donors seem to agree. PMID:29451923

  9. Use of the Physiotherapy Evidence Database (PEDro) in Japan

    PubMed Central

    TAKASAKI, Hiroshi; ELKINS, Mark R.; MOSELEY, Anne M.

    2016-01-01

    Background: The Physiotherapy Evidence Database (PEDro) may help users to overcome some obstacles to evidence-based physiotherapy. Understanding the extent to which Japanese physiotherapists access research evidence via the PEDro website may suggest strategies to enhance evidence-based physiotherapy in Japan. Objectives: To quantify usage of PEDro in Japan, to compare this to usage in other countries, and to examine variations in PEDro usage within Japan. Design: An observational study of PEDro usage with geographic analysis. Methods: Data about visits to the home-page and searches of the database were recorded for 4 years. These data were analysed by each region of the World Confederation for Physical Therapy, each country in the Asia Western Pacific region, and each prefecture in Japan. Results: From 2010 to 2013, users of PEDro made 2.27 million visits to the home-page and ran 6.28 million searches. Usage (ie, number of searches normalised by population) was highest in Europe, followed by North America Carribean, South America, Asia Western Pacific, and Africa. Within the Asia Western Pacific region, population-normalised usage was highest in Australia, then New Zealand and Singapore. Japan ranked 10 among the 26 countries in the region. Within Japan, the highest population-normalised usage was in the Nagano, Kumamoto and Aomori prefectures, which was ten-fold higher usage than in some other prefectures. Conclusions: Although Japan has higher PEDro usage than many other countries in the Asia Western Pacific region, some prefectures had very low usage, suggesting that evidence-based practice may not be being adopted uniformly across Japan. PMID:28289582

  10. A Spatiotemporal Analysis of Brazilian Science from the Perspective of Researchers' Career Trajectories.

    PubMed

    Furtado, Caio Alves; Davis, Clodoveu A; Gonçalves, Marcos André; de Almeida, Jussara Marques

    2015-01-01

    The growth of Brazilian scientific production in recent years is remarkable, which motivates an investigation on the factors, inside and outside the country, that helped shape this wealthy research environment. This article provides a thorough analysis of the education of researchers that constitute the main Brazilian research groups, using data on about 6,000 researchers involved in the country's National Institutes of Science and Technology (INCT) initiative. Data on the steps taken by each researcher in her education, from the bachelor's degree to doctorate, including a possible postdoctoral experience, and employment, are extracted from an official curriculum vitae repository. The location and the time at which each career step occurred define spatiotemporal career trajectories. We then analyze such trajectories considering additional data, including the area of knowledge of the INCTs to which each researcher is associated. We found an increasing prevalence of Brazilian institutions in the education of Brazilian scientists, as the number of doctorates earned abroad is decreasing over time. Postdoctoral stages, on the other hand, often take place in Europe or in the United States. Taking an international postdoctoral position after a full education in Brazil suggests a drive towards seeking higher-level exchange and cooperation with foreign groups in a more advanced career stage. Results also show that Brazilian researchers tend to seek employment in regions that are close to the institutions at which they received their bachelor's degrees, suggesting low mobility within the country. This study can be instrumental in defining public policies for correcting distortions, and can help other developing countries that aim to improve their national science systems.

  11. Greenhouse Gas Emissions, Energy Consumption and Economic Growth: A Panel Cointegration Analysis for 16 Asian Countries.

    PubMed

    Lu, Wen-Cheng

    2017-11-22

    This research investigates the co-movement and causality relationships between greenhouse gas emissions, energy consumption and economic growth for 16 Asian countries over the period 1990-2012. The empirical findings suggest that in the long run, bidirectional Granger causality between energy consumption, GDP and greenhouse gas emissions and between GDP, greenhouse gas emissions and energy consumption is established. A non-linear, quadratic relationship is revealed between greenhouse gas emissions, energy consumption and economic growth, consistent with the environmental Kuznets curve for these 16 Asian countries and a subsample of the Asian new industrial economy. Short-run relationships are regionally specific across the Asian continent. From the viewpoint of energy policy in Asia, various governments support low-carbon or renewable energy use and are reducing fossil fuel combustion to sustain economic growth, but in some countries, evidence suggests that energy conservation might only be marginal.

  12. Greenhouse Gas Emissions, Energy Consumption and Economic Growth: A Panel Cointegration Analysis for 16 Asian Countries

    PubMed Central

    2017-01-01

    This research investigates the co-movement and causality relationships between greenhouse gas emissions, energy consumption and economic growth for 16 Asian countries over the period 1990–2012. The empirical findings suggest that in the long run, bidirectional Granger causality between energy consumption, GDP and greenhouse gas emissions and between GDP, greenhouse gas emissions and energy consumption is established. A non-linear, quadratic relationship is revealed between greenhouse gas emissions, energy consumption and economic growth, consistent with the environmental Kuznets curve for these 16 Asian countries and a subsample of the Asian new industrial economy. Short-run relationships are regionally specific across the Asian continent. From the viewpoint of energy policy in Asia, various governments support low-carbon or renewable energy use and are reducing fossil fuel combustion to sustain economic growth, but in some countries, evidence suggests that energy conservation might only be marginal. PMID:29165399

  13. Spatial Dynamics of the Communities and the Role of Major Countries in the International Rare Earths Trade: A Complex Network Analysis.

    PubMed

    Wang, Xibo; Ge, Jianping; Wei, Wendong; Li, Hanshi; Wu, Chen; Zhu, Ge

    2016-01-01

    Rare earths (RE) are critical materials in many high-technology products. Due to the uneven distribution and important functions for industrial development, most countries import RE from a handful of suppliers that are rich in RE, such as China. However, because of the rapid growth of RE exploitation and pollution of the mining and production process, some of the main suppliers have gradually tended to reduce the RE production and exports. Especially in the last decade, international RE trade has been changing in the trade community and trade volume. Based on complex network theory, we built an unweighted and weighted network to explore the evolution of the communities and identify the role of the major countries in the RE trade. The results show that an international RE trade network was dispersed and unstable because of the existence of five to nine trade communities in the unweighted network and four to eight trade communities in the weighted network in the past 13 years. Moreover, trade groups formed due to the great influence of geopolitical relations. China was often associated with the South America and African countries in the same trade group. In addition, Japan, China, the United States, and Germany had the largest impacts on international RE trade from 2002 to 2014. Last, some policy suggestions were highlighted according to the results.

  14. Spatial Dynamics of the Communities and the Role of Major Countries in the International Rare Earths Trade: A Complex Network Analysis

    PubMed Central

    Wang, Xibo; Ge, Jianping; Wei, Wendong; Li, Hanshi; Wu, Chen; Zhu, Ge

    2016-01-01

    Rare earths (RE) are critical materials in many high-technology products. Due to the uneven distribution and important functions for industrial development, most countries import RE from a handful of suppliers that are rich in RE, such as China. However, because of the rapid growth of RE exploitation and pollution of the mining and production process, some of the main suppliers have gradually tended to reduce the RE production and exports. Especially in the last decade, international RE trade has been changing in the trade community and trade volume. Based on complex network theory, we built an unweighted and weighted network to explore the evolution of the communities and identify the role of the major countries in the RE trade. The results show that an international RE trade network was dispersed and unstable because of the existence of five to nine trade communities in the unweighted network and four to eight trade communities in the weighted network in the past 13 years. Moreover, trade groups formed due to the great influence of geopolitical relations. China was often associated with the South America and African countries in the same trade group. In addition, Japan, China, the United States, and Germany had the largest impacts on international RE trade from 2002 to 2014. Last, some policy suggestions were highlighted according to the results. PMID:27137779

  15. The economic benefits of malaria elimination: do they include increases in tourism?

    PubMed Central

    2012-01-01

    Background Policy makers have speculated that one of the economic benefits of malaria elimination includes increases in foreign direct investment, particularly tourism. Methods This study examines the empirical relationship between the demand for travel and malaria cases in two countries with large tourism industries around the time in which they carried out malaria-elimination campaigns. In Mauritius, this analysis examines historical, yearly tourist arrivals and malaria cases from 1978–1999, accounting for the background secular trend of increasing international travel. In Dominican Republic, a country embarking upon malaria elimination, it employs a time-series analysis of the monthly, international tourist arrivals from 1998–2010 to determine whether the timing of significant deviations in tourist arrivals coincides with malaria outbreaks. Results While naïve relationships exist in both cases, the results show that the relationships between tourist arrivals and malaria cases are relatively weak and statistically insignificant once secular confounders are accounted for. Conclusions This suggests that any economic benefits from tourism that may be derived from actively pursuing elimination in countries that have high tourism potential are likely to be small when measured at a national level. Rather, tourism benefits are likely to be experienced with greater impact in more concentrated tourist areas within countries, and future studies should seek to assess these relationships at a regional or local level. PMID:22839351

  16. Multiple locus VNTR analysis highlights that geographical clustering and distribution of Dichelobacter nodosus, the causal agent of footrot in sheep, correlates with inter-country movements☆

    PubMed Central

    Russell, Claire L.; Smith, Edward M.; Calvo-Bado, Leonides A.; Green, Laura E.; Wellington, Elizabeth M.H.; Medley, Graham F.; Moore, Lynda J.; Grogono-Thomas, Rosemary

    2014-01-01

    Dichelobacter nodosus is a Gram-negative, anaerobic bacterium and the causal agent of footrot in sheep. Multiple locus variable number tandem repeat (VNTR) analysis (MLVA) is a portable technique that involves the identification and enumeration of polymorphic tandem repeats across the genome. The aims of this study were to develop an MLVA scheme for D. nodosus suitable for use as a molecular typing tool, and to apply it to a global collection of isolates. Seventy-seven isolates selected from regions with a long history of footrot (GB, Australia) and regions where footrot has recently been reported (India, Scandinavia), were characterised. From an initial 61 potential VNTR regions, four loci were identified as usable and in combination had the attributes required of a typing method for use in bacterial epidemiology: high discriminatory power (D > 0.95), typeability and reproducibility. Results from the analysis indicate that D. nodosus appears to have evolved via recombinational exchanges and clonal diversification. This has resulted in some clonal complexes that contain isolates from multiple countries and continents; and others that contain isolates from a single geographic location (country or region). The distribution of alleles between countries matches historical accounts of sheep movements, suggesting that the MLVA technique is sufficiently specific and sensitive for an epidemiological investigation of the global distribution of D. nodosus. PMID:23748018

  17. Modelling rubella in Europe.

    PubMed Central

    Edmunds, W. J.; van de Heijden, O. G.; Eerola, M.; Gay, N. J.

    2000-01-01

    The prevention of congenital rubella syndrome (CRS), as a complication of rubella infection during pregnancy, is the main aim of rubella vaccination programmes. However, as vaccination of infants leads to an increase in the average age at which those who were not immunized become infected, certain rubella vaccination programmes can lead to an increase in the incidence of CRS. In this paper we use a mathematical model of the transmission dynamics of rubella virus to investigate the likely impact of different vaccination policies in Europe. The model was able to capture pre- and post-vaccination patterns of infection and prevalence of serological markers under a wide variety of scenarios, suggesting that the model structure and parameter estimates were appropriate. Analytical and numerical results suggest that endemic circulation of rubella is unlikely in Finland, the United Kingdom, The Netherlands, and perhaps Denmark, provided vaccine coverage is uniform across geographical and social groups. In Italy and Germany vaccine coverage in infancy has not been sufficient to interrupt rubella transmission, and continued epidemics of CRS seem probable. It seems unlikely that the immunization programmes in these countries are doing more harm than good, but this may be partly as a result of selective immunization of schoolgirls. Indeed, in both these countries, selective vaccination of schoolgirls with inadequate vaccination histories is likely to be an important mechanism by which CRS incidence is suppressed (unlike the other countries, which have had sufficiently high infant coverage rates to withdraw this option). Reducing inequalities in the uptake of rubella vaccine may bring greater health benefits than increasing the mean level of coverage. PMID:11218213

  18. Price subsidies and the market for mosquito nets in developing countries: A study of Tanzania's discount voucher scheme.

    PubMed

    Gingrich, Chris D; Hanson, Kara; Marchant, Tanya; Mulligan, Jo-Ann; Mponda, Hadji

    2011-07-01

    This study uses a partial equilibrium simulation model to explore how price subsidies for insecticide-treated mosquito nets (ITNs) affect households' purchases of ITNs. The model describes the ITN market in a typical developing country and is applied to the situation in Tanzania, where the Tanzania National Voucher Scheme (TNVS) provides a targeted subsidy to vulnerable population groups by means of a discount voucher. The data for this study come from a nationally-representative household survey completed July-August 2006 covering over 4300 households in 21 districts. The simulation results show the impact of the voucher program on ITN coverage among target households, namely those that experienced the birth of a child. More specifically, the share of target households purchasing an ITN increased from 18 to 62 percent because of the discount voucher. The model also suggests that the voucher program could cause the retail ITN price to rise due to an overall increase in demand. As a result, ITN purchases by households without a voucher may actually decline. The simulation model suggests that additional increases toward the stated goal of 80 percent ITN coverage for pregnant women and children could best be achieved through a combination of "catch up" mass distribution programs and expanding the target group for the voucher program to cover additional households. The model can be employed in other countries considering use of a targeted price subsidy for ITNs, and could be adapted to assess the impact of subsidies for other public health commodities. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Childhood growth, schooling, and cognitive development: further evidence from the Young Lives study.

    PubMed

    Fink, Günther; Rockers, Peter C

    2014-07-01

    A growing literature has linked early childhood growth to later-life cognition and schooling outcomes in developing countries. Although existing evidence suggests that children's ability to recover from early growth delays in later childhood is limited, longitudinal studies on the persistence and risk of growth faltering beyond age 5 y remain scarce. Using longitudinal data recently collected from 4 developing countries as part of the Young Lives study, we investigated catch-up growth in children between the ages of 8 and 15 y and the effects of growth during this late-childhood and early-adolescence period on schooling and developmental outcomes. We analyzed the associations between children's physical growth and development by using longitudinal data from 3327 children aged 8-15 y collected in Ethiopia, India, Peru, and Vietnam as part of the Young Lives project. The study yielded 2 main results. First, 36% of children stunted at age 8 y managed to catch up with their peers by age 15 y, and those who caught up had smaller deficits in cognitive scores than did children who remained stunted. Second, physical growth faltering was not restricted to early childhood but rather affected a substantial share of children in the 8-15-y age range, with large negative consequences for cognition and schooling outcomes. The results from this study suggest that child development in developing countries is a dynamic process offering continued opportunities for children to catch up during adolescence and sustained risks for children to fall behind in their developmental trajectories. © 2014 American Society for Nutrition.

  20. Availability, price and affordability of cardiovascular medicines: A comparison across 36 countries using WHO/HAI data

    PubMed Central

    2010-01-01

    Background The global burden of cardiovascular disease (CVD) continues to rise. Successful treatment of CVD requires adequate pharmaceutical management. The aim was to examine the availability, pricing and affordability of cardiovascular medicines in developing countries using the standardized data collected according to the World Health Organization/Health Action International methodology. Methods The following medicines were included: atenolol, captopril, hydrochlorothiazide, losartan and nifedipine. Data from 36 countries were analyzed. Outcome measures were percentage availability, price ratios to international reference prices and number of day's wages needed by the lowest-paid unskilled government worker to purchase one month of chronic treatment. Patient prices were adjusted for inflation and purchasing power, procurement prices only for inflation. Data were analyzed for both generic and originator brand products and the public and private sector and summarized by World Bank Income Groups. Results For all measures, there was great variability across surveys. The overall availability of cardiovascular medicines was poor (mean 26.3% in public sector, 57.3% private sector). Procurement prices were very competitive in some countries, whereas others consistently paid high prices. Patient prices were generally substantially higher than international references prices; some countries, however, performed well. Chronic treatment with anti-hypertensive medication cost more than one day's wages in many cases. In particular when monotherapy is insufficient, treatment became unaffordable. Conclusions The results of this study emphasize the need of focusing attention and financing on making chronic disease medicines accessible, in particular in the public sector. Several policy options are suggested to reach this goal. PMID:20534118

  1. Trade liberalization, social policies and health: an empirical case study.

    PubMed

    McNamara, Courtney

    2015-10-12

    This study investigates the health impacts of a major liberalization episode in the textile and clothing (T&C) sector. This episode triggered substantial shifts in employment across a wide range of countries. It is the first study to empirically link trade liberalization to health via changes in employment and offers some of the first empirical insights on how trade liberalization interacts with social policies to influence health. Data from 32 T&C reliant countries were analysed in reference to the pre- and post-liberalization periods of 2000-2004 and 2005-2009. Fuzzy-set qualitative comparative analysis (fsQCA) was used to examine the association between countries' a) level of development b) labour market and welfare state protections c) T&C employment changes and d) changes in adult female and infant mortality rates. Process tracing was used to further investigate these associations through twelve in-depth country studies. Results from the fsQCA relate changes in employment after the phase-out to both changing adult female and infant mortality rates. Findings from the in-depth country studies suggest that the worsening of adult female mortality rates is related to workers' lack of social protection, both in the context of T&C employment growth and loss. Overall, it is found that social protection is often inaccessible to the type of workers who may be the most vulnerable to processes of liberalization and that many workers are particularly vulnerable due to the structure of social protection policies. Social policies are therefore found to both moderate pathways to health and influence the type of health-related pathways resulting from trade liberalizing policies.

  2. Examination of Previously Published Data to Identify Patterns in the Social Representation of “Loud Music” in Young Adults Across Countries

    PubMed Central

    Manchaiah, Vinaya; Zhao, Fei; Oladeji, Susan; Ratinaud, Pierre

    2018-01-01

    Purpose: The current study was aimed at understanding the patterns in the social representation of loud music reported by young adults in different countries. Materials and Methods: The study included a sample of 534 young adults (18–25 years) from India, Iran, Portugal, United Kingdom, and United States. Participants were recruited using a convince sampling, and data were collected using the free association task. Participants were asked to provide up to five words or phrases that come to mind when thinking about “loud music.” The data were first analyzed using the qualitative content analysis. This was followed by quantitative cluster analysis and chi-square analysis. Results: The content analysis suggested 19 main categories of responses related to loud music. The cluster analysis resulted in for main clusters, namely: (1) emotional oriented perception; (2) problem oriented perception; (3) music and enjoyment oriented perception; and (4) positive emotional and recreation-oriented perception. Country of origin was associated with the likelihood of participants being in each of these clusters. Conclusion: The current study highlights the differences and similarities in young adults’ perception of loud music. These results may have implications to hearing health education to facilitate healthy listening habits. PMID:29457602

  3. Standardization of the 24-hour diet recall calibration method used in the european prospective investigation into cancer and nutrition (EPIC): general concepts and preliminary results.

    PubMed

    Slimani, N; Ferrari, P; Ocké, M; Welch, A; Boeing, H; Liere, M; Pala, V; Amiano, P; Lagiou, A; Mattisson, I; Stripp, C; Engeset, D; Charrondière, R; Buzzard, M; Staveren, W; Riboli, E

    2000-12-01

    Despite increasing interest in the concept of calibration in dietary surveys, there is still little experience in the use and standardization of a common reference dietary method, especially in international studies. In this paper, we present the general theoretical framework and the approaches developed to standardize the computer-assisted 24 h diet recall method (EPIC-SOFT) used to collect about 37 000 24-h dietary recall measurements (24-HDR) from the 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). In addition, an analysis of variance was performed to examine the level of standardization of EPIC-SOFT across the 90 interviewers involved in the study. The analysis of variance used a random effects model in which mean energy intake per interviewer was used as the dependent variable, while age, body mass index (BMI), energy requirement, week day, season, special diet, special day, physical activity and the EPIC-SOFT version were used as independent variables. The analysis was performed separately for men and women. The results show no statistical difference between interviewers in all countries for men and five out of eight countries for women, after adjustment for physical activity and the EPIC-SOFT program version used, and the exclusion of one interviewer in Germany (for men), and one in Denmark (for women). These results showed an interviewer effect in certain countries and a significant difference between gender, suggesting an underlying respondent's effect due to the higher under-reporting among women that was consistently observed in EPIC. However, the actual difference between interviewer and country mean energy intakes is about 10%. Furthermore, no statistical differences in mean energy intakes were observed across centres from the same country, except in Italy and Germany for men, and France and Spain for women, where the populations were recruited from areas scattered throughout the countries. Despite these encouraging results and the efforts to standardize the 24-HDR interview method, conscious or unconscious behaviour of respondents and/or interviewer bias cannot be prevented entirely. Further evaluation of the reliability of EPIC-SOFT measurements will be conducted through validation against independent biological markers (nitrogen, potassium).

  4. The Biodiversity Informatics Potential Index

    PubMed Central

    2011-01-01

    Background Biodiversity informatics is a relatively new discipline extending computer science in the context of biodiversity data, and its development to date has not been uniform throughout the world. Digitizing effort and capacity building are costly, and ways should be found to prioritize them rationally. The proposed 'Biodiversity Informatics Potential (BIP) Index' seeks to fulfill such a prioritization role. We propose that the potential for biodiversity informatics be assessed through three concepts: (a) the intrinsic biodiversity potential (the biological richness or ecological diversity) of a country; (b) the capacity of the country to generate biodiversity data records; and (c) the availability of technical infrastructure in a country for managing and publishing such records. Methods Broadly, the techniques used to construct the BIP Index were rank correlation, multiple regression analysis, principal components analysis and optimization by linear programming. We built the BIP Index by finding a parsimonious set of country-level human, economic and environmental variables that best predicted the availability of primary biodiversity data accessible through the Global Biodiversity Information Facility (GBIF) network, and constructing an optimized model with these variables. The model was then applied to all countries for which sufficient data existed, to obtain a score for each country. Countries were ranked according to that score. Results Many of the current GBIF participants ranked highly in the BIP Index, although some of them seemed not to have realized their biodiversity informatics potential. The BIP Index attributed low ranking to most non-participant countries; however, a few of them scored highly, suggesting that these would be high-return new participants if encouraged to contribute towards the GBIF mission of free and open access to biodiversity data. Conclusions The BIP Index could potentially help in (a) identifying countries most likely to contribute to filling gaps in digitized biodiversity data; (b) assisting countries potentially in need (for example mega-diverse) to mobilize resources and collect data that could be used in decision-making; and (c) allowing identification of which biodiversity informatics-resourced countries could afford to assist countries lacking in biodiversity informatics capacity, and which data-rich countries should benefit most from such help. PMID:22373233

  5. Mind the Gap! A Multilevel Analysis of Factors Related to Variation in Published Cost-Effectiveness Estimates within and between Countries.

    PubMed

    Boehler, Christian E H; Lord, Joanne

    2016-01-01

    Published cost-effectiveness estimates can vary considerably, both within and between countries. Despite extensive discussion, little is known empirically about factors relating to these variations. To use multilevel statistical modeling to integrate cost-effectiveness estimates from published economic evaluations to investigate potential causes of variation. Cost-effectiveness studies of statins for cardiovascular disease prevention were identified by systematic review. Estimates of incremental costs and effects were extracted from reported base case, sensitivity, and subgroup analyses, with estimates grouped in studies and in countries. Three bivariate models were developed: a cross-classified model to accommodate data from multinational studies, a hierarchical model with multinational data allocated to a single category at country level, and a hierarchical model excluding multinational data. Covariates at different levels were drawn from a long list of factors suggested in the literature. We found 67 studies reporting 2094 cost-effectiveness estimates relating to 23 countries (6 studies reporting for more than 1 country). Data and study-level covariates included patient characteristics, intervention and comparator cost, and some study methods (e.g., discount rates and time horizon). After adjusting for these factors, the proportion of variation attributable to countries was negligible in the cross-classified model but moderate in the hierarchical models (14%-19% of total variance). Country-level variables that improved the fit of the hierarchical models included measures of income and health care finance, health care resources, and population risks. Our analysis suggested that variability in published cost-effectiveness estimates is related more to differences in study methods than to differences in national context. Multinational studies were associated with much lower country-level variation than single-country studies. These findings are for a single clinical question and may be atypical. © The Author(s) 2015.

  6. Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six Central and Eastern European countries.

    PubMed

    Stepurko, Tetiana; Pavlova, Milena; Groot, Wim

    2016-08-02

    The measurement of consumer satisfaction is an essential part of the assessment of health care services in terms of service quality and health care system responsiveness. Studies across Europe have described various strategies health care users employ to secure services with good quality and quick access. In Central and Eastern European countries, such strategies also include informal payments to health care providers. This paper analyzes the satisfaction of health care users with the quality of and access to health care services. The study focuses on six Central and Eastern European countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine). We use data on past experience with health care use collected in 2010 through uniform national surveys in these countries. Based on these data, we carry out a multi-country analysis to investigate factors associated with the satisfaction of health care users in the six countries. The results indicate that about 10-14 % of the service users are not satisfied with the quality of, or access to health care services they used in the preceding year. However, significant differences across countries and services are observed, e.g. the highest level of dissatisfaction with access to outpatient services (16.4 %) is observed among patients in Lithuania, while in Poland, the level of dissatisfaction with quality of outpatient and inpatient services are much lower than dissatisfaction with access. The study also analyses the association of users' satisfaction with factors such as making informal payments, inability to pay and relative importance of service attributes stated by the service users. These multi-country findings provide evidence for health policy making in the Central and Eastern European countries. Although the average rates of satisfactions per country are relatively high, the results suggest that there is ample room for improvements. Specifically, many service-users still report dissatisfaction especially those who pay informally and those unable to pay. The high shares of informal payments and inability of users to deal with the health expenditures lead to doubts about the fairness of the health care provision in Central and Eastern Europe. There is an urgent need for policy makers in the region to not only acknowledge but also to effectively address this key problem.

  7. Spanish cross-cultural adaptation and psychometric properties of the Schizophrenia Quality of Life short-version questionnaire (SQoL18) in 3 middle-income countries: Bolivia, Chile and Peru.

    PubMed

    Caqueo-Urízar, Alejandra; Boyer, Laurent; Boucekine, Mohamed; Auquier, Pascal

    2014-10-01

    The aim of this study was to adapt the Schizophrenia - Quality of Life short-version questionnaire (SQoL18) for use in three middle-income countries in Latin America and to evaluate the factor structure, reliability, and external validity of this questionnaire. The SQoL18 was translated into Spanish using a well-validated forward-backward process. We evaluated the psychometric properties of the SQoL18 in a sample of 253 patients with schizophrenia attending outpatient mental health services in three Latin American countries. For participants in each country (Bolivia, N=83; Chile, N=85; Peru, N=85), psychometric properties were compared to those reported from the reference population (507 patients with schizophrenia) assessed in the validation study. In addition, differential item functioning (DIF) analyses were performed to see whether all items behave in the same way in each country. Factor analysis performed in the 3 countries showed that the questionnaire's structure adequately matched the initial structure of the SQoL18. The unidimensionality of the dimensions was preserved, and the internal/external validity indices were close to those of the reference population. However, one dimension of the SQoL18 (resilience) presented some unsatisfactory properties including low Cronbach's alpha coefficients, one INFIT value higher than 1.2, and one item showing DIF between the 3 countries. These results demonstrate the satisfactory acceptability and psychometric properties of the SQoL18, suggesting the relevance of this questionnaire among patients with schizophrenia in these 3 Latin American countries. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Cachexia research in Japan: facts and numbers on prevalence, incidence and clinical impact.

    PubMed

    Konishi, Masaaki; Ishida, Junichi; Springer, Jochen; Anker, Stefan D; von Haehling, Stephan

    2016-12-01

    Even though most clinical data on cachexia have been reported from Western countries, cachexia may be a growing problem in Asia as well, as the population in this area of the world is considerably larger. Considering the current definitions of obesity and sarcopenia in Japan, which are different from the ones in Western countries, the lack of a distinct cachexia definition in Japan is strinking. Only one epidemiological study has reported the prevalence of cachexia using weight loss as part of the definition in patients with stage III or IV non-small cell lung cancer. Although the reported prevalence of 45.6% is within the range of that in Western countries (28-57% in advanced cancer), we cannot compare the prevalence of cachexia in other types of cancer, heart failure, chronic obstructive pulmonary disease (COPD), and kidney disease (CKD) between Japan and Western countries. In patients with heart failure, one third of Japanese patients has a body mass index <20.3 kg/m 2 whereas the prevalence of underweight is 13.6% in reports from Western countries. These results may suggest that there are more cachectic heart failure patients in Japan, or that using the same definition like Western countries leads to gross overestimation of the prevalence of cachexia in Japan. The rate of underweight patients in COPD has been reported as 31-41% in COPD and seems to be high in comparison to the prevalence of cachexia in Western countries (27-35%). The reported lowest quartile value of BMI (19.6 kg/m 2 ) in CKD may match with the prevalence of cachexia in Western countries (30-60%). The number of clinical trials targeting cachexia is very limited in Japan so far.

  9. Maternal Education Gradients in Infant Health in Four South American Countries.

    PubMed

    Wehby, George L; López-Camelo, Jorge S

    2017-11-01

    Objective We investigate gradients (i.e. differences) in infant health outcomes by maternal education in Argentina, Brazil, Chile, and Venezuela and explore channels related to father's education, household labor outcomes, and maternal health, fertility, and use of prenatal services and technology. Methods We employ secondary interview and birth record data similarly collected across a network of birth hospitals from the early 1980s through 2011 within the Latin American Collaborative Study of Congenital Anomalies (ECLAMC). Focusing on children without birth defects, we estimate gradients in several infant health outcomes including birth weight, gestational age, and hospital discharge status by maternal education using ordinary least squares regression models adjusting for several demographic factors. To explore channels, we add as covariates father's education, parental occupational activity, maternal health and fertility history, and use of prenatal services and technology and evaluate changes in the coefficient of maternal education. We use the same models for each country sample. Results We find important differences in gradients across countries. We find evidence for educational gradients in preterm birth in three countries but weaker evidence for gradients in fetal growth. The extent to which observed household and maternal factors explain these gradients based on changes in the regression coefficient of maternal education when controlling for these factors as covariates also varies between countries. In contrast, we generally find evidence across all countries that higher maternal education is associated with increased use of prenatal care services and technology. Conclusions Our findings suggest that differences in infant health by maternal education and their underlying mechanisms vary and are not necessarily generalizable across countries. However, the positive association between maternal education and use of prenatal services and technology is more consistent across examined countries.

  10. The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges

    PubMed Central

    Noori, Teymur; Pharris, Anastasia; Axelsson, Maria; Costagliola, Dominique; Cowan, Susan; Croxford, Sara; d’Arminio Monforte, Antonella; del Amo, Julia; Delpech, Valerie; Díaz, Asunción; Girardi, Enrico; Gunsenheimer-Bartmeyer, Barbara; Hernando, Victoria; Jose, Sophie; Leierer, Gisela; Nikolopoulos, Georgios; Obel, Niels; Op de Coul, Eline; Paraskeva, Dimitra; Reiss, Peter; Sabin, Caroline; Sasse, André; Schmid, Daniela; Sonnerborg, Anders; Spina, Alexander; Suligoi, Barbara; Supervie, Virginie; Touloumi, Giota; Van Beckhoven, Dominique; van Sighem, Ard; Vourli, Georgia; Zangerle, Robert; Porter, Kholoud

    2017-01-01

    Abstract Background. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a “90-90-90” target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons. Methods. Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardized, 4-stage continuum of HIV care for 11 European Union countries for 2013. Stages were defined as (1) number of people living with HIV in the country by end of 2013; (2) proportion of stage 1 ever diagnosed; (3) proportion of stage 2 that ever initiated ART; and (4) proportion of stage 3 who became virally suppressed (≤200 copies/mL). Case surveillance data were used primarily to derive stages 1 (using back-calculation models) and 2, and cohort data for stages 3 and 4. Results. In 2013, 674500 people in the 11 countries were estimated to be living with HIV, ranging from 5500 to 153400 in each country. Overall HIV prevalence was 0.22% (range, 0.09%–0.36%). Overall proportions of each previous stage were 84% diagnosed, 84% on ART, and 85% virally suppressed (60% of people living with HIV). Two countries achieved ≥90% for all stages, and more than half had reached ≥90% for at least 1 stage. Conclusions. European Union countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting that further efforts are needed to improve HIV testing rates. Standardizing methods to derive comparable continuums of care remains a challenge. PMID:28369283

  11. A novel approach for comparing patterns of foreign body injuries across countries: A case study comparing European Countries and Bosnia and Herzegovina.

    PubMed

    Lorenzoni, Giulia; Umihanić, Sekib; Azzolina, Danila; Manza, Emiliano; Brkić, Fuad; Gregori, Dario

    2018-02-01

    The present study aimed at analyzing the characteristics of FB injuries from Bosnia and Herzegovina (B&H), a rapidly growing newly industrialized country, and to compare them with cases from European countries. The analysis is based on FB injury cases included in the Susy Safe registry. Cases from the Ear-Nose-Throat (ENT) Clinic, University Clinical Center of Tuzla (B&H) were compared with cases from European countries participating in the Susy Safe project. Multiple Correspondence Analysis (MCA) was performed to elucidate differences within a large data set regarding mechanisms and objects causing injuries. The results of the MCA showed that the first three dimensions explained 43% of the variability. The first dimension was identified by children hospitalized for FB ingestion, the second one by children hospitalized for FB aspiration (lower airways), and the third one by children with an FB in the ear or in the upper airways. The analysis of the median of coordinates of factors contributing to each dimension showed that the greatest difference between B&H and European countries regarded the third one. Looking at the profile of these patients, it might be suggested that the proportion of males and females and the type of activity in which they were involved at time of injury occurrence are different among the countries considered CONCLUSIONS: This study proposes a simple tool for assessing differences among countries in the distribution of FB injuries. This case study shows that B&H has different patterns of FB injuries in the upper respiratory tract. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Collaboration Networks in Applied Conservation Projects across Europe

    PubMed Central

    Manolache, Steluta; Ciocănea, Cristiana Maria; Miu, Iulia Viorica; Popescu, Viorel Dan

    2016-01-01

    The main funding instrument for implementing EU policies on nature conservation and supporting environmental and climate action is the LIFE Nature programme, established by the European Commission in 1992. LIFE Nature projects (>1400 awarded) are applied conservation projects in which partnerships between institutions are critical for successful conservation outcomes, yet little is known about the structure of collaborative networks within and between EU countries. The aim of our study is to understand the nature of collaboration in LIFE Nature projects using a novel application of social network theory at two levels: (1) collaboration between countries, and (2) collaboration within countries using six case studies: Western Europe (United Kingdom and Netherlands), Eastern Europe (Romania and Latvia) and Southern Europe (Greece and Portugal). Using data on 1261 projects financed between 1996 and 2013, we found that Italy was the most successful country not only in terms of awarded number of projects, but also in terms of overall influence being by far the most influent country in the European LIFE Nature network, having the highest eigenvector (0.989) and degree centrality (0.177). Another key player in the network is Netherlands, which ensures a fast communication flow with other network members (closeness—0.318) by staying connected with the most active countries. Although Western European countries have higher centrality scores than most of the Eastern European countries, our results showed that overall there is a lower tendency to create partnerships between different organization categories. Also, the comparisons of the six case studies indicates significant differences in regards to the pattern of creating partnerships, providing valuable information on collaboration on EU nature conservation. This study represents a starting point in predicting the formation of future partnerships within LIFE Nature programme, suggesting ways to improve transnational cooperation and communication. PMID:27723834

  13. Changes in Child Mortality Over Time Across the Wealth Gradient in Less-Developed Countries

    PubMed Central

    2014-01-01

    BACKGROUND: It is unknown whether inequalities in under-5 mortality by wealth in low- and middle-income countries (LMICs) are growing or declining. METHODS: All Demographic and Health Surveys conducted between 2002 and 2012 were used to measure under-5 mortality trends in 3 wealth tertiles. Two approaches were used to estimate changes in under-5 mortality: within-survey changes from all 54 countries, and between-survey changes for 29 countries with repeated survey waves. The principal outcome measures include annual decline in mortality, and the ratio of mortality between the poorest and least-poor wealth tertiles. RESULTS: Mortality information in 85 surveys from 929 224 households and 1 267 167 women living in 54 countries was used. In the subset of 29 countries with repeat surveys, mortality declined annually by 4.36, 3.36, and 2.06 deaths per 1000 live births among the poorest, middle, and least-poor tertiles, respectively (P = .031 for difference). The mortality ratio declined from 1.68 to 1.48 during the study period (P = .006 for trend). In the complete set of 85 surveys, the mortality ratio declined in 64 surveys (from 2.11 to 1.55), and increased in 21 surveys (from 1.58 to 1.88). Multivariate analyses suggest that convergence was associated with good governance (P ≤ .03 for 4 governance indicators: government effectiveness, rule of law, regulatory quality, and control of corruption). CONCLUSIONS: Overall, under-5 mortality in low- and middle-income countries has decreased faster among the poorest compared with the least poor between 1995 and 2012, but progress in some countries has lagged, especially with poor governance. PMID:25384496

  14. Maternal and infant characteristics: differences and similarities between the Nordic countries and the US

    PubMed Central

    Löfling, Lukas; Bröms, Gabriella; Bahmanyar, Shahram; Kieler, Helle

    2016-01-01

    Background Data from the Nordic health care registers have been of great value in perinatal epidemiological research. It has been assumed that findings from the Nordic population (Denmark, Finland, Iceland, Norway, and Sweden) are applicable to other populations as well, including the population of the US. Objective To describe and compare maternal and infant characteristics between the Nordic and the American populations as recorded in the official statistics. Materials and methods This population-based study included data on all females who gave birth and their infants in the Nordic countries and the US. The data were obtained from the US National Center for Health Statistics and the official statistics data for the Nordic countries. The data from all six countries included births from 2006 to 2010. Results The mean maternal age at delivery was lower in the US than in the Nordic countries (27.5 vs 30.3 years). Cesarean sections (32.2% vs 17.9%), low birth weight (8.2% vs 4.8%), and preterm birth (12.3% vs 5.9%) were more common in the US than in the Nordic countries. Smoking during early pregnancy was slightly less common in the US compared with Nordic countries (9.8% vs 11.2%). Restricting the data from the US to females with a university degree, characteristics such as age at delivery, birth weight, and preterm deliveries were more in alignment with the Nordic data. Conclusion There are differences in some key maternal and neonatal characteristics between the Nordic countries and the US. However, some characteristics are related to socioeconomic status, suggesting that the Nordic data seem to be applicable to the part of the population in the US with a higher socioeconomic status. PMID:27536160

  15. Collaboration Networks in Applied Conservation Projects across Europe.

    PubMed

    Nita, Andreea; Rozylowicz, Laurentiu; Manolache, Steluta; Ciocănea, Cristiana Maria; Miu, Iulia Viorica; Popescu, Viorel Dan

    2016-01-01

    The main funding instrument for implementing EU policies on nature conservation and supporting environmental and climate action is the LIFE Nature programme, established by the European Commission in 1992. LIFE Nature projects (>1400 awarded) are applied conservation projects in which partnerships between institutions are critical for successful conservation outcomes, yet little is known about the structure of collaborative networks within and between EU countries. The aim of our study is to understand the nature of collaboration in LIFE Nature projects using a novel application of social network theory at two levels: (1) collaboration between countries, and (2) collaboration within countries using six case studies: Western Europe (United Kingdom and Netherlands), Eastern Europe (Romania and Latvia) and Southern Europe (Greece and Portugal). Using data on 1261 projects financed between 1996 and 2013, we found that Italy was the most successful country not only in terms of awarded number of projects, but also in terms of overall influence being by far the most influent country in the European LIFE Nature network, having the highest eigenvector (0.989) and degree centrality (0.177). Another key player in the network is Netherlands, which ensures a fast communication flow with other network members (closeness-0.318) by staying connected with the most active countries. Although Western European countries have higher centrality scores than most of the Eastern European countries, our results showed that overall there is a lower tendency to create partnerships between different organization categories. Also, the comparisons of the six case studies indicates significant differences in regards to the pattern of creating partnerships, providing valuable information on collaboration on EU nature conservation. This study represents a starting point in predicting the formation of future partnerships within LIFE Nature programme, suggesting ways to improve transnational cooperation and communication.

  16. Global patterns of workplace productivity for people with depression: absenteeism and presenteeism costs across eight diverse countries.

    PubMed

    Evans-Lacko, S; Knapp, M

    2016-11-01

    Depression is a leading cause of disability worldwide. Research suggests that by far, the greatest contributor to the overall economic impact of depression is loss in productivity; however, there is very little research on the costs of depression outside of Western high-income countries. Thus, this study examines the impact of depression on workplace productivity across eight diverse countries. We estimated the extent and costs of depression-related absenteeism and presenteeism in the workplace across eight countries: Brazil, Canada, China, Japan, South Korea, Mexico, South Africa, and the USA. We also examined the individual, workplace, and societal factors associated with lower productivity. To the best of our knowledge, this is the first study to examine the impact of depression on workplace productivity across a diverse set of countries, in terms of both culture and GDP. Mean annual per person costs for absenteeism were lowest in South Korea at $181 and highest in Japan ($2674). Mean presenteeism costs per person were highest in the USA ($5524) and Brazil ($5788). Costs associated with presenteeism tended to be 5-10 times higher than those associated with absenteeism. These findings suggest that the impact of depression in the workplace is considerable across all countries, both in absolute monetary terms and in relation to proportion of country GDP. Overall, depression is an issue deserving much greater attention, regardless of a country's economic development, national income or culture.

  17. Estimating the impact of birth control on fertility rate in sub-Saharan Africa.

    PubMed

    Ijaiya, Gafar T; Raheem, Usman A; Olatinwo, Abdulwaheed O; Ijaiya, Munir-Deen A; Ijaiya, Mukaila A

    2009-12-01

    Using a cross-country data drawn from 40 countries and a multiple regression analysis, this paper examines the impact of birth control devices on the rate of fertility in sub-Saharan Africa. Our a-priori expectations are that the more women used birth control devices, the less will be the fertility rate in sub-Saharan Africa. The result obtained from the study indicates that except for withdrawal method that fall contrary to our expectation other variables (methods) like the use of pills, injection, intra uterine device (IUD), condom/diaphragm and cervical cap, female sterilization and periodic abstinence/rhythm fulfilled our a-priori expectations. These results notwithstanding, the paper suggests measures, such as the need for massive enlightenment campaign on the benefit of these birth control devices, the frequent checking of the potency of the devices and good governance in the delivery of the devices

  18. Does culture matter?: a cross-national investigation of women's responses to cancer prevention campaigns.

    PubMed

    Han, Kyoo-Hoon; Jo, Samsup

    2012-01-01

    We examined how culture influences the persuasive effects of health campaigns that promote early screening for cancers that occur in women. Two message dimensions were included: individualistic vs. collectivistic appeal and gain vs. loss frame. A total of 955 females from three countries-the United States, South Korea, and Japan-participated in the experiment. From the results, we found that message framing alone did not significantly influence the effectiveness of public campaigns for women's cancer prevention; and this tendency was similar across the three countries. Gain-framed messages are likely to be more persuasive when combined with a collectivistic appeal, however, whereas loss-framed messages tend to be more effective when combined with an individualistic appeal in both the United States and South Korea; but this result was not the case for Japan. Based on the findings, we suggested theoretical and managerial implications as well as several directions for future research.

  19. A Global Perspective on Religious Participation and Suicide.

    PubMed

    Hsieh, Ning

    2017-09-01

    Although sociological research in the Durkheimian tradition has generally accepted that religious involvement protects against suicide, few studies have examined this theoretical proposition outside Western industrialized settings. Using multilevel models to analyze data from the World Health Organization Mortality Database and the World Values Survey (1981-2007) across 42 countries in seven geographical-cultural regions, this study explores whether religious participation is more protective against suicide in some regions than others and, if so, why. Results indicate that while religious participation is protective in Latin America, eastern Europe, northern Europe, and English-speaking countries, it may aggravate the risk of suicide in East Asia, western Europe, and southern Europe. This regional variation is the result of differences in both the degree of integration/regulation of religious communities and suicide underreporting. Overall, the findings support the network perspective of Durkheim's classical theory and suggest that researchers should be more cautious about suicide underreporting in less industrialized settings.

  20. Global progress and backsliding on gasoline taxes and subsidies

    NASA Astrophysics Data System (ADS)

    Ross, Michael L.; Hazlett, Chad; Mahdavi, Paasha

    2017-01-01

    To reduce greenhouse gas emissions in the coming decades, many governments will have to reform their energy policies. These policies are difficult to measure with any precision. As a result, it is unclear whether progress has been made towards important energy policy reforms, such as reducing fossil fuel subsidies. We use new data to measure net taxes and subsidies for gasoline in almost all countries at the monthly level and find evidence of both progress and backsliding. From 2003 to 2015, gasoline taxes rose in 83 states but fell in 46 states. During the same period, the global mean gasoline tax fell by 13.3% due to faster consumption growth in countries with lower taxes. Our results suggest that global progress towards fossil fuel price reform has been mixed, and that many governments are failing to exploit one of the most cost-effective policy tools for limiting greenhouse gas emissions.

  1. Economic growth, combustible renewables and waste consumption, and CO₂ emissions in North Africa.

    PubMed

    Ben Jebli, Mehdi; Ben Youssef, Slim

    2015-10-01

    This paper uses panel cointegration techniques and Granger causality tests to examine the dynamic causal link between per capita real gross domestic product (GDP), combustible renewables and waste (CRW) consumption, and CO2 emissions for a panel of five North African countries during the period 1971-2008. Granger causality test results suggest short- and long-run unidirectional causalities running from CO2 emissions and CRW consumption to real GDP and a short-run unidirectional causality running from CRW to CO2 emissions. The results from panel long-run fully modified ordinary least squares (FMOLS) and dynamic ordinary least squares (DOLS) estimates show that CO2 emissions and CRW consumption have a positive and statistically significant impact on GDP. Our policy recommendations are that these countries should use more CRW because this increases their output, reduces their energy dependency on fossil energy, and may decrease their CO2 emissions.

  2. The U.S. military's Neisseria gonorrhoeae resistance surveillance initiatives in selected populations of five countries.

    PubMed

    Tsai, Alice Y; Dueger, Erica; Macalino, Grace E; Montano, Silvia M; Tilley, Drake H; Mbuchi, Margaret; Wurapa, Eyako K; Saylors, Karen; Duplessis, Christopher C; Puplampu, Naiki; Garges, Eric C; McClelland, R Scott; Sanchez, Jose L

    2013-02-01

    Multi-drug resistant Neisseria gonorrhoeae (GC) threatens the successful treatment of gonorrhea. This report presents preliminary findings with regard to the prevalence of laboratory-confirmed GC and the extent of drug-resistance among sample populations in five countries. Between October 2010 and January 2013, 1,694 subjects (54% male; 45% female; 1% unknown) were enrolled and screened for the presence of laboratory-confirmed GC in the United States, Djibouti, Ghana, Kenya, and Peru. Overall, 108 (6%) of enrolled subjects tested positive for GC. Antimicrobial susceptibility testing results were available for 66 GC isolates. Resistance to at least three antibiotics was observed at each overseas site. All isolates tested in Ghana (n=6) were resistant to ciprofloxacin, penicillin, and tetracycline. In Djibouti, preliminary results suggested resistance to penicillin, tetracycline, ciprofloxacin, cefepime, and ceftriaxone. The small sample size and missing data prevent comparative analysis and limit the generalizability of these preliminary findings.

  3. Application of Raman spectroscopy for cervical dysplasia diagnosis

    PubMed Central

    Kanter, Elizabeth M.; Vargis, Elizabeth; Majumder, Shovan; Keller, Matthew D.; Woeste, Emily; Rao, Gautam G.; Mahadevan-Jansen, Anita

    2014-01-01

    Cervical cancer is the second most common malignancy among women worldwide, with over 490000 cases diagnosed and 274000 deaths each year. Although current screening methods have dramatically reduced cervical cancer incidence and mortality in developed countries, a “See and Treat” method would be preferred, especially in developing countries. Results from our previous work have suggested that Raman spectroscopy can be used to detect cervical precancers; however, with a classification accuracy of 88%, it was not clinically applicable. In this paper, we describe how incorporating a woman's hormonal status, particularly the point in menstrual cycle and menopausal state, into our previously developed classification algorithm improves the accuracy of our method to 94%. The results of this paper bring Raman spectroscopy one step closer to being utilized in a clinical setting to diagnose cervical dysplasia. Posterior probabilities of class membership, as determined by MRDF-SMLR, for patients regardless of menopausal status, and for pre-menopausal patients only PMID:19343687

  4. The building blocks of economic complexity

    PubMed Central

    Hidalgo, César A.; Hausmann, Ricardo

    2009-01-01

    For Adam Smith, wealth was related to the division of labor. As people and firms specialize in different activities, economic efficiency increases, suggesting that development is associated with an increase in the number of individual activities and with the complexity that emerges from the interactions between them. Here we develop a view of economic growth and development that gives a central role to the complexity of a country's economy by interpreting trade data as a bipartite network in which countries are connected to the products they export, and show that it is possible to quantify the complexity of a country's economy by characterizing the structure of this network. Furthermore, we show that the measures of complexity we derive are correlated with a country's level of income, and that deviations from this relationship are predictive of future growth. This suggests that countries tend to converge to the level of income dictated by the complexity of their productive structures, indicating that development efforts should focus on generating the conditions that would allow complexity to emerge to generate sustained growth and prosperity. PMID:19549871

  5. Country-specific dietary patterns and associations with socioeconomic status in European children: the IDEFICS study.

    PubMed

    Fernández-Alvira, J M; Bammann, K; Pala, V; Krogh, V; Barba, G; Eiben, G; Hebestreit, A; Veidebaum, T; Reisch, L; Tornaritis, M; Kovacs, E; Huybrechts, I; Moreno, L A

    2014-07-01

    Children from lower socioeconomic status (SES) may be at higher risk of unhealthy eating. We described country-specific dietary patterns among children aged 2-9 years from eight European countries participating in the IDEFICS study and assessed the association of dietary patterns with an additive SES indicator. Children aged 2-9 years from eight European countries were recruited in 2007-2008. Principal component analysis was applied to identify dietary country-specific patterns. Linear regression analyses were applied to assess their association with SES. Two to four dietary patterns were identified in the participating regions. The existence of a 'processed' pattern was found in the eight regions. Also, a 'healthy' pattern was identified in seven of the eight regions. In addition, region-specific patterns were identified, reflecting the existing gastronomic and cultural differences in Europe. The 'processed' pattern was significantly inversely associated with the SES additive indicator in all countries except Sweden, whereas the 'healthy' pattern was positively associated with SES in the Belgian, Estonian, German and Hungarian regions, but was not significant in the Italian, Spanish and Swedish regions. A 'processed' pattern and a 'healthy' pattern were found in most of the participating countries in the IDEFICS study, with comparable food item profiles. The results showed a strong inverse association of SES with the 'processed' pattern, suggesting that children of parents with lower SES may be at higher risk of unhealthy eating. Therefore, special focus should be given to parents and their children from lower SES levels when developing healthy eating promotion strategies.

  6. Somatotype in 6-11-year-old Italian and Estonian schoolchildren.

    PubMed

    Ventrella, A R; Semproli, S; Jürimäe, J; Toselli, S; Claessens, A L; Jürimäe, T; Brasili, P

    2008-01-01

    The study of somatotypes can contribute to the understanding of variability in human body build. The aim of this study was to compare the somatotypes of Italian and Estonian schoolchildren in order to evaluate factors that might lead to variability in somatotypes. The sample consisted of 762 Italian and 366 Estonian children aged 6-11 years. They were somatotyped by the Heath-Carter anthropometric method. Data on organised extra-curricular physical activity and hours of weekly training were also collected. One-way ANOVA was used to evaluate country-related variations of somatotype in each age/sex group, while factorial ANOVA was used to test the influence of country and organised physical activity on the variability of the anthropometric characteristics and somatotype components. There are significant differences in mean somatotypes between the Italian and Estonian children in many age classes and a different constitutional trend in children from the two different countries is observed. The Italian children are more endomorphic and less mesomorphic and ectomorphic than the Estonian children. On the other hand, it emerges from factorial ANOVA, that the somatotype components do not present significant variations related to organised physical activity and to the interaction between the country of origin and sport practice. Moreover, the results of the forward stepwise discriminant analyses show that mesomorphy is the best discriminator between the two countries, followed by ectomorphy. Our findings suggest that the observed differences between Italian and Estonian children could be related mainly to country rather than to the practice of organised physical activity in the two countries.

  7. Disparity in Dental Coverage Among Older Adult Populations: A Comparative Analysis Across Selected European Countries and the United States

    PubMed Central

    Manski, Richard; Moeller, John; Chen, Haiyan; Widström, Eeva; Lee, Jinkook; Listl, Stefan

    2014-01-01

    Background Insurance against the cost risks associated with prevention and treatment of oral diseases can reduce inequalities in dental care use and oral health. The purpose of this study was to examine the extent of variation in dental insurance coverage for older adult populations within and between the United States and various European countries. Method The analyses relied on 2006/2007 data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) and 2004-2006 data from of the Health and Retirement Study (HRS) in the United States for respondents aged 51 years and older. A series of logistic regression models was estimated to identify disparities in dental coverage. Results The highest extent of significant insurance differences between various population subgroups was found for the United States. In comparison with countries belonging to the Eastern and Southern welfare state regimes, a lower number of significant coverage differences occurred for Scandinavian countries. Countries categorized as having comprehensive public insurance coverage showed a tendency towards less insurance variation within their populations than countries categorized as not having comprehensive public coverage, exceptions being Poland and Switzerland. Conclusions The findings of the present study suggest that significant variations in dental coverage exist within all elderly populations examined and the extent of inequalities also differs between countries. By and large, the observed variations corroborate the perception that population dental coverage is more equally distributed under public subsidy. This could be relevant information for decision makers who seek to improve policies towards more equitable dental coverage. PMID:25363376

  8. Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study

    PubMed Central

    Delgado, Carmen; Sánchez-Prada, Andrés; Parra-Vidales, Esther; de Leo, Diego; Franco-Martín, Manuel

    2018-01-01

    Background This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. Objective The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Methods Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Results Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country. Conclusions Although all countries and stakeholders agree in identifying resource constraints as the main barrier to the use of emerging technologies, factors facilitating their use in suicide prevention differ among countries and among stakeholders. PMID:29367183

  9. Can only poorer European countries afford large carnivores?

    PubMed

    Kojola, Ilpo; Hallikainen, Ville; Helle, Timo; Swenson, Jon E

    2018-01-01

    One of the classic approaches in environmental economics is the environmental Kuznets curve, which predicts that when a national economy grows from low to medium levels, threats to biodiversity conservation increase, but they decrease when the economy moves from medium to high. We evaluated this approach by examining how population densities of the brown bear (Ursus arctos), gray wolf (Canis lupus), and Eurasian lynx (Lynx lynx) were related to the national economy in 24 European countries. We used forest proportions, the existence of a compensation system, and country group (former socialist countries, Nordic countries, other countries) as covariates in a linear model with the first- and the second-order polynomial terms of per capita gross domestic product (GDP). Country group was treated as a random factor, but remained insignificant and was ignored. All models concerning brown bear and wolf provided evidence that population densities decreased with increasing GDP, but densities of lynx were virtually independent of GDP. Models for the wolf explained >80% of the variation in densities, without a difference between the models with all independent variables and the model with only GDP. For the bear, the model with GDP alone accounted for 10%, and all three variables 33%, of the variation in densities. Wolves exhibit a higher capacity for dispersal and reproduction than bear or lynx, but still exists at the lowest densities in wealthy European countries. We are aware that several other factors, not available for our models, influenced large carnivore densities. Based on the pronounced differences among large carnivore species in their countrywide relationships between densities and GDP, and a strikingly high relationship for the gray wolf, we suggest that our results reflected differences in political history and public acceptance of these species among countries. The compensation paid for the damages caused by the carnivores is not a key to higher carnivore densities, but might be necessity for the presence of large carnivores to be accepted in countries with high GDP.

  10. Breast feeding initiation rate across Western countries: does religion matter? An ecological study.

    PubMed

    Bernard, Jonathan Y; Cohen, Emmanuel; Kramer, Michael S

    2016-01-01

    Breast feeding initiation rates remain below 80% in some Western countries. Many individual-level determinants are known; however, less is known regarding cultural and societal determinants, such as religion, that could explain population-level variations. We examined the correlations of the proportions of Catholics and Protestants with the breast feeding initiation rates across and within Western countries. Using publicly available data, we carried out an ecological study comparing the proportions of Catholics and Protestants with the rates of breast feeding initiation. We correlated data at the country level, and additionally explored within-country data in five Western countries: France (Departments), Ireland (counties), the UK (countries), Canada (provinces) and the USA (states). Our analyses accounted for human development index, gross domestic product and population density. We observed a negative correlation (r=-0.30) between the proportion of Catholics and the rate of breast feeding initiation in Western countries. This correlation was consistent when using within-country data in France (r=-0.27), Ireland (r=-0.23), the UK (r=-0.79) and Canada (r=-0.62). In the USA, the positive correlation (r=0.26) between a state's proportion of Catholics and its breast feeding initiation rate was confounded by race, education and socioeconomic status (SES). After controlling for education and SES, the state proportion of non-Hispanic white Catholics was negatively correlated (r=-0.29) with the rate of breast feeding initiation. In this ecological study, we found consistent negative correlations between Catholicism and breast feeding initiation rates. Qualitative and quantitative studies at the individual level are needed to confirm and explain our findings. Our results suggest that women living in a country or region where Catholicism has historically dominated are less likely to initiate breast feeding, and that breast feeding promotion policies should be adapted to better fit populations' cultural and religious norms.

  11. Early menarche: A systematic review of its effect on sexual and reproductive health in low- and middle-income countries

    PubMed Central

    Choi, Cecilia; Tai, Hina; Lee, Grace; Sommer, Marni

    2017-01-01

    Background Adolescent girls aged 15–19 bear a disproportionate burden of negative sexual and reproductive health outcomes in low- and middle-income countries. Research from several high-income countries suggests that early age at menarche is an important determinant of sexual and reproductive health. We conducted this systematic review to better understand whether and how early menarche is associated with various negative sexual and reproductive health outcomes in low- and middle-income countries and the implications of such associations. Methods We systematically searched eight health and social sciences databases for peer-reviewed literature on menarche and sexual and reproductive health in low- and middle-income countries. Two reviewers independently assessed all studies for inclusion, overall quality and risk of bias, and performed data extraction on all included studies. Results Twenty-four articles met all inclusion criteria–nine of moderate quality and fifteen with several methodological weaknesses. Our review of the minimal existing literature showed that early menarche is associated with early sexual initiation, early pregnancy and some sexually transmitted infections in low- and middle-income countries, similar to what has been observed in high-income countries. Early menarche is also associated with early marriage–an association that may have particularly important implications for countries with high child marriage rates. Conclusions Early age at menarche may be an important factor affecting the sexual and reproductive health of adolescent girls and young women in low- and middle-income countries. More research is needed to confirm the existence of the identified associations across different settings and to better understand the process through which early menarche and other markers of early pubertal development may contribute to the increased vulnerability of girls to negative sexual and reproductive health outcomes in low- and middle-income countries. Given the association of early menarche with early marriage, ongoing efforts to reduce child marriage may benefit from targeting efforts to early maturing girls. PMID:28591132

  12. National spending on health by source for 184 countries between 2013 and 2040.

    PubMed

    Dieleman, Joseph L; Templin, Tara; Sadat, Nafis; Reidy, Patrick; Chapin, Abigail; Foreman, Kyle; Haakenstad, Annie; Evans, Tim; Murray, Christopher J L; Kurowski, Christoph

    2016-06-18

    A general consensus exists that as a country develops economically, health spending per capita rises and the share of that spending that is prepaid through government or private mechanisms also rises. However, the speed and magnitude of these changes vary substantially across countries, even at similar levels of development. In this study, we use past trends and relationships to estimate future health spending, disaggregated by the source of those funds, to identify the financing trajectories that are likely to occur if current policies and trajectories evolve as expected. We extracted data from WHO's Health Spending Observatory and the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report. We converted these data to a common purchasing power-adjusted and inflation-adjusted currency. We used a series of ensemble models and observed empirical norms to estimate future government out-of-pocket private prepaid health spending and development assistance for health. We aggregated each country's estimates to generate total health spending from 2013 to 2040 for 184 countries. We compared these estimates with each other and internationally recognised benchmarks. Global spending on health is expected to increase from US$7·83 trillion in 2013 to $18·28 (uncertainty interval 14·42-22·24) trillion in 2040 (in 2010 purchasing power parity-adjusted dollars). We expect per-capita health spending to increase annually by 2·7% (1·9-3·4) in high-income countries, 3·4% (2·4-4·2) in upper-middle-income countries, 3·0% (2·3-3·6) in lower-middle-income countries, and 2·4% (1·6-3·1) in low-income countries. Given the gaps in current health spending, these rates provide no evidence of increasing parity in health spending. In 1995 and 2015, low-income countries spent $0·03 for every dollar spent in high-income countries, even after adjusting for purchasing power, and the same is projected for 2040. Most importantly, health spending in many low-income countries is expected to remain low. Estimates suggest that, by 2040, only one (3%) of 34 low-income countries and 36 (37%) of 98 middle-income countries will reach the Chatham House goal of 5% of gross domestic product consisting of government health spending. Despite remarkable health gains, past health financing trends and relationships suggest that many low-income and lower-middle-income countries will not meet internationally set health spending targets and that spending gaps between low-income and high-income countries are unlikely to narrow unless substantive policy interventions occur. Although gains in health system efficiency can be used to make progress, current trends suggest that meaningful increases in health system resources will require concerted action. Bill & Melinda Gates Foundation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Quality of claims, references and the presentation of risk results in medical journal advertising: a comparative study in Australia, Malaysia and the United States.

    PubMed

    Othman, Noordin; Vitry, Agnes I; Roughead, Elizabeth E

    2010-05-29

    Journal advertising is used by pharmaceutical companies to disseminate medicine information to doctors. The quality of claims, references and the presentation of risk results in Australia and the US has been questioned in several studies. No recent evidence is available on the quality of claims, references and the presentation of risk results in journal advertising in Australia and the US and no Malaysian data have been published. The aim of this study was to compare the quality of claims, references and the presentation of risk results in journal advertising in these three countries. A consecutive sample of 85 unique advertisements from each country was selected from journal advertising published between January 2004 to December 2006. Claims, references and the presentation of risk results in medical journal advertising were compared between the three countries. Less than one-third of the claims were unambiguous claims (Australia, 30%, Malaysia 17%, US, 23%). In Malaysia significantly less unambiguous claims were provided than in Australia and the US (P < 0.001). However, the unambiguous claims were supported by more references than other claims (80%). Most evidence was obtained from at least one randomized controlled trial, a systematic review or meta-analysis (Australia, 84%, Malaysia, 81%, US, 76%) with journal articles being the most commonly cited references in all countries. Data on file were significantly more likely to be cited in the US (17%) than in Australia (2%) and Malaysia (4%) (P < 0.001). Advertisements that provided quantitative information reported risk results exclusively as a relative risk reduction. The majority of claims were vague suggesting poor quality of claims in journal advertising in these three countries. Evidence from a randomized controlled trial, systematic review or meta- analysis was commonly cited to support claims. However, the more frequent use of data that have not been published and independently reviewed in the US compared to Australia and Malaysia raises questions on the quality of references in the US. The use of relative rather than absolute benefits may overemphasize the benefit of medicines which may leave doctors susceptible to misinterpreting information.

  14. Power-line electrocution of birds (Electrocucion de Aves en Lineas Electricas en Mexico)

    Treesearch

    Patricia Manzano Fischer

    2006-01-01

    A result of rapid growth in human population and energy use, is proliferating power lines that electrocute birds, killing eagles and causing power outages. The United States was one of the first countries to recognize the significance of this problem. Suggested Practices for the Protection of Raptors on Power Lines, first published in the 1970s, has now been translated...

  15. Databases and Networking for Development. The Organization of Information in Europe in the Field of Policy and Planning for Developing Countries.

    ERIC Educational Resources Information Center

    Lindsay, John

    This work suggests that better organization of existing sources of information available in Europe and better application of these sources to training can result in improved understanding of how information systems work, and it provides an annotated list of some of these sources. The guide opens with an introduction to public policy and urban…

  16. International Students of Speech and Language Therapy in the UK: Do We Meet Their Needs?

    ERIC Educational Resources Information Center

    Marshall, Julie; Goldbart, Juliet; Evans, Ruth

    2004-01-01

    Background: Informal evidence suggests that many Speech and Language Therapy (SLT) students from outside of the UK and/or Republic of Ireland who come to the UK either do not return to their home country on qualification or do not practise as SLTs in the public sector. Many factors may contribute to this situation. Concern that it may result in…

  17. Attitudes and Acceptance of Oral and Parenteral HIV Preexposure Prophylaxis among Potential User Groups: A Multinational Study

    PubMed Central

    Gomez, Gabriela B.; Garnett, Geoffrey P.; Dybul, Mark R.; Piot, Peter K.

    2012-01-01

    Background The use of antiviral medications by HIV negative people to prevent acquisition of HIV or pre-exposure prophylaxis (PrEP) has shown promising results in recent trials. To understand the potential impact of PrEP for HIV prevention, in addition to efficacy data, we need to understand both the acceptability of PrEP among members of potential user groups and the factors likely to determine uptake. Methods and findings Surveys of willingness to use PrEP products were conducted with 1,790 members of potential user groups (FSWs, MSM, IDUs, SDCs and young women) in seven countries: Peru, Ukraine, India, Kenya, Botswana, Uganda and South Africa. Analyses of variance were used to assess levels of acceptance across different user groups and countries. Conjoint analysis was used to examine the attitudes and preferences towards hypothetical and known attributes of PrEP programs and medications. Overall, members of potential user groups were willing to consider taking PrEP (61% reported that they would definitely use PrEP). Current results demonstrate that key user groups in different countries perceived PrEP as giving them new possibilities in their lives and would consider using it as soon as it becomes available. These results were maintained when subjects were reminded of potential side effects, the need to combine condom use with PrEP, and for regular HIV testing. Across populations, route of administration was considered the most important attribute of the presented alternatives. Conclusions Despite multiple conceivable barriers, there was a general willingness to adopt PrEP in key populations, which suggests that if efficacious and affordable, it could be a useful tool in HIV prevention. There would be a willingness to experience inconvenience and expense at the levels included in the survey. The results suggest that delivery in a long lasting injection would be a good target in drug development. PMID:22247757

  18. Life-history theory and climate change: resolving population and parental investment paradoxes.

    PubMed

    Caudell, Mark; Quinlan, Robert

    2016-11-01

    Population growth in the next half-century is on pace to raise global carbon emissions by half. Carbon emissions are associated with fertility as a by-product of somatic and parental investment, which is predicted to involve time orientation/preference as a mediating psychological mechanism. Here, we draw upon life-history theory (LHT) to investigate associations between future orientation and fertility, and their impacts on carbon emissions. We argue ' K -strategy' life history (LH) in high-income countries has resulted in parental investment behaviours involving future orientation that, paradoxically, promote unsustainable carbon emissions, thereby lowering the Earth's K or carrying capacity. Increasing the rate of approach towards this capacity are ' r -strategy' LHs in low-income countries that promote population growth. We explore interactions between future orientation and development that might slow the rate of approach towards global K . Examination of 67 000 individuals across 75 countries suggests that future orientation interacts with the relationship between environmental risk and fertility and with development related parental investment, particularly investment in higher education, to slow population growth and mitigate per capita carbon emissions. Results emphasize that LHT will be an important tool in understanding the demographic and consumption patterns that drive anthropogenic climate change.

  19. Food Safety in Low and Middle Income Countries

    PubMed Central

    Grace, Delia

    2015-01-01

    Evidence on foodborne disease (FBD) in low and middle income countries (LMICs) is still limited, but important studies in recent years have broadened our understanding. These suggest that developing country consumers are concerned about FBD; that most of the known burden of FBD disease comes from biological hazards; and, that most FBD is the result of consumption of fresh, perishable foods sold in informal markets. FBD is likely to increase in LMICs as the result of massive increases in the consumption of risky foods (livestock and fish products and produce) and lengthening and broadening value chains. Although intensification of agricultural production is a strong trend, so far agro-industrial production and modern retail have not demonstrated clear advantages in food safety and disease control. There is limited evidence on effective, sustainable and scalable interventions to improve food safety in domestic markets. Training farmers on input use and good practices often benefits those farmers trained, but has not been scalable or sustainable, except where good practices are linked to eligibility for export. Training informal value chain actors who receive business benefits from being trained has been more successful. New technologies, growing public concern and increased emphasis on food system governance can also improve food safety. PMID:26343693

  20. Women’s Individual Asset Ownership and Experience of Intimate Partner Violence: Evidence From 28 International Surveys

    PubMed Central

    Pereira, Audrey; Bleck, Jennifer; Palermo, Tia M.; Yount, Kathryn M.

    2017-01-01

    Objectives. To assess the oft-perceived protective relationship between women’s asset ownership and experience of intimate partner violence (IPV) in the previous 12 months. Methods. We used international survey data from women aged 15 to 49 years from 28 Demographic and Health Surveys (2010–2014) to examine the association between owning assets and experience of recent IPV, matching on household wealth by using multivariate probit models. Matching methods helped to account for the higher probability that women in wealthier households also have a higher likelihood of owning assets. Results. Asset ownership of any type was negatively associated with IPV in 3 countries, positively associated in 5 countries, and had no significant relationship in 20 countries (P < .10). Disaggregation by asset type, sole or joint ownership, women’s age, and community level of women’s asset ownership similarly showed no conclusive patterns. Conclusions. Results suggest that the relationship between women’s asset ownership and IPV is highly context specific. Additional methodologies and data are needed to identify causality, and to understand how asset ownership differs from other types of women’s economic empowerment. PMID:28398779

  1. Food Safety in Low and Middle Income Countries.

    PubMed

    Grace, Delia

    2015-08-27

    Evidence on foodborne disease (FBD) in low and middle income countries (LMICs) is still limited, but important studies in recent years have broadened our understanding. These suggest that developing country consumers are concerned about FBD; that most of the known burden of FBD disease comes from biological hazards; and, that most FBD is the result of consumption of fresh, perishable foods sold in informal markets. FBD is likely to increase in LMICs as the result of massive increases in the consumption of risky foods (livestock and fish products and produce) and lengthening and broadening value chains. Although intensification of agricultural production is a strong trend, so far agro-industrial production and modern retail have not demonstrated clear advantages in food safety and disease control. There is limited evidence on effective, sustainable and scalable interventions to improve food safety in domestic markets. Training farmers on input use and good practices often benefits those farmers trained, but has not been scalable or sustainable, except where good practices are linked to eligibility for export. Training informal value chain actors who receive business benefits from being trained has been more successful. New technologies, growing public concern and increased emphasis on food system governance can also improve food safety.

  2. Quantitative and qualitative research across cultures and languages: cultural metrics and their application.

    PubMed

    Wagner, Wolfgang; Hansen, Karolina; Kronberger, Nicole

    2014-12-01

    Growing globalisation of the world draws attention to cultural differences between people from different countries or from different cultures within the countries. Notwithstanding the diversity of people's worldviews, current cross-cultural research still faces the challenge of how to avoid ethnocentrism; comparing Western-driven phenomena with like variables across countries without checking their conceptual equivalence clearly is highly problematic. In the present article we argue that simple comparison of measurements (in the quantitative domain) or of semantic interpretations (in the qualitative domain) across cultures easily leads to inadequate results. Questionnaire items or text produced in interviews or via open-ended questions have culturally laden meanings and cannot be mapped onto the same semantic metric. We call the culture-specific space and relationship between variables or meanings a 'cultural metric', that is a set of notions that are inter-related and that mutually specify each other's meaning. We illustrate the problems and their possible solutions with examples from quantitative and qualitative research. The suggested methods allow to respect the semantic space of notions in cultures and language groups and the resulting similarities or differences between cultures can be better understood and interpreted.

  3. Scaling up health knowledge at European level requires sharing integrated data: an approach for collection of database specification.

    PubMed

    Menditto, Enrica; Bolufer De Gea, Angela; Cahir, Caitriona; Marengoni, Alessandra; Riegler, Salvatore; Fico, Giuseppe; Costa, Elisio; Monaco, Alessandro; Pecorelli, Sergio; Pani, Luca; Prados-Torres, Alexandra

    2016-01-01

    Computerized health care databases have been widely described as an excellent opportunity for research. The availability of "big data" has brought about a wave of innovation in projects when conducting health services research. Most of the available secondary data sources are restricted to the geographical scope of a given country and present heterogeneous structure and content. Under the umbrella of the European Innovation Partnership on Active and Healthy Ageing, collaborative work conducted by the partners of the group on "adherence to prescription and medical plans" identified the use of observational and large-population databases to monitor medication-taking behavior in the elderly. This article describes the methodology used to gather the information from available databases among the Adherence Action Group partners with the aim of improving data sharing on a European level. A total of six databases belonging to three different European countries (Spain, Republic of Ireland, and Italy) were included in the analysis. Preliminary results suggest that there are some similarities. However, these results should be applied in different contexts and European countries, supporting the idea that large European studies should be designed in order to get the most of already available databases.

  4. Semantic Features for Classifying Referring Search Terms

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

    May, Chandler J.; Henry, Michael J.; McGrath, Liam R.

    2012-05-11

    When an internet user clicks on a result in a search engine, a request is submitted to the destination web server that includes a referrer field containing the search terms given by the user. Using this information, website owners can analyze the search terms leading to their websites to better understand their visitors needs. This work explores some of the features that can be used for classification-based analysis of such referring search terms. We present initial results for the example task of classifying HTTP requests countries of origin. A system that can accurately predict the country of origin from querymore » text may be a valuable complement to IP lookup methods which are susceptible to the obfuscation of dereferrers or proxies. We suggest that the addition of semantic features improves classifier performance in this example application. We begin by looking at related work and presenting our approach. After describing initial experiments and results, we discuss paths forward for this work.« less

  5. Magnitude of Treatment Abandonment in Childhood Cancer.

    PubMed

    Friedrich, Paola; Lam, Catherine G; Itriago, Elena; Perez, Rafael; Ribeiro, Raul C; Arora, Ramandeep S

    2015-01-01

    Treatment abandonment (TxA) is recognized as a leading cause of treatment failure for children with cancer in low-and-middle-income countries (LMC). However, its global frequency and burden have remained elusive due to lack of global data. This study aimed to obtain an estimate using survey and population data. Childhood cancer clinicians (medical oncologists, surgeons, and radiation therapists), nurses, social workers, and psychologists involved in care of children with cancer were approached through an online survey February-May 2012. Incidence and population data were obtained from public sources. Descriptive, univariable, and multivariable analyses were conducted. 602 responses from 101 countries were obtained from physicians (84%), practicing pediatric hematology/oncology (83%) in general or children's hospitals (79%). Results suggested, 23,854 (15%) of 155,088 children <15 years old newly diagnosed with cancer annually in the countries analyzed, abandon therapy. Importantly, 83% of new childhood cancer cases and 99% of TxA were attributable to LMC. The annual number of cases of TxA expected in LMC worldwide (26,166) was nearly equivalent to the annual number of cancer cases in children <15 years expected in HIC (26,368). Approximately two thirds of LMC had median TxA ≥ 6%, but TxA ≥ 6% was reported in high- (9%), upper-middle- (41%), lower-middle- (80%), and low-income countries (90%, p<0.001). Most LMC centers reporting TxA > 6% were outside the capital. Lower national income category, higher reliance on out-of-pocket payments, and high prevalence of economic hardship at the center were independent contextual predictors for TxA ≥ 6% (p<0.001). Global survival data available for more developed and less developed regions suggests TxA may account for at least a third of the survival gap between HIC and LMC. Results show TxA is prevalent (compromising cancer survival for 1 in 7 children globally), confirm the suspected high burden of TxA in LMC, and illustrate the negative impact of poverty on its occurrence. The present estimates may appear small compared to the global burden of child death from malnutrition and infection (measured in millions). However, absolute numbers suggest the burden of TxA in LMC is nearly equivalent to annually losing all kids diagnosed with cancer in HIC just to TxA, without even considering deaths from disease progression, relapse or toxicity-the main causes of childhood cancer mortality in HIC. Results document the importance of monitoring and addressing TxA as part of childhood cancer outcomes in at-risk settings.

  6. Resource requirements for cancer registration in areas with limited resources: Analysis of cost data from four low- and middle-income countries☆

    PubMed Central

    Tangka, Florence K.L.; Subramanian, Sujha; Edwards, Patrick; Cole-Beebe, Maggie; Parkin, D. Maxwell; Bray, Freddie; Joseph, Rachael; Mery, Les; Saraiya, Mona

    2018-01-01

    Background The key aims of this study were to identify sources of support for cancer registry activities, to quantify resource use and estimate costs to operate registries in low- and middle-income countries (LMIC) at different stages of development across three continents. Methods Using the Centers for Disease Control and Prevention’s (CDC’s) International Registry Costing Tool (IntRegCosting Tool), cost and resource use data were collected from eight population-based cancer registries, including one in a low-income country (Uganda [Kampala)]), two in lower to middle-income countries (Kenya [Nairobi] and India [Mumbai]), and five in an upper to middle-income country (Colombia [Pasto, Barranquilla, Bucaramanga, Manizales and Cali cancer registries]). Results Host institution contributions accounted for 30%–70% of total investment in cancer registry activities. Cancer registration involves substantial fixed cost and labor. Labor accounts for more than 50% of all expenditures across all registries. The cost per cancer case registered in low-income and lower-middle-income countries ranged from US $3.77 to US $15.62 (United States dollars). In Colombia, an upper to middle-income country, the cost per case registered ranged from US $41.28 to US $113.39. Registries serving large populations (over 15 million inhabitants) had a lower cost per inhabitant (less than US $0.01 in Mumbai, India) than registries serving small populations (under 500,000 inhabitants) [US $0.22] in Pasto, Colombia. Conclusion This study estimates the total cost and resources used for cancer registration across several countries in the limited-resource setting, and provides cancer registration stakeholders and registries-with opportunities to identify cost savings and efficiency improvements. Our results suggest that cancer registration involve substantial fixed costs and labor, and that partnership with other institutions is critical for the operation and sustainability of cancer registries in limited resource settings. Although we included registries from a variety of limited-resource areas, information from eight registries in four countries may not be large enough to capture all the potential differences among the registries in limited-resource settings. PMID:27793574

  7. Use of New Technologies in the Prevention of Suicide in Europe: An Exploratory Study

    PubMed Central

    Delgado, Carmen; Sánchez-Prada, Andrés; Pérez-López, Mercedes; Franco-Martín, Manuel A

    2017-01-01

    Background New technologies are an integral component of today’s society and can complement existing suicide prevention programs. Here, we analyzed the use of new technologies in the prevention of suicide in 8 different European countries. Objective The aim of this paper was to assess the opinions of professionals in incorporating such resources into the design of a suicide prevention program for the region of Zamora in Spain. This investigation, encompassed within the European project entitled European Regions Enforcing Actions against Suicide (EUREGENAS), includes 11 regions from 8 different countries and attempts to advance the field of suicide prevention in Europe. Methods Using a specifically designed questionnaire, we assessed the opinions of 3 different groups of stakeholders regarding the use, frequency of use, facilitators, content, and format of new technologies for the prevention of suicide. The stakeholders were comprised of policy and public management professionals, professionals working in the area of mental health, and professionals related to the social area and non-governmental organizations (NGOs). A total of 416 participants were recruited in 11 regions from 8 different European countries. Results The utility of the new technologies was valued positively in all 8 countries, despite these resources being seldom used in those countries. In all the countries, the factors that contributed most to facilitating the use of new technologies were accessibility and free of charge. Regarding the format of new technologies, the most widely preferred formats for use as a tool for the prevention of suicide were websites and email. The availability of information about signs of alarm and risk factors was the most relevant content for the prevention of suicide through the use of new technologies. The presence of a reference mental health professional (MHP) was also considered to be a key aspect. The countries differed in the evaluations given to the different formats suggesting that the cultural characteristics of the country should be taken into account. Conclusions New technologies are much appreciated resources; however they are not often underused in the field of suicide prevention. The results of this exploratory study show that new technologies are indeed useful resources and should be incorporated into suicide prevention programs. PMID:28655705

  8. Preparedness for Zika virus testing in the World Health Organization Western Pacific Region

    PubMed Central

    Squires, Raynal C

    2016-01-01

    On 1 February 2016, the World Health Organization (WHO) declared that clusters of microcephaly cases and other neurological disorders occurring in Zika virus (ZIKV)-affected areas constituted a public health emergency of international concern. Increased surveillance of the virus, including the requirement for laboratory confirmation of infection, was recommended. The WHO Regional Office for the Western Pacific therefore initiated a rapid survey among national-level public health laboratories in 19 countries and areas to determine regional capacity for ZIKV detection. The survey indicated that 16/19 (84%) countries had capacity for molecular detection of ZIKV while others facilitated testing through referral. These results suggest that robust laboratory capacity is in place to support ZIKV surveillance in the Western Pacific Region. PMID:27757256

  9. Fourth Wes Fabb Oration Diversity of primary care in Asia Pacific: pathways to convergence

    PubMed Central

    2010-01-01

    Asia Pacific is one of the 6 regions of the World Organization of Family Doctors (Wonca). It is a region with 16 full and 2 associate members coming from 14 countries. One of the main activities in the region is the regional conference highlighted by the Wes Fabb Oration. This Fourth Wes Fabb Oration has a historical perspective and three main parts: the results of a cross sectional survey done among member organizations and three countries not affiliated yet with Wonca which show Family Medicine as to status, practice, education and research; the regional initiatives and activities which indicate convergence; and, suggested action points which can further promote family medicine development, collaboration, and convergence. PMID:20346130

  10. 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

  11. Preparedness for Zika virus testing in the World Health Organization Western Pacific Region.

    PubMed

    Squires, Raynal C; Konings, Frank

    2016-01-01

    On 1 February 2016, the World Health Organization (WHO) declared that clusters of microcephaly cases and other neurological disorders occurring in Zika virus (ZIKV)-affected areas constituted a public health emergency of international concern. Increased surveillance of the virus, including the requirement for laboratory confirmation of infection, was recommended. The WHO Regional Office for the Western Pacific therefore initiated a rapid survey among national-level public health laboratories in 19 countries and areas to determine regional capacity for ZIKV detection. The survey indicated that 16/19 (84%) countries had capacity for molecular detection of ZIKV while others facilitated testing through referral. These results suggest that robust laboratory capacity is in place to support ZIKV surveillance in the Western Pacific Region.

  12. A Health Systems Approach to Integrated Community Case Management of Childhood Illness: Methods and Tools

    PubMed Central

    McGorman, Laura; Marsh, David R.; Guenther, Tanya; Gilroy, Kate; Barat, Lawrence M.; Hammamy, Diaa; Wansi, Emmanuel; Peterson, Stefan; Hamer, Davidson H.; George, Asha

    2012-01-01

    Integrated community case management (iCCM) of childhood illness is an increasingly popular strategy to expand life-saving health services to underserved communities. However, community health approaches vary widely across countries and do not always distribute resources evenly across local health systems. We present a harmonized framework, developed through interagency consultation and review, which supports the design of CCM by using a systems approach. To verify that the framework produces results, we also suggest a list of complementary indicators, including nine global metrics, and a menu of 39 country-specific measures. When used by program managers and evaluators, we propose that the framework and indicators can facilitate the design, implementation, and evaluation of community case management. PMID:23136280

  13. Human epidermal growth factor receptor 2 status of gastric cancer patients in Asia: results from a large, multicountry study.

    PubMed

    Pathmanathan, Nirmala; Geng, Jing-Shu; Li, Wencai; Nie, Xiu; Veloso, Januario; Wang, John; Hill, Julie; Mccloud, Philip; Bilous, Michael

    2017-06-01

    Current estimates of the human epidermal growth factor receptor 2 (HER2)-positivity rate in gastric cancer vary widely in the literature, and there are limited data from countries in Asia. The primary aim of this study was to conduct a clinical audit of laboratories across seven countries in Asia to determine the incidence of HER2-positive gastric cancer in this region. Pathologists were asked to collect data on patient gender, age, cancer site, specimen type, tumor spread, type and grade, HER2 test results, including protein and/or gene copy enumeration, and final HER2 status on consecutive gastric cancer cases tested for HER2 in their laboratory over a 2-year period. HER2 results from 5,301 gastric cancers were submitted by 50 laboratories. The overall HER2-positivity rate was 9.7% which, after the exclusion of China, increased to 18.1%. The rate between countries ranged from 0% to 23.1%, and from 0% to 50.0% between laboratories. An equivocal HER2 result was recorded in 19.5% of cases. Despite the lack of centralized testing to confirm the accuracy of HER2 diagnoses, the incidence of HER2-positive gastric cancer observed here was comparable to that reported in the literature. Nevertheless, rates were highly variable between countries and laboratories, which suggests a lack of HER2 testing expertise in gastric cancer. Given that the mortality rates for gastric cancer in Eastern Asia are the highest in the world, efforts should focus on improving HER2 testing expertise in the region so that patients receive the appropriate treatment early in their disease. © 2016 The Authors. Asia-Pacific Journal of Clinical Oncology Published by John Wiley & Sons Australia, Ltd.

  14. The status of paediatric medicines initiatives around the world--What has happened and what has not?

    PubMed

    Hoppu, Kalle; Anabwani, Gabriel; Garcia-Bournissen, Facundo; Gazarian, Madlen; Kearns, Gregory L; Nakamura, Hidefumi; Peterson, Robert G; Sri Ranganathan, Shalini; de Wildt, Saskia N

    2012-01-01

    This review was conducted to examine the current status of paediatric medicines initiatives across the globe. The authors made a non-systematic descriptive review of current world situation. Two regions, the United States (US) and the European Union (EU), and the World Health Organization (WHO) have introduced strong paediatric initiatives to improve children's health through improving access to better paediatric medicines. The experience from the US initiative indicates that it is possible to stimulate development and study of paediatric medicines and provide important new information for improvement of paediatric therapy. The early results from the EU initiative are similarly encouraging. In Canada, Japan, Australia and other developed countries, specific paediatric medicines initiatives have been less extensive and weaker, with modest results. Disappointingly, current evidence suggests that results from clinical trials outside the US often do not benefit children in the country in which the trials were largely conducted. Pharmaceutical companies that have derived a financial benefit commensurate with the cost of doing the paediatric trials in one country do not seem to be making the results of these trials available to all countries if there is no financial incentive to the company. The WHO campaign 'make medicines child size' has produced substantive accomplishments in building improved foundations to improve mechanisms that will enhance children's access to critical medicines in resource-limited settings. However, practically all of this work has been performed using an amalgamation of short-term funding from a variety of sources as opposed to a sustained, programmatic commitment. Although much still needs to be done, it's clear that with concerted efforts and appropriate resources, change is possible but slow. Retaining and fostering public and political interest in paediatric medicines is challenging, but pivotal for success.

  15. Knowledge, actual and potential use of HIV self-sampling testing kits among MSM recruited in eight European countries.

    PubMed

    Hoyos, J; Maté, T; Indave, B I; Agustí, C; Chanos, S; Pichon, F; Kuske, M; Cigan, B; Fuertes, R; Ooms, L; Stefanescu, R; Cabeza de Vaca, C; Arranz, B; de la Fuente, L; Belza, M J

    2018-02-01

    To describe the knowledge as well as current and potential use of self-sampling kits among men who have sex with men (MSM) and to analyse their preferred biological sample and result communication method. We analyse data of MSM of HIV negative or unknown serostatus from an online survey conducted in eight countries (Belgium, Denmark, Germany, Greece, Portugal, Romania, Slovenia and Spain) between April and December 2016. It was advertised mainly in gay dating websites. We conduct a descriptive analysis of the main characteristics of the participants, and present data on indicators of knowledge, use and potential use of HIV self-sampling as well as their preferences regarding blood or saliva sample and face or non-face-to-face result communication by country of residence. A total of 8.226 participants of HIV negative or unknown serostatus were included in the analysis. Overall, 25.5% of participants knew about self-sampling (range: 18.8-47.2%) and 1.1% had used it in the past (range: 0.3-8.9%). Potential use was high, with 66.6% of all participants reporting that they would have already used it if available in the past (range: 62.1-82.1%). Most (78.6%) reported that they would prefer using a blood-based kit, and receiving the result of the test through a non-face-to-face-method (70.8%), even in the case of receiving a reactive result. The high potential use reported by MSM recruited in eight different European countries suggests that self-sampling kits are a highly acceptable testing methodology that could contribute to the promotion of HIV testing in this population. © 2018 British HIV Association.

  16. Online Sexual Activity Experiences Among College Students: A Four-Country Comparison.

    PubMed

    Döring, Nicola; Daneback, Kristian; Shaughnessy, Krystelle; Grov, Christian; Byers, E Sandra

    2017-08-01

    The purpose of this study was to compare male and female college students in four countries (Canada, Germany, Sweden, and the U.S.) on their lifetime experiences (prevalence) and frequency of recent experiences with six types of online sexual activities (OSA): sexual information, sexual entertainment, sexual contacts, sexual minority communities, sexual products, and sex work. Participants (N = 2690; M age, 24.65 years; 53.4 % women, 46.6 % men) were recruited from a university in each of the countries to complete an online survey that included background and demographic questions, and questions about OSA. Most participants reported experience with accessing sexual information (89.8 %) and sexual entertainment (76.5 %) online. Almost half (48.5 %) reported browsing for sexual products, and a substantial minority reported having engaged in cybersex (30.8 %). Very few participants (1.1 %) paid for online sexual services or received payment (0.5 %). In general, participants showed relatively infrequent experience with all types of OSA within the last 3 months. Men showed both higher prevalence and frequency of use of sexually stimulating material online than did women. However, this gender gap was smaller than in previous studies. Country and gender by country effects were (with one exception) either very small or non-existent, suggesting that, overall, students in the four countries were similar in their OSA experiences. Results are discussed in light of an emerging global net generation and globalized sexual culture.

  17. Corporal punishment, maternal warmth, and child adjustment: a longitudinal study in eight countries.

    PubMed

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

    2014-01-01

    Two key tasks facing parents across cultures are managing children's behaviors (and misbehaviors) and conveying love and affection. Previous research has found that corporal punishment generally is related to worse child adjustment, whereas parental warmth is related to better child adjustment. This study examined whether the association between corporal punishment and child adjustment problems (anxiety and aggression) is moderated by maternal warmth in a diverse set of countries that vary in a number of sociodemographic and psychological ways. Interviews were conducted with 7- to 10-year-old children (N = 1,196; 51% girls) and their mothers in 8 countries: China, Colombia, Italy, Jordan, Kenya, the Philippines, Thailand, and the United States. Follow-up interviews were conducted 1 and 2 years later. Corporal punishment was related to increases, and maternal warmth was related to decreases, in children's anxiety and aggression over time; however, these associations varied somewhat across groups. Maternal warmth moderated the effect of corporal punishment in some countries, with increases in anxiety over time for children whose mothers were high in both warmth and corporal punishment. The findings illustrate the overall association between corporal punishment and child anxiety and aggression as well as patterns specific to particular countries. Results suggest that clinicians across countries should advise parents against using corporal punishment, even in the context of parent-child relationships that are otherwise warm, and should assist parents in finding other ways to manage children's behaviors.

  18. Information Processing and Retrieval in Arab Countries: Traditional Approaches and Modern Potentials.

    ERIC Educational Resources Information Center

    Madkour, M. A. K.

    1980-01-01

    Discusses underlying assumptions and prerequisites for information development in Arab countries. Administrative and environmental impediments which hinder the optimum utilization of available resources and suggestions for improvements are outlined. A brief bibliography is provided. (Author/RAA)

  19. And justice for all: Examining corruption as a contextual source of mental illness.

    PubMed

    van Deurzen, Ioana

    2017-01-01

    In the present study, I focus on the relationship between corruption and mental health as measured by the level of depressive symptoms. I use data collected by the European Social Survey in 2006, 2012 and 2014 from 99,159 individuals that lived in 24 European countries. I employ two types of analyses: static analyses, i.e., multilevel models estimated in each wave, and dynamic analyses, i.e., fixed effects models for pseudo-panel data. Both static and dynamic analyses suggested that corruption had a detrimental effect on mental health. However, the results were not robust in models where the country's wealth was accounted for. Furthermore, this study presents evidence that the level of societal corruption is detrimental especially for the mental health of religious persons and individuals that experience material adversity. Regarding a potentially different effect of corruption on mental health between western and eastern European countries, no significant differences were found. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. European Pharmacy Students' Experience With Virtual Patient Technology

    PubMed Central

    Madeira, Filipe

    2012-01-01

    Objective. To describe how virtual patients are being used to simulate real-life clinical scenarios in undergraduate pharmacy education in Europe. Methods. One hundred ninety-four participants at the 2011 Congress of the European Pharmaceutical Students Association (EPSA) completed an exploratory cross-sectional survey instrument. Results. Of the 46 universities and 23 countries represented at the EPSA Congress, only 12 students from 6 universities in 6 different countries reported having experience with virtual patient technology. The students were satisfied with the virtual patient technology and considered it more useful as a teaching and learning tool than an assessment tool. Respondents who had not used virtual patient technology expressed support regarding its potential benefits in pharmacy education. French and Dutch students were significantly less interested in virtual patient technology than were their counterparts from other European countries. Conclusion. The limited use of virtual patients in pharmacy education in Europe suggests the need for initiatives to increase the use of virtual patient technology and the benefits of computer-assisted learning in pharmacy education. PMID:22919082

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