Tobacco Control and Tobacco Farming in African Countries

PubMed Central

Hu, Teh-wei; Lee, Anita H.

2015-01-01

During the past decade, tobacco leaf production has shifted from high-income countries to developing countries, particularly those in Africa. Most African governments promote tobacco farming as a way to alleviate poverty. The economic benefit of tobacco farming has been used by the tobacco industry to block tobacco control policies. The tobacco industry is active in promoting the alleged positive aspects of tobacco farming and in “protecting” farmers from what they portray as unfair tobacco control regulations that reduce demand. Tobacco farming has many negative consequences for the health and wellbeing of farmers, as well as for the environment and the long-term wellbeing of the country concerned.1-3 We provide an overview of tobacco farming issues in Africa. Encompassing multi-dimensional issues of economic development, there is far more to it than tobacco control questions. PMID:25428192

Viability of Commercially Available Bleach for Water Treatment in Developing Countries

PubMed Central

2009-01-01

Treating household water with low-cost, widely available commercial bleach is recommended by some organizations to improve water quality and reduce disease in developing countries. I analyzed the chlorine concentration of 32 bleaches from 12 developing countries; the average error between advertised and measured concentration was 35% (range = –45%–100%; standard deviation = 40%). Because of disparities between advertised and actual concentration, the use of commercial bleach for water treatment in developing countries is not recommended without ongoing quality control testing. PMID:19762657

Viability of commercially available bleach for water treatment in developing countries.

PubMed

Lantagne, Daniele S

2009-11-01

Treating household water with low-cost, widely available commercial bleach is recommended by some organizations to improve water quality and reduce disease in developing countries. I analyzed the chlorine concentration of 32 bleaches from 12 developing countries; the average error between advertised and measured concentration was 35% (range = -45%-100%; standard deviation = 40%). Because of disparities between advertised and actual concentration, the use of commercial bleach for water treatment in developing countries is not recommended without ongoing quality control testing.

Dependent convergence: the importation of technological hazards by semiperipheral countries.

PubMed

Siqueira, C E; Levenstein, C

2000-01-01

This article complements the substantial body of literature produced over the last three decades on the export of hazards from developed countries to developing countries. After reviewing the central arguments proposed by this literature, the authors add to the debate by focusing on the role of national actors in the importation of these hazards, based on the experience of late 1970s' developments in the petrochemical industry in Brazil. The Brazilian case indicates that social struggles and/or interactions among actors in developing and developed nations determine to what extent hazardous technologies are imported without environmental controls and to what extent their hazardous effects are controlled by these nations. This study suggests that the future development of a more inclusive theory of export-import of hazardous technologies and products should take into account the dialectical relationship established between social actors internal to the exporting and importing countries.

Control Measures Used during Lymphogranuloma Venereum Outbreak, Europe

PubMed Central

Hulscher, Marlies E.J.L.; Vos, Dieuwke; van de Laar, Marita J.W.; Fenton, Kevin A.; van Steenbergen, Jim E.; van der Meer, Jos W.M.; Grol, Richard P.T.M.

2008-01-01

To assess the response to the reemergence of lymphogranuloma venereum, we conducted a cross-sectional survey by administering a structured questionnaire to representatives from 26 European countries. Responses were received from 18 countries. The ability to respond quickly and the measures used for outbreak detection and control varied. Evidence-based criteria were not consistently used to develop recommendations. We did not develop criteria to determine the effectiveness of the recommendations. The degree of preparedness for an unexpected outbreak, as well as the ability of countries to respond quickly to alerts, varied, which indicates weaknesses in the ability to control an outbreak. More guidance is needed to implement and evaluate control measures used during international outbreaks. PMID:18394274

The fight against tobacco in developing countries.

PubMed

Mackay, J L

1994-02-01

The battle to reduce the tobacco epidemic is not being won; the epidemic is merely being transferred from rich to poor countries. Tobacco-related mortality will rise from the present annual global toll of 3 million to over 10 million by the year 2025. Currently, most of these deaths are in developed countries but 7 out of the 10 million deaths will occur in developing countries by 2025. Developing countries cannot afford this increase, either in terms of human health or in economic costs, such as medical and health care costs, costs of lost productivity, costs of fires or costs of the misuse of land used to grow tobacco. As many of the tobacco-related illnesses, such as lung cancer or emphysema, are incurable even with expensive technology, the key to tobacco control lies in prevention. The essential elements of a national tobacco control policy are the same for all countries throughout the world--the only differences lie in fine tuning to a country's current situation. While indigenous production and consumption of tobacco remain a problem, of particular concern is the penetration of developing countries by the transnational tobacco companies, with aggressive promotional campaigns and the use of political and commercial pressures to open up markets and to promote foreign cigarettes. This includes specific targeting of women, few of whom currently smoke in developing countries. Also, tobacco advertising revenue prevents the media from reporting on the hazards of tobacco, a particularly serious problem in developing countries where awareness of the harmfulness of tobacco is low.(ABSTRACT TRUNCATED AT 250 WORDS)

Sexually transmitted diseases in Ethiopia. Social factors contributing to their spread and implications for developing countries.

PubMed

Plorde, D S

1981-12-01

Sexually transmitted diseases in developing countries are causing concern to those responsible for their control and eradication. To gain a better understanding of the problems involved in a country struggling with development, the economic and psychosocial factors influencing the spread of STD in Ethiopia have been studied. Increased migration and urbanisation and the changing role of women have led to a rise in prostitution. Thus changes in the social structure--particularly in relation to the education and employment of women--and improved medical services are essential for the long-term control of STD.

The Social Development Summit and the developing countries.

PubMed

Barnabas, A P; Kulkarni, P D; Nanavatty, M C; Singh, R R

1996-01-01

This article discusses some concerns of the 1996 UN Summit on Social Development. Conference organizers identified the three key conference issues as poverty alleviation, social integration of the marginalized and disadvantaged, and expansion of productive employment. The goal of a "society for all" means dealing with the increasing differences between rich and poor countries, the survival of weaker economies in a competitive market system, wide variations in consumption patterns between countries, attainment of political stability while respecting ethnic identity, the rise in social problems among countries with a high human development index, and increasing joblessness. The Human Development Report for 1994 emphasizes human security. Social development is not the equivalent of human resource development nor a side issue of economic growth. The integration of ethnic groups poses social and political problems. There remains a question about what political system and culture would be best for social integration. Developed countries define poverty as the inability of people and government to provide resources and necessary services for people's productive activity. Poverty in developing countries is blamed on colonialism. Globally, developed countries control 71% of world trade. Sharing resources to meet basic needs throughout the world is not an operational ideal. The highest 20% of income earners receive 83% of the world income. The culture of poverty is the strategy used by the poor to survive. Welfare is not an end in itself but does enable the poor to improve their conditions. Development that focuses on productive employment is uncertain. Developed and developing countries do not share similar perceptions of human rights. There is a question as to who should set the priorities for social development. Sustainable social development is related to preservation of natural resources, control of population growth, and promotion of social security.

Smoking control strategies in developing countries: report of a WHO Expert Committee.

PubMed

Masironi, R

1984-01-01

An Expert Committee met in World Health Organization Headquarters in Geneva in November 1982 to discuss Smoking Control Strategies in Developing Countries. They reviewed the harmful health effects of different types of tobacco which characterized developing countries and the adverse effects of tobacco use on their economics due to smoking related diseases and higher smokers' work absenteeism. It advised on the objectives of smoking control programs, including data collection; education and information; legislation; smoking cessation; the role of medical, political, social, and religious leaders; the role of WHO, UN agencies, and nongovernmental organizations; research on smoking behavior; and evaluation of program efficacy. In addition, the Committee provided guidance on how to counteract tobacco industry arguments. More than a million people worldwide die prematurely each year because of cigarette smoking. In developed countries smoking is generally understood to cause lung cancer, coronary heart disease, chronic bronchitis, and other respiratory disorders. Major campaigns have been launched to reduce the rate of smoking. The public in most developing countries are unaware of the dangers, and no educational, legislative, or other measures are being taken to combat the smoking epidemic. The Committee called for firm steps to be taken to prevent this unnecessary modern epidemic. The incidence of tobacco related diseases is increasing in developing countries. Many of the developing countries have cigarettes on sale with high yields of tar and nicotine. Tobacco cultivation has spread to about 120 countries, becoming a substantial source of employment and creating new vested interests. Overall, the costs outweigh the "benefits." Tobacco taxes may be Politically comfortable," that is, easy to administer and generally acceptable to smokers, but these taxes do not contribute to national wealth but merely redistribute wealth. They cannot offset the economic losses caused by tobacco production and use: health service expenditures on smoking related diseases, disablement and work absenteeism, domestic and forest fires, use of scarce fule to cure tobacco, and reduced food production. Action against smoking can be inexpensive yet effective. Health warnings can be placed on cigarette packets, and legislation can be enacted to put an end to the double standards in marketing practices, whereby cigarettes of the same brand carrying health warnings in developed countries are marketed without these warnings in developing countries. Recommendations issued to governments and public health authorities in developing countries are listed.

Heavy Metal Risk Management: Case Analysis

PubMed Central

Kim, Ji Ae; Lee, Seung Ha; Choi, Seung Hyun; Jung, Ki Kyung; Park, Mi Sun; Jeong, Ji Yoon; Hwang, Myung Sil; Yoon, Hae Jung; Choi, Dal Woong

2012-01-01

To prepare measures for practical policy utilization and the control of heavy metals, hazard control related institutions by country, present states of control by country, and present states of control by heavy metals were examined. Hazard control cases by heavy metals in various countries were compared and analyzed. In certain countries (e.g., the U.S., the U.K., and Japan), hazardous substances found in foods (e.g., arsenic, lead, cadmium, and mercury) are controlled. In addition, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) recommends calculating the provisional tolerable weekly intake (PTWI) of individual heavy metals instead of the acceptable daily intake (ADI) to compare their pollution levels considering their toxicity accumulated in the human body. In Korea, exposure assessments have been conducted, and in other countries, hazardous substances are controlled by various governing bodies. As such, in Korea and other countries, diverse food heavy metal monitoring and human body exposure assessments are conducted, and reducing measures are prepared accordingly. To reduce the danger of hazardous substances, many countries provide leaflets and guidelines, develop hazardous heavy metal intake recommendations, and take necessary actions. Hazard control case analyses can assist in securing consumer safety by establishing systematic and reliable hazard control methods. PMID:24278603

Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries.

PubMed

Palafox, Benjamin; McKee, Martin; Balabanova, Dina; AlHabib, Khalid F; Avezum, Alvaro Jr; Bahonar, Ahmad; Ismail, Noorhassim; Chifamba, Jephat; Chow, Clara K; Corsi, Daniel J; Dagenais, Gilles R; Diaz, Rafael; Gupta, Rajeev; Iqbal, Romaina; Kaur, Manmeet; Khatib, Rasha; Kruger, Annamarie; Kruger, Iolanthe Marike; Lanas, Fernando; Lopez-Jaramillo, Patricio; Minfan, Fu; Mohan, Viswanathan; Mony, Prem K; Oguz, Aytekin; Palileo-Villanueva, Lia M; Perel, Pablo; Poirier, Paul; Rangarajan, Sumathy; Rensheng, Lei; Rosengren, Annika; Soman, Biju; Stuckler, David; Subramanian, S V; Teo, Koon; Tsolekile, Lungiswa P; Wielgosz, Andreas; Yaguang, Peng; Yeates, Karen; Yongzhen, Mo; Yusoff, Khalid; Yusuf, Rita; Yusufali, Afzalhussein; Zatońska, Katarzyna; Yusuf, Salim

2016-12-08

Effective policies to control hypertension require an understanding of its distribution in the population and the barriers people face along the pathway from detection through to treatment and control. One key factor is household wealth, which may enable or limit a household's ability to access health care services and adequately control such a chronic condition. This study aims to describe the scale and patterns of wealth-related inequalities in the awareness, treatment and control of hypertension in 21 countries using baseline data from the Prospective Urban and Rural Epidemiology study. A cross-section of 163,397 adults aged 35 to 70 years were recruited from 661 urban and rural communities in selected low-, middle- and high-income countries (complete data for this analysis from 151,619 participants). Using blood pressure measurements, self-reported health and household data, concentration indices adjusted for age, sex and urban-rural location, we estimate the magnitude of wealth-related inequalities in the levels of hypertension awareness, treatment, and control in each of the 21 country samples. Overall, the magnitude of wealth-related inequalities in hypertension awareness, treatment, and control was observed to be higher in poorer than in richer countries. In poorer countries, levels of hypertension awareness and treatment tended to be higher among wealthier households; while a similar pro-rich distribution was observed for hypertension control in countries at all levels of economic development. In some countries, hypertension awareness was greater among the poor (Sweden, Argentina, Poland), as was treatment (Sweden, Poland) and control (Sweden). Inequality in hypertension management outcomes decreased as countries became richer, but the considerable variation in patterns of wealth-related inequality - even among countries at similar levels of economic development - underscores the importance of health systems in improving hypertension management for all. These findings show that some, but not all, countries, including those with limited resources, have been able to achieve more equitable management of hypertension; and strategies must be tailored to national contexts to achieve optimal impact at population level.

Dog population management for the control of human echinococcosis.

PubMed

Kachani, Malika; Heath, David

2014-11-01

Cystic and alveolar hydatid disease of humans caused by infection with Echinococcus granulosus or Echinococcus multilocularis are significant zoonoses in developing countries. For human infections, the main definitive host is the dog, and reduction in the population of unwanted dogs, together with anthelmintic treatment of wanted dogs, are recommended control procedures for these zoonoses. Both owned and unowned dogs have been shown to be a major source of Echinococcus spp. infection in developing countries. Unowned dogs are the most challenging category in dog population management for the control of major zoonotic diseases. Unowned dogs are those dogs that do not have an owner, and those dogs whose owner cannot readily be identified. Control of numbers of unowned dogs can be done in various ways if funds are available. Fertility control and humane euthanasia are likely to be the most effective procedures in developing countries. Fertility control requires significant funding, and where resources are scarce humane euthanasia may be the most effective option. Both procedures are ongoing events, with no predictable end point. This paper examines the sociology and technology for the population management of owned and unowned dogs, specifically for the reduction of human hydatid disease. Examples are given for developing and developed countries. Although a "One Health" approach is desirable, the technology for hydatid control is different from that for rabies, and FAO Animal Welfare recommendations for dog population management should be adjusted accordingly. Copyright © 2014 Elsevier B.V. All rights reserved.

Socioeconomic impact on device-associated infections in pediatric intensive care units of 16 limited-resource countries: international Nosocomial Infection Control Consortium findings.

PubMed

Rosenthal, Victor D; Jarvis, William R; Jamulitrat, Silom; Silva, Cristiane Pavanello Rodrigues; Ramachandran, Bala; Dueñas, Lourdes; Gurskis, Vaidotas; Ersoz, Gulden; Novales, María Guadalupe Miranda; Khader, Ilham Abu; Ammar, Khaldi; Guzmán, Nayide Barahona; Navoa-Ng, Josephine Anne; Seliem, Zeinab Salah; Espinoza, Teodora Atencio; Meng, Cheong Yuet; Jayatilleke, Kushlani

2012-07-01

We report the results of the International Nosocomial Infection Control Consortium prospective surveillance study from January 2004 to December 2009 in 33 pediatric intensive care units of 16 countries and the impact of being in a private vs. public hospital and the income country level on device-associated health care-associated infection rates. Additionally, we aim to compare these findings with the results of the Centers for Disease Control and Prevention National Healthcare Safety Network annual report to show the differences between developed and developing countries regarding device-associated health care-associated infection rates. A prospective cohort, active device-associated health care-associated infection surveillance study was conducted on 23,700 patients in International Nosocomial Infection Control Consortium pediatric intensive care units. The protocol and methodology implemented were developed by International Nosocomial Infection Control Consortium. Data collection was performed in the participating intensive care units. Data uploading and analyses were conducted at International Nosocomial Infection Control Consortium headquarters on proprietary software. Device-associated health care-associated infection rates were recorded by applying Centers for Disease Control and Prevention National Healthcare Safety Network device-associated infection definitions, and the impact of being in a private vs. public hospital and the income country level on device-associated infection risk was evaluated. None. Central line-associated bloodstream infection rates were similar in private, public, or academic hospitals (7.3 vs. 8.4 central line-associated bloodstream infection per 1,000 catheter-days [p < .35 vs. 8.2; p < .42]). Central line-associated bloodstream infection rates in lower middle-income countries were higher than low-income countries or upper middle-income countries (12.2 vs. 5.5 central line-associated bloodstream infections per 1,000 catheter-days [p < .02 vs. 7.0; p < .001]). Catheter-associated urinary tract infection rates were similar in academic, public and private hospitals: (4.2 vs. 5.2 catheter-associated urinary tract infection per 1,000 catheter-days [p = .41 vs. 3.0; p = .195]). Catheter-associated urinary tract infection rates were higher in lower middle-income countries than low-income countries or upper middle-income countries (5.9 vs. 0.6 catheter-associated urinary tract infection per 1,000 catheter-days [p < .004 vs. 3.7; p < .01]). Ventilator-associated pneumonia rates in academic hospitals were higher than private or public hospitals: (8.3 vs. 3.5 ventilator-associated pneumonias per 1,000 ventilator-days [p < .001 vs. 4.7; p < .001]). Lower middle-income countries had higher ventilator-associated pneumonia rates than low-income countries or upper middle-income countries: (9.0 vs. 0.5 per 1,000 ventilator-days [p < .001 vs. 5.4; p < .001]). Hand hygiene compliance rates were higher in public than academic or private hospitals (65.2% vs. 54.8% [p < .001 vs. 13.3%; p < .01]). Country socioeconomic level influence device-associated infection rates in developing countries and need to be considered when comparing device-associated infections from one country to another.

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

PubMed Central

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

2000-01-01

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

[The informed consent in international clinical trials including developing countries].

PubMed

Montenegro Surís, Alexander; Monreal Agüero, Magda Elaine

2008-01-01

The informed consent procedure has been one of the most important controversies of ethical debates about clinical trials in developing countries. In this essay we present our recommendations about important aspects to consider in the informed consent procedure for clinical trials in developing countries. We performed a full publications review identified by MEDLINE using these terms combinations: informed consent, developing countries, less developed countries and clinical trials. To protect volunteers in less developed countries should be valuated the importance of the community in the informed consent proceeding. The signing and dating of the informed consent form is not always the best procedure to document the informed consent. The informed consent form should be written by local translators. Alternative medias of communications could be needed for communicatios of the information to volunteers. Comparing with developed countries the informed consent proceeding in clinical trials in developing countries frequently require additional efforts. The developing of pragmatic researches is needed to implement informed consent proceedings assuring subjects voluntarily in each developing country. The main aspects to define in each clinical trial for each country are the influence of the community, the effective communication of the information, the documentation of the informed consent and local authority's control.

Strengthening public health pesticide management in countries endemic with malaria or other major vector-borne diseases: an evaluation of three strategies.

PubMed

van den Berg, Henk; Yadav, Rajpal S; Zaim, Morteza

2014-09-18

Public health pesticides has been the mainstay control of vectors of malaria and other diseases, and public health pests, but there is increasing concern over how these pesticides are being managed. Poor pesticide management could lead to risks to human health and the environment, or diminish the effectiveness of interventions. Strategies for strengthening the management of public health pesticides, from manufacture to disposal, should be evaluated to propose future directions. The process and outcomes of three strategies were studied in five regions of the WHO (African Region, Eastern Mediterranean Region, South-East Asia Region, Western Pacific Region, and American Region) and 13 selected countries. These strategies are: regional policy development, in-depth country support and thematic support across countries. Consensus, frameworks and action plans on public health pesticide management were developed at regional level. Country support for situation analysis and national action planning highlighted weaknesses over the entire spectrum of pesticide management practices, mainly related to malaria control. The thematic support on pesticide quality control contributed to structural improvements on a priority issue for malaria control across countries. The three strategies showed promising and complementary results, but guidelines and tools for implementation of the strategies should be further improved. Increased national and international priority should be given to support the development of policy, legislation and capacity that are necessary for sound management of public health pesticides.

Comparison of approaches to rheumatic fever surveillance across Organisation for Economic Co-operation and Development countries.

PubMed

Oliver, Jane; Baker, Michael G; Pierse, Nevil; Carapetis, Jonathan

2015-11-01

Rheumatic fever (RF) prevention, control and surveillance are increasingly important priorities in New Zealand (NZ) and Australia. We compared RF surveillance across Organisation for Economic Co-operation and Development (OECD) member countries to assist in benchmarking and identifying useful approaches. A structured literature review was completed using Medline and PubMed databases, investigating RF incidence rates. Surveillance methods were noted. Health department websites were searched to assess whether addressing RF was a Government priority. Of 32 OECD member countries, nine reported RF incidence rates after 1999. Highest rates were seen in indigenous Australians, and NZ Māori and Pacific peoples. NZ and Australian surveillance systems are highly developed, with notification and register data compiled regularly. Only these two Governments appeared to prioritise RF surveillance and control. Other countries relied mainly on hospitalisation data. There is a lack of standardisation across incidence rate calculations. Israel and Italy may have relatively high RF rates among developed countries. RF lingers in specific populations in OECD member countries. At a minimum, RF registers are needed in higher incidence countries. Countries with low RF incidences should periodically review surveillance information to ensure rates are not increasing. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

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.

Tobacco growing and the sustainable development goals, Malawi

PubMed Central

Bialous, Stella Aguinaga; Munthali, Spy; Max, Wendy

2017-01-01

Abstract Negative impacts of tobacco result from human consumption and from tobacco-growing activities, most of which now occur in low- and middle-income countries. Malawi is the world’s largest producer of burley tobacco and its population is affected by the negative consequences of both tobacco consumption and production. In countries like Malawi, tobacco control refers to control of the tobacco supply chain, rather than control of consumption. We review the impact of tobacco cultivation, using Malawi as an example, to illustrate the economic, environmental, health and social issues faced by low- and middle-income countries that still produce significant tobacco crops. We place these issues in the context of the sustainable development goals (SDGs), particularly 3a which calls on all governments to strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control. Other goals address the negative effects that tobacco cultivation has on development. The SDGs offer an opportunity for low- and middle-income countries that are dependent on tobacco production and that are not yet parties to the Convention, to reconsider joining the FCTC. PMID:28479637

Changes in chlamydia control activities in Europe between 2007 and 2012: a cross-national survey

PubMed Central

Sfetcu, Otilia; van der Sande, Marianne A.; Andersen, Berit; Herrmann, Björn; Ward, Helen; Götz, Hannelore M.; Uusküla, Anneli; Woodhall, Sarah C.; Redmond, Shelagh M.; Amato-Gauci, Andrew J.; Low, Nicola; van Bergen, Jan E.

2016-01-01

Background: In 2012, the levels of chlamydia control activities including primary prevention, effective case management with partner management and surveillance were assessed in 2012 across countries in the European Union and European Economic Area (EU/EEA), on initiative of the European Centre for Disease Control (ECDC) survey, and the findings were compared with those from a similar survey in 2007. Methods: Experts in the 30 EU/EEA countries were invited to respond to an online questionnaire; 28 countries responded, of which 25 participated in both the 2007 and 2012 surveys. Analyses focused on 13 indicators of chlamydia prevention and control activities; countries were assigned to one of five categories of chlamydia control. Results: In 2012, more countries than in 2007 reported availability of national chlamydia case management guidelines (80% vs. 68%), opportunistic chlamydia testing (68% vs. 44%) and consistent use of nucleic acid amplification tests (64% vs. 36%). The number of countries reporting having a national sexually transmitted infection control strategy or a surveillance system for chlamydia did not change notably. In 2012, most countries (18/25, 72%) had implemented primary prevention activities and case management guidelines addressing partner management, compared with 44% (11/25) of countries in 2007. Conclusion: Overall, chlamydia control activities in EU/EEA countries strengthened between 2007 and 2012. Several countries still need to develop essential chlamydia control activities, whereas others may strengthen implementation and monitoring of existing activities. PMID:26498953

Pharmaceutical patents and price controls.

PubMed

Vogel, Ronald J

2002-07-01

Since 1995, every member-country of the World Trade Organization (WTO) has agreed to honor a 20-year patent-life, from the date of a pharmaceutical company's application for the patent, in the country of application. Patent protection retards competitive imitation of an invented product. This kind of protection is particularly important for pharmaceuticals, because pharmaceuticals that are not derived from biotechnology can be imitated easily and inexpensively. The economic function of a patent is to allow a period of above-normal profits for a technically and commercially successful product; these profits stimulate further investment and invention. However, direct price controls, or permutations of direct price controls on pharmaceutical compounds, can fully or partially circumvent the economic intent of patent agreements. This paper formulates an economic model that takes into account demand and cost/supply dimensions of the output and pricing of a hypothetical pharmaceutical, extrapolating about the respective effects of direct price controls and lack of price controls, and describing permutations of direct price controls in different countries. The pharmaceutical industry depends on patents to fund the development and introduction of new products. A country can indirectly circumvent the economic logic of a patent by using price controls, but it cannot shift the economic costs of such a policy to another country that does not use price controls. Instead, less money is available for research and development (R&D). Pharmaceutical price controls allow some countries to avoid the constraints of patent agreements without breaking those agreements outright. This, in turn, reduces the amount of profit available for further R&D, which is a detriment to consumers worldwide.

26 CFR 1.955-3 - Election as to date of determining qualified investments in less developed countries.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the foreign base company income of the controlled foreign corporation for all prior taxable years... countries at the close of such taxable year exceed its qualified investments in less developed countries at the close of the taxable year immediately following such taxable year, and reducing such excess by (2...

Some of Indonesian Cyber Law Problems

NASA Astrophysics Data System (ADS)

Machmuddin, D. D.; Pratama, B.

2017-01-01

Cyber regulation is very important to control human interaction within the Internet network in cyber space. On the surface, innovation development in science and technology facilitates human activity. But on the inside, innovation was controlled by new business model. In cyber business activities mingle with individual protection. By this condition, the law should keep the balance of the activities. Cyber law problems, were not particular country concern, but its global concern. This is a good opportunity for developing country to catch up with developed country. Beside this opportunity for talented people in law and technology is become necessity. This paper tries to describe cyber law in Indonesia. As a product of a developing country there are some of weakness that can be explained. Terminology and territory of cyber space is become interesting to discuss, because this two problems can give a broad view on cyber law in Indonesia.

Developed-developing country partnerships: benefits to developed countries?

PubMed

Syed, Shamsuzzoha B; Dadwal, Viva; Rutter, Paul; Storr, Julie; Hightower, Joyce D; Gooden, Rachel; Carlet, Jean; Bagheri Nejad, Sepideh; Kelley, Edward T; Donaldson, Liam; Pittet, Didier

2012-06-18

Developing countries can generate effective solutions for today's global health challenges. This paper reviews relevant literature to construct the case for international cooperation, and in particular, developed-developing country partnerships. Standard database and web-based searches were conducted for publications in English between 1990 and 2010. Studies containing full or partial data relating to international cooperation between developed and developing countries were retained for further analysis. Of 227 articles retained through initial screening, 65 were included in the final analysis. The results were two-fold: some articles pointed to intangible benefits accrued by developed country partners, but the majority of information pointed to developing country innovations that can potentially inform health systems in developed countries. This information spanned all six WHO health system components. Ten key health areas where developed countries have the most to learn from the developing world were identified and include, rural health service delivery; skills substitution; decentralisation of management; creative problem-solving; education in communicable disease control; innovation in mobile phone use; low technology simulation training; local product manufacture; health financing; and social entrepreneurship. While there are no guarantees that innovations from developing country experiences can effectively transfer to developed countries, combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is virgin and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardized method for reporting partnership benefits is needed--this is perhaps the single most immediate need in planning for, and realizing, the full potential of international cooperation between developed and developing countries.

An Epidemiological Trend of Urogenital Schistosomiasis in Ethiopia

PubMed Central

Chala, Bayissa; Torben, Workineh

2018-01-01

Schistosomiasis is a major public health problem in Ethiopia. Currently, the prevalence of the disease can possibly be heightened due to man-made ecological transformations particularly related to the recent development programs involving irrigation and construction of dams. The expansion of some of the water resource development projects has been cited enhancing the upsurge of urogenital schistosomiasis mainly in the lower altitude areas of the country. In connection to the extensive initiation of development projects in low altitude areas of the country, simultaneous and adequate attentions have never been given to address a pre-assessment of health impacts of the development programs prior to launching the projects. Helpful appraisals focusing on evaluation of epidemiology of urogenital schistosomiasis in Ethiopia have not been explored. Therefore, the current review attempts to trace an overall picture of the epidemiological status of urogenital schistosomiasis in the country; the past and existing trends of urogenital schistosomiasis surveys and control programs of the country are reviewed. Essential recommendations are highlighted for possible inputs in future control design strategies of national control program of schistosomiasis. PMID:29556490

Agricultural policy and sustainable livestock development.

PubMed

Schillhorn van Veen, T W

1999-01-01

Future agricultural and rural development is, to a large extent, influenced by the projected food needs of 2.5 billion people expected to swell the world population by 2020. This increase will require more food in general and, in view of recent experience in East Asia, more animal products. To achieve this increase will require judicious use of resources, and trade, especially in those countries where natural resources are insufficient to support food production. Achieving food sufficiency in a sustainable manner is a major challenge for farmers, agro-industries, researchers and governments. The latter play an important role as many of the farmers' choices are, to a large extent, directed by government or supra-government, often through macro- and micro-economic policy. In many countries the economic, environmental, trade and agricultural policies have not been conducive to an agricultural development that is risk-free with respect to the environment, animal welfare or public health. The recent decline of government support in agriculture forced farmers in Western countries to think about more risk adverse agricultural practices and more efficient production systems. On the other hand, many countries in Eastern Europe and the former Soviet Union, as well as other developing countries, are still going through a painful process of adjustment to new market conditions. International banks and development agencies have a mandate to help developing countries, but are somewhat restricted both by needing to work directly with governments and by their perceived dogmatic approach to development. Changing policies do, now and in the future, also affect the development of animal disease control programmes, including the control of parasitic diseases. On the one hand there is an increasing interest in risk-free control practices, and on the other hand a demand for greater regulatory control over the production process. As parasitic diseases of animals are closely linked to the environment (i.e. grazing and waste management) and public health (i.e. parasitic zoonoses), the new interest in sustainable agriculture provides a challenge for those concerned with the control and prevention of animal parasitism.

Concurrent diphtheria and infectious mononucleosis: difficulties for management, investigation and control of diphtheria in developing countries.

PubMed

Mattos-Guaraldi, A L; Damasco, P V; Gomes, D L R; Melendez, M G; Santos, L S; Marinelli, R S; Napoleão, F; Sabbadini, P S; Santos, C S; Moreira, L O; Hirata, R

2011-11-01

We report a case of concurrent diphtheria and infectious mononucleosis in an 11-year-old Brazilian child. Two days after specific treatment for diphtheria was started the patient was discharged following clinical recovery. This case highlights the difficulties in the clinical diagnosis of diphtheria in partially immunized individuals, and for the management and control of diphtheria in developing countries.

Comparison of tobacco control policies in the Eastern Mediterranean countries based on Tobacco Control Scale scores.

PubMed

Heydari, G; Talischi, F; Masjedi, M R; Alguomani, H; Joossens, L; Ghafari, M

2012-08-01

This cross-sectional survey aimed to provide an overview of tobacco control strategies in the countries of the Eastern Mediterranean Region (EMR). A questionnaire to collate data on implementation of 6 major policies was developed based on the previously published Tobacco Control Scale and using MPOWER measures of the WHO Tobacco Free Initiative and the Tobacco Atlas. Only 3 of the 21 countries scored higher than 50 out of 100: Islamic Republic of Iran (61), Jordan (55) and Egypt (51) More than half of countries scored less than 26. Highest scores were achieved by Afghanistan in cigarette pricing, Oman in smoking bans in public places, Islamic Republic of Iran in budgeting, prohibition of advertisements and health warnings against smoking and Syrian Arab Republic, Tunisia and Kuwait in tobacco cessation programmes. The low mean total score in EMR countries (29.7) compared with European countries (47.2) highlights the need for better future planning and policy-making for tobacco control in the Region.

Prevention of nosocomial infections in developing countries, a systematic review.

PubMed

Murni, Indah; Duke, Trevor; Triasih, Rina; Kinney, Sharon; Daley, Andrew J; Soenarto, Yati

2013-05-01

Prevention of nosocomial infection is key to providing good quality, safe healthcare. Infection control programmes (hand-hygiene campaigns and antibiotic stewardship) are effective in reducing nosocomial infections in developed countries. However, the effectiveness of these programmes in developing countries is uncertain. To evaluate the effectiveness of interventions for preventing nosocomial infections in developing countries. A systematic search for studies which evaluated interventions to prevent nosocomial infection in both adults and children in developing countries was undertaken using PubMed. Only intervention trials with a randomized controlled, quasi-experimental or sequential design were included. Where there was adequate homogeneity, a meta-analysis of specific interventions was performed using the Mantel-Haenzel fixed effects method to estimate the pooled risk difference. Thirty-four studies were found. Most studies were from South America and Asia. Most were before-and-after intervention studies from tertiary urban hospitals. Hand-hygiene campaigns that were a major component of multifaceted interventions (18 studies) showed the strongest effectiveness for reducing nosocomial infection rates (median effect 49%, effect range 12.7-100%). Hand-hygiene campaigns alone and studies of antibiotic stewardship to improve rational antibiotic use reduced nosocomial infection rates in three studies [risk difference (RD) of -0.09 (95%CI -0.12 to -0.07) and RD of -0.02 (95% CI -0.02 to -0.01), respectively]. Multifaceted interventions including hand-hygiene campaigns, antibiotic stewardship and other elementary infection control practices are effective in developing countries. The modest effect size of hand-hygiene campaigns alone and negligible effect size of antibiotic stewardship reflect the limited number of studies with sufficient homogeneity to conduct meta-analyses.

An international analysis of cigarette affordability

PubMed Central

Blecher, E; van Walbeek, C P

2004-01-01

Objective: To investigate how affordable cigarettes are in developed and developing countries, and to calculate by how much the affordability of cigarettes has changed between 1990 and 2001; and secondly, to investigate the relation between cigarette affordability and consumption. Design: Affordability was defined as the cost of cigarettes relative to per capita income. Trends in cigarette affordability, and affordability elasticities of demand, were estimated using regression techniques. Subjects: Seventy countries were investigated, of which 28 are categorised as high income developed countries, while 42 are categorised as developing countries. Cigarette prices were obtained for the main city/cities in the countries. Results: Despite the fact that cigarettes are more expensive in developed countries, the high levels of income make cigarettes more affordable in these countries vis-à-vis developing countries. Of the 28 developed countries, cigarettes became more affordable in 11 and less affordable in 17 countries during the 1990s. Of the 42 developing countries, cigarettes became more affordable in 24 and less affordable in 18 countries. Based on a cross sectional analysis, a 1% increase in the relative income price (the inverse of cigarette affordability) is expected to decrease cigarette consumption by between 0.49–0.57%. Conclusions: Cigarette affordability, more than just the price, determines cigarette consumption. While cigarettes have become more affordable in many developing countries, some developing countries (for example, South Africa, Poland, and Thailand) have implemented strong and effective tobacco control policies, and have been able to decrease cigarette consumption as a result. PMID:15564616

Understanding the LANDSAT market in developing countries

NASA Technical Reports Server (NTRS)

Willard, M. R.

1980-01-01

The constraints on the growth of the market which stem from the development process itself and from a country's technical, political, and institutional attributes were examined. Four competing factors guide the development of policy regarding an operational land remote sensing system and are summarized. The factors are: there is a need to boost U.S. experts in areas where the U.S. holds a technological lead; the need to develop user applications in developing countries on their terms coincides with foreign policy; developing countries desire to take control of their own development; and the U.S. government wants to enlist the participation of major companies in the management, operation, and ownership of the operational system.

Development of Children at Risk for Adverse Outcomes Participating in Early Intervention in Developing Countries: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Wallander, Jan L.; Bann, Carla M.; Biasini, Fred J.; Goudar, Shivaprasad S.; Pasha, Omrana; Chomba, Elwyn; McClure, Elizabeth; Carlo, Waldemar A.

2014-01-01

Background: Previous research has indicated positive effects of early developmental intervention (EDI) on the development of children in developing countries. Few studies, however, have examined longitudinally when differential treatment effects may be observed and whether differential outcomes are associated with exposure to different risk…

Tobacco Control and the World Trade Organization: Mapping Member States’ Positions after the Framework Convention on Tobacco Control

PubMed Central

Holden, Chris; Callard, Cynthia

2016-01-01

Objective To note the frequency of discussions and disputes about tobacco control measures at the World Trade Organization (WTO) before and after the coming into force of the Framework Convention on Tobacco Control (FCTC). To review trends or patterns in the positions taken by members of the WTO with respect to tobacco control measures. To discuss possible explanations for these observed trends/patterns. Methods We gathered data on tobacco related disputes in the WTO since its establishment in 1995 and its forerunner, the General Agreement on Tariffs and Trade (GATT), prior- and post-FCTC. We also looked at debates on tobacco control measures within the WTO more broadly. To this end, we classified and coded the positions of WTO member states during discussions on tobacco control and the FCTC, from 1995 until 2013, within the Technical Barriers to Trade (TBT) Committee and the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Council. Results There is a growing interest within the WTO for tobacco related issues and opposition to tobacco control measures is moving away from high-income countries towards low(er) income countries. Conclusion The growing prominence of tobacco issues in the WTO can be attributed at least in part to the fact that during the last decade tobacco firms have been marginalised from the domestic policy-making process in many countries, which has forced them to look for other ways and forums to influence decision-making. Furthermore, the finding that almost all recent opposition within the WTO to stronger tobacco regulations came from developing countries is consistent with a relative shift of transnational tobacco companies’ lobbying efforts from developed to developing countries. PMID:26585705

Developed-developing country partnerships: Benefits to developed countries?

PubMed Central

2012-01-01

Developing countries can generate effective solutions for today’s global health challenges. This paper reviews relevant literature to construct the case for international cooperation, and in particular, developed-developing country partnerships. Standard database and web-based searches were conducted for publications in English between 1990 and 2010. Studies containing full or partial data relating to international cooperation between developed and developing countries were retained for further analysis. Of 227 articles retained through initial screening, 65 were included in the final analysis. The results were two-fold: some articles pointed to intangible benefits accrued by developed country partners, but the majority of information pointed to developing country innovations that can potentially inform health systems in developed countries. This information spanned all six WHO health system components. Ten key health areas where developed countries have the most to learn from the developing world were identified and include, rural health service delivery; skills substitution; decentralisation of management; creative problem-solving; education in communicable disease control; innovation in mobile phone use; low technology simulation training; local product manufacture; health financing; and social entrepreneurship. While there are no guarantees that innovations from developing country experiences can effectively transfer to developed countries, combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is virgin and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardized method for reporting partnership benefits is needed—this is perhaps the single most immediate need in planning for, and realizing, the full potential of international cooperation between developed and developing countries. PMID:22709651

Postmarketing surveillance in developing countries.

PubMed

Meirik, O

1988-01-01

Authorities in developing countries need to monitor the possible adverse consequences of the increasing use of drugs in their countries. Definite differences exist in the risk-benefit ratios for developed and developing countries, particularly with fertility-regulating drugs. Some physicians believe that the increased risk of thrombosis associated with oral contraceptives (OCs) should not be considered as important in developing countries due to the fact that the background level of venous thrombosis is so low in developing countries that even a 50- or 100-fold increase in relative risk would neither be detectable nor important compared to the risk of unwanted pregnancy. In addition, evidence exists of geographically linked factors in the etiology of some adverse drug reactions (ADRs). Authorities in Brazil, India, Indonesia, Pakistan, the Philippines, Thailand, and Venezuela have established voluntary ADR reporting systems. Several developing countries also actively follow the World Health Organization's International Drug Monitoring Program and have access to its data base. A number of other methodological approaches to postmarketing surveillance are in use in addition to voluntary ADR reporting systems. These include cross-sectional surveys, studies of temporal and geographic correlations of diseases and drug use, and case-control and cohort studies. Each of these approaches offers specific advantages. Postmarketing surveillance should begin at the time new drugs, including contraceptive methods are introduced. Surveillance needs to be an integral part of plans for the introduction of new contraceptive methods in settings where the infrastructure to carry out such surveillance is in place. 3 major public sector agencies, Family Health International, the Population Council, and the World Health Organization, developed a plan to obtain funding for the postmarketing surveillance of a contraceptive implant, Norplant-R. A controlled cohort study will be conducted in 6-10 developing countries. The pilot phase of the surveillance began in 1987. The project objective is to detect possible adverse effects of Norplant-R as well as any health benefits of the method. It also will assess the feasibility of the cohort methodology for postmarketing surveillance in developing countries.

[World population growth and the food supply].

PubMed

Huang, Y

1982-07-29

The general trend in the last several hundred years has been that the speed of growth in the food supply exceeds the speed of the population growth. For the time being, 2 major problems still exist. The 1st problem is that food production is still influenced by natural conditions. For example, abnormal weather conditions may cause regional food shortages. The 2nd problem is the imbalance of food consumption by the world population. This phenomenon exists between different social classes as well as between developed and developing countries. According to statistics released by the World Bank, 1 billion suffer from malnutrition today and most of them are in developing countries. In developed countries, about half of their increase in the food supply is for feed grains, and those countries follow the policy of reducing farm land for the purpose of maintaing stabl e grain prices. Up to the present time, grain prices have been unstable, and this has become a rather heavy economic burden for numerous developing countries. Many developing countries are trying to increase grain production by increasing their arable land and promoting their cultivating techniques. However, these countries are facing the problems of finding and adequate water supply, fertilizer, and pesticides. In addition, a rapid population growth in these countries has offset their endeavors in agriculture. In recent years, these counties have realized the necessity of birth control. The world population growth rate has decreased from 2% to about 1.7% in 1981. Birth control and an increase in the food supply will bring new hope to the world's problems of overpopulation and food supply.

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.

[Children and bankers in Bangladesh].

PubMed

Hartmann, B

1991-06-01

This critique of the World Bank's role in developing country population programs begins with a description of a 1987 case in which an 80-year- old Bangladeshi man was persuaded to undergo vasectomy and then robbed of his incentive payment by the health agent. For over 20 years, the World Bank has pressured 3rd World governments to implement population control programs. Although there are divergent opinions within the World Bank, the most dominant is the neomalthusian view that the poor through their high fertility help perpetuate their own poverty. This view hides the real source of poverty in the Third World: the unequal distribution of resources within these countries and between the developed and developing countries. The World Bank has always been blind to the inequalities, and has associated with the elites of developing countries who monopolize the resources of their countries and thereby impede authentic development. Furthermore, the emphasis on population control distorts social policy and hinders the implementation of safe and voluntary family planning services. In many countries the World Bank has required governments to give greater priority to population control than to basic health services. It has pressured them to relax contraceptive prescription norms and has promoted the more effective methods without regard to proper use or side effects. In Bangladesh the World Bank has sponsored sterilization programs that rely on coercion and incentives. In that country of enormous inequities, 10% of landowners control over 50% of lands, while nearly half the population is landless and chronically underemployed. Political power is concentrated in the military government, which annually receives over 1.5 billion dollars in external aid. External aid primarily benefits the wealthy. 3/4 of the population are undernourished and less than 1/3 are literate or have access to basic health care. The poor of Bangladesh, as in many other countries, feel that their only source of security is to have many children, a significant proportion of whom will not survive. In rural Bangladesh, where chronic hunger and unemployment are rife, the incentives and the pressures of family planning and health workers were sufficient to persuade many persons to undergo sterilization. Payment of commissions to workers to promote sterilization has discouraged them from supplying adequate information about sterilization for fear of losing clients. Population from other donors and wide publicity about the abuses in the sterilization program and the high rates of regret among women undergoing sterilization only for the incentives have led to some modifications, but the World Bank has continued to exert pressure on the Bangladeshi government to develop fertility-control programs. The damaging effects of World Bank population programs can also be seen in Indonesia, Nepal, and other developing countries.

Renewed mobilization against malaria.

PubMed

1991-01-01

1 million people die in the world from malaria annually, 800,000 of whom are 5 year old children in Sub-Sahara Africa. Further it affects 270 million people. In fact, 110 million develop malaria, 90 million of whom are from Sub-Saharan Africa. Thus WHO has introduced a new world initiative for malaria control to reverse the worsening trend that began in the mid 1970s. In October 1991, 150 officials from 50 African, Asian, and Latin American countries and participants from UN cooperation and development agencies and bilateral agencies attended an interregional conference at the WHO Regional office for Africa in Brazzaville, Congo. It strove to evaluate malaria situations specific to Africa, to update the malaria control plan in Africa, and to contribute to the development of an implementable world strategy. This world strategy needs to consider the local situation and encourage participation of the government and people of affected countries. Further individuals, communities, and various sectors of the national economy including those involved in health, education, development, and agriculture need to participate in malaria control. In addition, for this strategy to work, most countries must strengthen the management and financing of health services to meet their needs. For example, local populations must share local operating costs such as those for essential drugs and mosquito control operations. Community participation must also include personal protection such as impregnated bed nets and environmental measures. Besides malaria control must be integrated into the existing health system at country, provincial, and peripheral levels. In sum, improved case management, control of malaria transmission, and prevention and control of epidemics form the basis for the new strategy.

Building capacity for tobacco control research and policy

PubMed Central

Stillman, F; Yang, G; Figueiredo, V; Hernandez‐Avila, M; Samet, J

2006-01-01

The Fogarty International Center (FIC) initiative, “International Tobacco and Health Research Capacity Building Program” represents an important step in US government funding for global tobacco control. Low‐ and middle‐income countries of the world face a rising threat to public health from the rapidly escalating epidemic of tobacco use. Many are now parties to the Framework Convention on Tobacco Control (FCTC) and capacity development to meet FCTC provisions. One initial grant provided through the FIC was to the Institute for Global Tobacco Control (IGTC) at the Johns Hopkins Bloomberg School of Public Health (JHSPH) to support capacity building and research programmes in China, Brazil, and Mexico. The initiative's capacity building effort focused on: (1) building the evidence base for tobacco control, (2) expanding the infrastructure of each country to deliver tobacco control, and (3) developing the next generation of leaders as well as encouraging networking throughout the country and with neighbouring countries. This paper describes the approach taken and the research foci, as well some of the main outcomes and some identified challenges posed by the effort. Individual research papers are in progress to provide more in‐depth reporting of study results. PMID:16723670

Prevention of cervical cancer in HIV-seropositive women from developing countries: a systematic review protocol.

PubMed

Mapanga, Witness; Elhakeem, Ahmed; Feresu, Shingairai A; Maseko, Fresier; Chipato, Tsungai

2017-04-24

Over 85% of cervical cancer cases and deaths occur in developing countries. HIV-seropositive women are more likely to develop precancerous lesions that lead to cervical cancer than HIV-negative women. However, the literature on cervical cancer prevention in seropositive women in developing countries has not been reviewed. The aim of this study is to systematically review cervical cancer prevention modalities available for HIV-seropositive women in developing countries. This protocol was developed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and the systematic review will be reported in accordance with the PRISMA guidelines. Embase, MEDLINE, PubMed, CINAHL and Cochrane Library will be searched from inception up to date of final search, and additional studies will be located through citation and reference list tracking. Eligible studies will be randomised controlled trials, prospective and retrospective cohort studies, case-control and cross-sectional studies carried out in developing countries. Studies will be included if they are published in English and examine cervical cancer prevention modalities in HIV-seropositive women. Results will be summarised in tables and, where appropriate, combined using meta-analysis. This review will address the gap in evidence by systematically reviewing the published literature on the different prevention modalities being used to prevent cervical cancer in HIV-seropositive women in developing countries. The findings may be used to inform evidence-based guidelines for prevention of cervical cancer in seropositive women as well as future research. PROSPERO CRD42017054678 .

Urban air pollution in megacities of the world

NASA Astrophysics Data System (ADS)

Mage, David; Ozolins, Guntis; Peterson, Peter; Webster, Anthony; Orthofer, Rudi; Vandeweerd, Veerle; Gwynne, Michael

Urban air pollution is a major environmental problem in the developing countries of the world. WHO and UNEP created an air pollution monitoring network as part of the Global Environment Monitoring System. This network now covers over 50 cities in 35 developing and developed countries throughout the world. The analyses of the data reported by the network over the past 15-20 yr indicate that the lessons of the prior experiences in the developed countries (U.S.A., U.K.) have not been learned. A study of air pollution in 20 of the 24 megacities of the world (over 10 million people by year 2000) shows that ambient air pollution concentrations are at levels where serious health effects are reported. The expected rise of population in the next century, mainly in the developing countries with a lack of capital for air pollution control, means that there is a great potential that conditions will worsen in many more cities that will reach megacity status. This paper maps the potential for air pollution that cities will experience in the future unless control strategies are developed and implemented during the next several decades.

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.

Is the DOTS strategy sufficient to achieve tuberculosis control in low- and middle-income countries? 1. Need for interventions in universities and medical schools.

PubMed

Caminero, J A

2003-06-01

Now that progress is gradually being made in the implementation of the DOTS strategy in low-income countries, we must take into account the fact that nearly 30% of all tuberculosis (TB) cases worldwide occur in middle-income countries, which usually have an adequate health infrastructure and sufficient economic resources for TB control. These countries nevertheless have other limitations that make it necessary to develop other aspects in addition to the DOTS strategy. These can be summarised in three main themes: 1) adequate coordination of all health structures involved in TB management, ensuring that they follow the basic norms of the National Tuberculosis Programme (NTP), 2) direct intervention in universities and medical schools, which are ubiquitous in such countries, and 3) specific collaboration with specialists and physicians in private practice, an important obstacle to the success of NTPs in several countries. A detailed analysis is presented of strategies that need to be implemented in different countries depending on their economic resources and their TB situation. The need to carry out specific interventions in addition to training in DOTS in universities and medical schools in order to improve TB control is discussed. A specific project in this area developed by the IUATLD in Latin America is described.

Tuberculosis in the tropics.

PubMed

Krause, V L; Britton, W J

1993-09-20

Until recently tuberculosis was considered a well controlled disease, at least in developed countries. In developing countries, more than seven million people are affected by active tuberculosis. This situation is exacerbated by poor infrastructure to support tuberculosis control measures and the interaction between tuberculosis and infection with the human immunodeficiency virus. The three major strategies for controlling tuberculosis remain BCG vaccination in children, appropriate preventive therapy and, most importantly, reducing the sources of infection through case finding and curative treatment. Research and resources to improve on these strategies should be given high priority by the international health community.

Considerations for conducting epidemiologic case-control studies of cancer in developing countries.

PubMed

Brinton, L A; Herrero, R; Brenes, M; Montalván, P; de la Guardia, M E; Avila, A; Domínguez, I L; Basurto, E; Reeves, W C

1991-01-01

The challenges involved in conducting epidemiologic studies of cancer in developing countries can be and often are unique. This article reports on our experience in performing a case-control study of invasive cervical cancer in four Latin American countries (Columbia, Costa Rica, Mexico, and Panama), the summary medical results of which have been published in a previous issue of this journal (1). The study involved a number of principal activities--mainly selecting, conducting interviews with, and obtaining appropriate biologic specimens from 759 cervical cancer patients, 1,467 matched female controls, and 689 male sex partners of monogamous female subjects. This presentation provides an overview of the planning and methods used to select the subjects, conduct the survey work, and obtain complete and effectively unbiased data. It also points out some of the important advantages and disadvantages of working in developing areas similar to those serving as locales for this study.

Control of corruption, democratic accountability, and effectiveness of HIV/AIDS official development assistance.

PubMed

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

2016-01-01

Despite continued global efforts, HIV/AIDS outcomes in developing countries have not made much progress. Poor governance in recipient countries is often seen as one of the reasons for ineffectiveness of aid efforts to achieve stated objectives and desired outcomes. This study examines the impact of two important dimensions of governance - control of corruption and democratic accountability - on the effectiveness of HIV/AIDS official development assistance. An empirical analysis using dynamic panel Generalized Method of Moments estimation was conducted on 2001-2010 datasets. Control of corruption and democratic accountability revealed an independent effect and interaction with the amount of HIV/AIDS aid on incidence of HIV/AIDS, respectively, while none of the two governance variables had a significant effect on HIV/AIDS prevalence. Specifically, in countries with accountability level below -2.269, aid has a detrimental effect on incidence of HIV/AIDS. The study findings suggest that aid programs need to be preceded or at least accompanied by serious efforts to improve governance in recipient countries and that democratic accountability ought to receive more critical attention.

Strategy to combat obesity and to promote physical activity in Arab countries.

PubMed

Musaiger, Abdulrahman O; Al Hazzaa, Hazzaa M; Al-Qahtani, Aayed; Elati, Jalila; Ramadan, Jasem; Aboulella, Nebal A; Mokhtar, Najat; Kilani, Hashem A

2011-01-01

Obesity has become a major public health problem in the Arab countries, creating a health and economic burden on these countries' government services. There is an urgent need to develop a strategy for prevention and control of obesity. The third Arab Conference on Obesity and Physical Activity was held in Bahrain in January 2010, and proposed the Strategy to Combat Obesity and Promote Physical Activity in Arab Countries. This strategy provides useful guidelines for each Arab country to prepare its own strategy or plan of action to prevent and control obesity. The strategy focused on expected outcomes, objectives, indicators to measure the objectives, and action needs for 9 target areas: child-care centers for preschool children, schools, primary health care, secondary care, food companies, food preparation institutes, media, public benefit organizations, and the workplace. Follow-up and future developments of this strategy were also included.

Controlling measles using supplemental immunization activities: A mathematical model to inform optimal policy

PubMed Central

Verguet, Stéphane; Johri, Mira; Morris, Shaun K.; Gauvreau, Cindy L.; Jha, Prabhat; Jit, Mark

2015-01-01

Background The Measles & Rubella Initiative, a broad consortium of global health agencies, has provided support to measles-burdened countries, focusing on sustaining high coverage of routine immunization of children and supplementing it with a second dose opportunity for measles vaccine through supplemental immunization activities (SIAs). We estimate optimal scheduling of SIAs in countries with the highest measles burden. Methods We develop an age-stratified dynamic compartmental model of measles transmission. We explore the frequency of SIAs in order to achieve measles control in selected countries and two Indian states with high measles burden. Specifically, we compute the maximum allowable time period between two consecutive SIAs to achieve measles control. Results Our analysis indicates that a single SIA will not control measles transmission in any of the countries with high measles burden. However, regular SIAs at high coverage levels are a viable strategy to prevent measles outbreaks. The periodicity of SIAs differs between countries and even within a single country, and is determined by population demographics and existing routine immunization coverage. Conclusions Our analysis can guide country policymakers deciding on the optimal scheduling of SIA campaigns and the best combination of routine and SIA vaccination to control measles. PMID:25541214

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.

The Global Fund: managing great expectations.

PubMed

Brugha, Ruairí; Donoghue, Martine; Starling, Mary; Ndubani, Phillimon; Ssengooba, Freddie; Fernandes, Benedita; Walt, Gill

The Global Fund to fight AIDS, Tuberculosis, and Malaria was created to increase funds to combat these three devastating diseases. We report interim findings, based on interviews with 137 national-level respondents that track early implementation processes in four African countries. Country coordinating mechanisms (CCMs) are country-level partnerships, which were formed quickly to develop and submit grant proposals to the Global Fund. CCM members were often ineffective at representing their constituencies and encountered obstacles in participating in CCM processes. Delay in dissemination of guidelines from the Global Fund led to uncertainty among members about the function of these new partnerships. Respondents expressed most concern about the limited capacity of fund recipients--government and non-government--to meet Global Fund conditions for performance-based disbursement. Delays in payment of funds to implementing agencies have frustrated rapid financing of disease control interventions. The Global Fund is one of several new global initiatives superimposed on existing country systems to finance the control of HIV/AIDS. New and existing donors need to coordinate assistance to developing countries by bringing together funding, planning, management, and reporting systems if global goals for disease control are to be achieved.

Human immunization in developing countries: practical and theoretical problems and prospects.

PubMed

Arya, S C

1994-11-01

While measles, pertussis and tetanus were responsible during the early 1990s for nearly two million deaths in developing countries, no deaths were attributable to them in industrialized countries. More than 96% of global deaths by communicable diseases were also from developing countries. Respiratory infections ranked first in communicable morbidity at all ages. Even though vaccines of bacterial or viral origin or a prophylactic for passive immunization are produced in 24, 16 and 15 developing countries, respectively, none of the developing countries manufactures a plasma-derived prophylactic or biological response modifier. Nearly every country relies on import of one or more vaccines. The suboptimal performance of otherwise meritorious products has been due to faulty vaccine administration practices. Expanding populations, poverty and lack of education, cold-chain defects, and inadequate facilities for transport of vaccines to target populations in remote areas have been responsible for the poor performance of vaccines in the community. Mounting foreign debts and budgetary strains resulting from the care and prevention of AIDS/HIV have considerably strained national and international efforts to offer routine vaccinations in childhood and pregnancy. This dismal situation could be tackled through research to obtain environmentally stable products for prophylactic use and monoclonal antibody formulations for passive immunization, and through international financial and technical support. All countries should exercise some technical control of the quality of imported and indigenous vaccines during their use for curative or prophylactic purposes. The involvement of private clinicians in immunizations would strengthen national efforts for control of communicable diseases including AIDS, but this is not enough if the local factors cited above are not improved.

Bucharest: poverty or population?

PubMed

1974-01-01

The controversy that occurred in Bucharest over the World Population Plan of Action had not been totally anticipated. Prior to the Conference, there appeared to be a general consensus that population growth was the crucial issue although it was recognized that population growth had to be considered in the context of socioeconomic and cultural development. What developed at Bucharest was a clear division between the developed countries who favored population control and implementation of family planning programs by 1986 and the developing countries who rejected the idea of population control unless it was associated with the redistribution of world resources. The reality of people having large families because they are poor cannot be denied, but, simultaneously, the problem of increasing numbers and their impact on the quality of life, nutrition, housing, education, and employment must be faced. Since affluent countries cannot be relied upon concerning the redistribution of their wealth, developing countries can bring about some change by redistributing the wealth within their countries. Adult literacy programs have been identified as a means to promote socioeconomic development, but these programs will only prove successful if they involve the adults in the process of learning by means of problem solving and cause them to reflect on their socioeconomic situation with the result of reinvolving themselves in society in order to change it.

STATISTICS AND INTELLIGENCE IN DEVELOPING COUNTRIES: A NOTE.

PubMed

Kodila-Tedika, Oasis; Asongu, Simplice A; Azia-Dimbu, Florentin

2017-05-01

The purpose of this study is to assess the relationship between intelligence (or human capital) and the statistical capacity of developing countries. The line of inquiry is motivated essentially by the scarce literature on poor statistics in developing countries and an evolving stream of literature on the knowledge economy. A positive association is established between intelligence quotient (IQ) and statistical capacity. The relationship is robust to alternative specifications with varying conditioning information sets and control for outliers. Policy implications are discussed.

Tobacco control and the dental profession. A survey of the Organisation for Economic Co-operation and Development (OECD) national dental associations.

PubMed

Beaglehole, Rob H; Tsakos, Georgios; Watt, Richard G

2005-10-01

To explore the current role played by national dental associations (NDAs) in tobacco control and to assess relevant policy initiatives across OECD countries. A self-complete questionnaire survey. Chief Executive Officers of NDAs of OECD countries. A response rate of 74% was achieved. An overview of tobacco control policies from OECD member states was obtained. Half of the NDAs reported that they had a policy on tobacco control. Furthermore, a minority of OECD countries appear to have tobacco control guidelines that specifically include reference to the role of dental professionals. Dentists are able to prescribe nicotine replacement therapy (NRT) in less than a third of OECD member states. In a small number of OECD countries there was funding available to encourage dentists to become more actively involved in tobacco control activities. Undergraduate training focusing on tobacco control is not universally provided across all OECD countries. There is an urgent need to put tobacco control initiatives on the oral health policy agenda of NDAs across the OECD. A range of policy opportunities exist to facilitate greater involvement of the dental profession in tobacco control activities.

Living with systemic lupus erythematosus in the developing world.

PubMed

Phuti, A; Schneider, M; Tikly, M; Hodkinson, B

2018-03-26

Most of our understanding of SLE and its negative impact originates from developed countries. This review aims to collate existing literature on Health-Related Quality of Life (HRQoL) in SLE patients living in developing countries to identify the gaps for the focus of future research. A narrative literature review was compiled using selected MeSH terms to search EBSCOHOST for articles published between January 1975 and February 2018 pertaining to HRQoL in SLE patients in developing countries. 31 studies from 11 countries were included for analysis. Only one longitudinal, one randomized controlled trial (RCT), one qualitative study, and two intervention studies were found. High disease activity and organ damage were associated with poor functional ability, mental health and low socio-economic status (SES). Poor SES is a recurring theme in developing countries, and worsens all SLE outcomes by reducing access to healthcare, mental, social and emotional support systems. In developing countries, SLE has a globally negative impact on patients' HRQoL, similar to that seen in developed countries. There is an urgent need for more HRQoL studies, and in particular, longitudinal, qualitative and interventional studies in these countries to investigate unmet needs, and to explore novel strategies to improve patient outcomes.

National HIV/AIDS mortality, prevalence, and incidence rates are associated with the Human Development Index.

PubMed

Lou, Li-Xia; Chen, Yi; Yu, Chao-Hui; Li, You-Ming; Ye, Juan

2014-10-01

HIV/AIDS is a worldwide threat to human health with mortality, prevalence, and incidence rates varying widely. We evaluated the association between the global HIV/AIDS epidemic and national socioeconomic development. We obtained global age-standardized HIV/AIDS mortality, prevalence, and incidence rates from World Health Statistics Report of the World Health Organization. The human development indexes (HDIs) of 141 countries were obtained from a Human Development Report. Countries were divided into 4 groups according to the HDI distribution. We explored the association between HIV/AIDS epidemic and HDI information using Spearman correlation analysis, regression analysis, and the Kruskal-Wallis test. HIV/AIDS mortality, prevalence, and incidence rates were inversely correlated with national HDI (r = -0.675, -0.519, and -0.398, respectively; P < .001), as well as the 4 indicators of HDI (ie, life expectancy at birth, mean years of schooling, expected years of schooling, and gross national income per capita). Low HDI countries had higher HIV/AIDS mortality, prevalence, and incidence rates than that of medium, high, and very high HDI countries. Quantile regression results indicated that HDI had a greater negative effect on the HIV/AIDS epidemic in countries with more severe HIV/AIDS epidemic. Less-developed countries are likely to have more severe HIV/AIDS epidemic. There is a need to pay more attention to HIV/AIDS control in less-developed countries, where lower socioeconomic status might have accelerated the HIV/AIDS epidemic more rapidly. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

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

2016-01-01

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

Paucity of family planning.

PubMed

Hawkins, C

1988-04-01

A wall chart compiled by the Population Crisis Committee of Washington D.C. called "World Access to Birth Control" is described. The chart compares developing countries and developed countries with respect to need of effective contraception, using data from the World Fertility Surveys. Up to 250 million women need contraception; a substantial percentage want no more children, over half in several large countries. The chart ranks the United Kingdom as 1st in providing family planning services, information, education and advertising. All of the developed countries were considered good except Russia and Romania, although some had deficiencies, such as Japan for lacking sterilization services. The U.S. ranked 7th, failing to provide women the full range of contraceptive methods, to provide adequate sex education and services to adolescents, and to publish information and adequate advertising about birth control. The USSR was placed 14th on the list of 15 because of poor quality and erratic supplies. Among the developing countries, Libya, Kampuchea and Laos were cited as having no services whatsoever. In contrast, several Asian national family planning programs, notably China, Taiwan, Singapore, South Korea and Hong Kong, had such excellent programs that fertility had declined over 30% in 15 years. In China, fertility has fallen 50% in that time.

Global Tobacco Surveillance System (GTSS): purpose, production, and potential.

PubMed

2005-01-01

The World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and Canadian Public Health Association (CPHA) developed the Global Tobacco Surveillance System (GTSS) to assist all 192 WHO Member States in collecting data on youth and adult tobacco use. The flexible GTSS system includes common data items but allows countries to include important unique information at their discretion. It uses a common survey methodology, similar field procedures for data collection, and similar data management and processing techniques. The GTSS includes collection of data through three surveys: the Global Youth Tobacco Survey (GYTS) for youth, and the Global School Personnel Survey (GSPS) and the Global Health Professional Survey (GHPS) for adults. GTSS data potentially can be applied in four ways. First, countries and research partners can disseminate data through publications, presentations, and an active GTSS web site. Second, countries can use GTSS data to inform politicians about the tobacco problem in their country, leading to new policy decisions to prevent and control tobacco use. Third, GTSS can provide countries with valuable feedback to evaluate and improve Country National Action Plans or develop new plans. Fourth, in response to the WHO FCTC call for countries to use consistent methods and procedures in their surveillance efforts, GTSS offers such consistency in sampling procedures, core questionnaire items, training infield procedures, and analysis of data across all survey sites. The GTSS represents the most comprehensive tobacco surveillance system ever developed and implemented. As an example, this paper describes development of the GYTS and discusses potential uses of the data. Sample data were drawn from 38 sites in 24 countries in the African Region, 82 sites in 35 countries in the Americas Region, 20 sites in 17 countries and the Gaza Strip/West Bank region in the Eastern Mediterranean Region, 25 sites in 22 countries in the European Region, 34 sites in six countries in the Southeast Asia Region, and 25 sites in 14 countries in the Western Pacific Region.

National prevalence of coronary heart disease and its relationship with human development index: A systematic review.

PubMed

Zhu, Ke-Fu; Wang, Yu-Ming; Zhu, Jin-Zhou; Zhou, Qin-Yi; Wang, Ning-Fu

2016-03-01

Coronary heart disease has become a major health concern over the past several decades. Several reviews have assessed the effects of socioeconomic status on the coronary heart disease epidemic in communities and countries, but only a few reviews have been performed at a global level. This study was to explore the relationship between the prevalence of coronary heart disease and socioeconomic development worldwide using the Human Development Index. Systematic review. The data in this study were collected from the MEDLINE database. Cross-sectional studies reporting the prevalence of coronary heart disease until November 2014 were collected. The Human Development Index was sourced from the United Nations Development Programme Database and was used to measure the socioeconomic achievements of countries. Each country was classified as a developing or developed country based on its level of development according to the Human Development Index value. Based on the data analysis on the global level, coronary heart disease prevalence had no association with the national Human Development Index (rho = 0.07). However, there was a positive association between coronary heart disease prevalence and the national Human Development Index in developing countries, although a negative association existed in developed countries (rho = 0.47 and -0.34, respectively). In addition, the past decades have witnessed a growing coronary heart disease epidemic in developing countries, with reverse trends observed in developed countries (P = 0.021 and 0.002, respectively). With the development of socioeconomic status, as measured by the Human Development Index, the prevalence of coronary heart disease is growing in developing countries, while declining in developed countries. Future research needs to pay more attention to the reasonable allocation of medical resources and control of coronary heart disease risk factors. © The European Society of Cardiology 2015.

Pollution, health and development: the need for a new paradigm.

PubMed

Landrigan, Philip J; Fuller, Richard

2016-03-01

Pollution is the largest cause of death in low- and middle-income countries. WHO estimates that 8.9 million persons die each year of diseases caused by pollution - 94% of them in poor countries. By comparison, HIV/AIDS causes 1.5 million deaths per year, and malaria and tuberculosis cause fewer than 1 million each. Diseases caused by pollution are very costly. Pollution can be prevented. In high-income countries, legal and technical control strategies have been developed and yielded great health and economic benefits. The removal of lead from gasoline increased the mean IQ of all American children and has generated an annual economic benefit of $213 billion. Unmet need: Despite its enormous human and economic costs, pollution has been overlooked in the international development agenda. Pollution control currently receives <0.5% of development spending. We have formed The Lancet-GAHP-Mount Sinai Commission on Pollution, Health and Development. This Commission will develop robust analyses of the impacts of pollution on health, economics, and development. It will inform heads of state and global funders about the enormous scale pollution's effects. The ultimate goal is to raise the priority of pollution and increase the resources allocated to control of this urgent public health problem.

United Nations Assistance Mission in Afghanistan: Background and Policy Issues

DTIC Science & Technology

2009-12-14

mainly through U.N. agencies and NGOs. 6 In 2007, Afghanistan placed 174th out of 178 countries on global rankings of the Human Development Index ( HDI ...and other insurgents to reestablish control of some areas of the country have slowed the pace and extent of economic development and the expansion of...improvement throughout the country . The international recovery and reconstruction effort in Afghanistan is immense and complicated and, in coordination

Tobacco control and the World Trade Organization: mapping member states' positions after the framework convention on tobacco control.

PubMed

Eckhardt, Jappe; Holden, Chris; Callard, Cynthia D

2016-11-01

To note the frequency of discussions and disputes about tobacco control measures at the World Trade Organization (WTO) before and after the coming into force of the Framework Convention on Tobacco Control (FCTC). To review trends or patterns in the positions taken by members of the WTO with respect to tobacco control measures. To discuss possible explanations for these observed trends/patterns. We gathered data on tobacco-related disputes in the WTO since its establishment in 1995 and its forerunner, the General Agreement on Tariffs and Trade (GATT), prior-FCTC and post-FCTC. We also looked at debates on tobacco control measures within the WTO more broadly. To this end, we classified and coded the positions of WTO member states during discussions on tobacco control and the FCTC, from 1995 until 2013, within the Technical Barriers to Trade (TBT) Committee and the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Council. There is a growing interest within the WTO for tobacco-related issues and opposition to tobacco control measures is moving away from high-income countries towards low(er) income countries. The growing prominence of tobacco issues in the WTO can be attributed at least in part to the fact that during the past decade tobacco firms have been marginalised from the domestic policy-making process in many countries, which has forced them to look for other ways and forums to influence decision-making. Furthermore, the finding that almost all recent opposition within the WTO to stronger tobacco regulations came from developing countries is consistent with a relative shift of transnational tobacco companies' lobbying efforts from developed to developing countries. 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/.

Research priorities for tobacco control in developing countries: a regional approach to a global consultative process

PubMed Central

Baris, E.; Brigden, L. W.; Prindiville, J.; e, S; Chitanondh, H.; Chandiwana, S.

2000-01-01

OBJECTIVE—To develop regional tobacco control research agendas for developing countries through a consultative process.
METHODS—Research for International Tobacco Control, located at the International Development Research Centre in Ottawa, Canada, convened three regional meetings for Latin America and the Caribbean, South and Southeast Asia, and Eastern, Central and Southern Africa. Participation by researchers, policymakers, and advocates from a wide range of disciplines ensured an accurate representation of regional issues.
RESULTS—The four main recurring themes within each regional agenda were: (1) the lack of standardised and comparable data; (2) the absence of a network for communication of information, data, and best practices; (3) a lack of adequate capacity for tobacco control research, especially in non-health related areas such as economics and policy analysis; and (4) a need for concerted mobilisation of human and financial resources in order to implement a comprehensive research agenda, build partnerships, and stimulate comparative research and analysis. Specific research issues included the need for descriptive data with respect to the supply side of the tobacco equation, and analytical data related to tobacco use, production and marketing, and taxation.
CONCLUSIONS—There was a uniform perception of tobacco as a multidisciplinary issue. All regional agendas included a balance of health, economic, agricultural, environmental, sociocultural, and international trade concerns. Research data are urgently required to provide a sound basis for the development of tobacco control policies and programmes. As tobacco control takes its rightful place on the global health agenda, it is vital that funding for tobacco control research be increased.


Keywords: regional tobacco control programmes; developing countries; tobacco control research PMID:10841859

From public health to international law: possible protocols for inclusion in the Framework Convention on Tobacco Control.

PubMed Central

Joossens, L.

2000-01-01

Faced with a difficult business environment in the United States and the falling demand for cigarettes in industrialized countries, multinational tobacco companies have been competing fiercely to expand their sales in developing countries. Because of the worldwide threat posed by smoking to health and the emphasis being placed by international tobacco companies on marketing in developing countries, an international regulatory strategy, such as the WHO proposed Framework Convention on Tobacco Control, is needed. This review describes from a public health perspective the possible scope and key considerations of protocols that should be included in the convention. The key international areas that should be considered in tobacco control are: prices, smuggling; tax-free tobacco products; advertising and sponsorship; the Internet; testing methods; package design and labelling; agriculture; and information sharing. PMID:10994267

International Comparison of Water Resources Utilization Efficiency in the Silk Road Economic Belt

NASA Astrophysics Data System (ADS)

Yan, Long; Ma, Jing; Deng, Wei; Wang, Yong

2018-03-01

In order to get knowledge of the standard of water utilization of the Silk Road Economic Belt from international point of view, the paper analyzes the annual variation of water resources utilization in the Silk Road Economic Belt, and compares with other typical countries. The study shows that Water resources utilization efficiency has been greatly improved in recent 20 years and the water consumption per USD 10000 of GDP has been declined 87.97%. the improvement of industrial water consumption efficiency is the key driving factors for substantial decrease in water consumption.The comparison of water utilization and human development shows that the higher HDI the country is, the more efficient water utilization the country has. water consumption per USD 10000 of GDP in country with HDI>0.9 is 194m³, being 8.5% of that in country with HDI from 0.5 to 0.6. On the premise of maintaining the stable economic and social development of the Silk Road Economic Belt, the realization of the control target of total water consumption must depend on the strict control over the disorderly expansion of irrigated area, the change in the mode of economic growth, the implementation of the development strategy for new industrialization and urbanization, vigorous development of the processing industry with low water consumption as well as the high-tech and high value-added industry. Only in this way, the control target of total water consumption can be realized in the process of completing the industrialization task.

Control of corruption, democratic accountability, and effectiveness of HIV/AIDS official development assistance

PubMed Central

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

2016-01-01

Background Despite continued global efforts, HIV/AIDS outcomes in developing countries have not made much progress. Poor governance in recipient countries is often seen as one of the reasons for ineffectiveness of aid efforts to achieve stated objectives and desired outcomes. Objective This study examines the impact of two important dimensions of governance – control of corruption and democratic accountability – on the effectiveness of HIV/AIDS official development assistance. Design An empirical analysis using dynamic panel Generalized Method of Moments estimation was conducted on 2001–2010 datasets. Results Control of corruption and democratic accountability revealed an independent effect and interaction with the amount of HIV/AIDS aid on incidence of HIV/AIDS, respectively, while none of the two governance variables had a significant effect on HIV/AIDS prevalence. Specifically, in countries with accountability level below −2.269, aid has a detrimental effect on incidence of HIV/AIDS. Conclusion The study findings suggest that aid programs need to be preceded or at least accompanied by serious efforts to improve governance in recipient countries and that democratic accountability ought to receive more critical attention. PMID:27189199

Study on Control of Security and Storage of Holdings: A RAMP Study with Guidelines.

ERIC Educational Resources Information Center

Thomas, D. L.

Intended to assist developing countries in the essential task of preserving historical records and, therefore, deliberately oriented towards economy and a low level of technology, this study provides an outline of currently accepted standards that archivists in developing countries, especially those in tropical areas, can apply to their own…

Backbone of complex networks of corporations: the flow of control.

PubMed

Glattfelder, J B; Battiston, S

2009-09-01

We present a methodology to extract the backbone of complex networks based on the weight and direction of links, as well as on nontopological properties of nodes. We show how the methodology can be applied in general to networks in which mass or energy is flowing along the links. In particular, the procedure enables us to address important questions in economics, namely, how control and wealth are structured and concentrated across national markets. We report on the first cross-country investigation of ownership networks, focusing on the stock markets of 48 countries around the world. On the one hand, our analysis confirms results expected on the basis of the literature on corporate control, namely, that in Anglo-Saxon countries control tends to be dispersed among numerous shareholders. On the other hand, it also reveals that in the same countries, control is found to be highly concentrated at the global level, namely, lying in the hands of very few important shareholders. Interestingly, the exact opposite is observed for European countries. These results have previously not been reported as they are not observable without the kind of network analysis developed here.

Backbone of complex networks of corporations: The flow of control

NASA Astrophysics Data System (ADS)

Glattfelder, J. B.; Battiston, S.

2009-09-01

We present a methodology to extract the backbone of complex networks based on the weight and direction of links, as well as on nontopological properties of nodes. We show how the methodology can be applied in general to networks in which mass or energy is flowing along the links. In particular, the procedure enables us to address important questions in economics, namely, how control and wealth are structured and concentrated across national markets. We report on the first cross-country investigation of ownership networks, focusing on the stock markets of 48 countries around the world. On the one hand, our analysis confirms results expected on the basis of the literature on corporate control, namely, that in Anglo-Saxon countries control tends to be dispersed among numerous shareholders. On the other hand, it also reveals that in the same countries, control is found to be highly concentrated at the global level, namely, lying in the hands of very few important shareholders. Interestingly, the exact opposite is observed for European countries. These results have previously not been reported as they are not observable without the kind of network analysis developed here.

Global partnerships are critical to advance the control of Neglected Zoonotic Diseases: The case of the Global Alliance for Rabies Control.

PubMed

Nel, Louis H; Taylor, Louise H; Balaram, Deepashree; Doyle, Kim A S

2017-01-01

There is a need for innovation to improve control of all Neglected Zoonotic Diseases (NZDs). The Global Alliance for Rabies Control was formed to prevent human deaths from rabies and relieve the burden of rabies in other animal populations, especially dogs. It aims to identify reasons for the neglect of rabies in developing countries and to develop strategies to improve rabies control. Through initiatives such as World Rabies Day and the Partners for Rabies Prevention, progress has been made towards increased awareness of the burden of rabies transmitted by dogs at scales from local to international. An evidence base of the feasibility of canine rabies elimination has been built up and now easier access to information and tools enables countries to design and implement rabies elimination strategies in a logical way, utilizing the structures of regional networks for rabies control. The body of evidence has built consensus amongst international stakeholders in rabies control and is now being used to encourage international policy change, attract investment and increase delivery of effective rabies control programmes in canine rabies endemic countries. Copyright © 2015 Elsevier B.V. All rights reserved.

Disease control priorities in developing countries: health policy responses to epidemiological change.

PubMed Central

Jamison, D T; Mosley, W H

1991-01-01

Health systems in developing countries are facing major challenges in the 1990s and beyond because of a growing epidemiological diversity as a consequence of rapid economic development and declining fertility. The infectious and parasitic diseases of childhood must remain a priority at the same time the chronic diseases among adults are emerging as a serious problem. Health policymakers must engage in undertaking an epidemiological and economic analysis of the major disease problems, evaluating the cost-effectiveness of alternative intervention strategies; designing health care delivery systems; and, choosing what governments can do through persuasion, taxation, regulation, and provision of services. The World Bank has commissioned studies of over two dozen diseases in developing countries which have confirmed the priority of child survival interventions and revealed that interventions for many neglected and emerging adult health problems have comparable cost-effectiveness. Most developing countries lack information about most major diseases among adults, reflecting lack of national capacities in epidemiological and economic analyses, health technology assessment, and environmental monitoring and control. There is a critical need for national and international investment in capacity building and essential national health research to build the base for health policies. PMID:1983911

Clinical guidelines in the European Union: mapping the regulatory basis, development, quality control, implementation and evaluation across member states.

PubMed

Legido-Quigley, Helena; Panteli, Dimitra; Brusamento, Serena; Knai, Cécile; Saliba, Vanessa; Turk, Eva; Solé, Meritxell; Augustin, Uta; Car, Josip; McKee, Martin; Busse, Reinhard

2012-10-01

Clinical guidelines are advocated to improve the quality of care, especially for chronic diseases. However, the regulatory basis of clinical guidelines, their development, quality control, implementation and use as well as evaluation within countries across the European Union is not systematically known. Using information collected from key informants in each country by means of a structured questionnaire, this mapping exercise illustrates the varied status of guideline production in European Union countries. Most European Union countries have an established national, regional or local clinical guideline programme, and a substantial proportion have developed guidelines on the prevention and management of chronic diseases. Several countries have mechanisms in place to ensure the quality of scientific evidence used for the development of guidelines is high and that the process is consistent and transparent. Others are only now taking an interest in guideline development and are taking the first steps towards establishing ways of implementing them. The majority of countries have no legal basis for the development of guidelines and those that have well established systems mostly implement them on a voluntary basis. The process of guideline development varies in its degrees of decentralisation across countries with many different types of organisations taking on this responsibility. There is general acceptance of the value of the instrument developed by the AGREE collaboration for evaluating the methodological robustness of guidelines. However, the extent to which guidelines are implemented in Europe is unknown, as there is no systematic data collection and, in most countries, no structure to enable it. There are few examples of formal evaluations of the development, quality, implementation and use of guidelines. Our findings call for renewed efforts to respond to the severe lack of standardized guideline terminology and accessibility as well as rigorous studies to evaluate the relationship between different ways to develop guidelines and their methodological quality, between their quality and the actual implementation and usage, and finally between implementation and health outcomes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Strategy to combat obesity and to promote physical activity in Arab countries

PubMed Central

Musaiger, Abdulrahman O; Al Hazzaa, Hazzaa M; Al-Qahtani, Aayed; Elati, Jalila; Ramadan, Jasem; AboulElla, Nebal A; Mokhtar, Najat; Kilani, Hashem A

2011-01-01

Obesity has become a major public health problem in the Arab countries, creating a health and economic burden on these countries’ government services. There is an urgent need to develop a strategy for prevention and control of obesity. The third Arab Conference on Obesity and Physical Activity was held in Bahrain in January 2010, and proposed the Strategy to Combat Obesity and Promote Physical Activity in Arab Countries. This strategy provides useful guidelines for each Arab country to prepare its own strategy or plan of action to prevent and control obesity. The strategy focused on expected outcomes, objectives, indicators to measure the objectives, and action needs for 9 target areas: child-care centers for preschool children, schools, primary health care, secondary care, food companies, food preparation institutes, media, public benefit organizations, and the workplace. Follow-up and future developments of this strategy were also included. PMID:21660292

A roadmap for development of sustainable E-waste management system in India.

PubMed

Wath, Sushant B; Vaidya, Atul N; Dutt, P S; Chakrabarti, Tapan

2010-12-01

The problem of E-waste has forced Environmental agencies of many countries to innovate, develop and adopt environmentally sound options and strategies for E-waste management, with a view to mitigate and control the ever growing threat of E-waste to the environment and human health. E-waste management is given the top priority in many developed countries, but in rapid developing countries like India, it is difficult to completely adopt or replicate the E-waste management system in developed countries due to many country specific issues viz. socio-economic conditions, lack of infrastructure, absence of appropriate legislations for E-waste, approach and commitments of the concerned, etc. This paper presents a review and assessment of the E-waste management system of developed as well as developing countries with a special emphasis on Switzerland, which is the first country in the world to have established and implemented a formal E-waste management system and has recycled 11kg/capita of WEEE against the target of 4kg/capita set by EU. And based on the discussions of various approaches, laws, legislations, practices of different countries, a road map for the development of sustainable and effective E-waste management system in India for ensuring environment, as well as, occupational safety and health, is proposed. Copyright © 2010 Elsevier B.V. All rights reserved.

Micro-Loans, Insecticide-Treated Bednets, and Malaria: Evidence from a Randomized Controlled Trial in Orissa, India.

PubMed

Tarozzi, Alessandro; Mahajan, Aprajit; Blackburn, Brian; Kopf, Dan; Krishnan, Lakshmi; Yoong, Joanne

2014-07-01

We describe findings from the first large-scale cluster randomized controlled trial in a developing country that evaluates the uptake of a health-protecting technology, insecticide-treated bednets (ITNs), through micro-consumer loans, as compared to free distribution and control conditions. Despite a relatively high price, 52 percent of sample households purchased ITNs, highlighting the role of liquidity constraints in explaining earlier low adoption rates. We find mixed evidence of improvements in malaria indices. We interpret the results and their implications within the debate about cost sharing, sustainability and liquidity constraints in public health initiatives in developing countries.

The Energy Puzzle Between the United States and China

DTIC Science & Technology

2013-03-01

information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM...development, energy growth and developments in energy technology. It concludes with the best case scenario of the two countries building a trust that...development, energy growth and developments in energy technology. It concludes with the best case scenario of the two countries building a trust that will

The "expert patient" approach for non-communicable disease management in low and middle income settings: When the reality confronts the rhetoric.

PubMed

Xiao, Yue

2015-09-01

This paper seeks to explore the relevance between the Western "expert patient" rhetoric and the reality of non-communicable diseases (NCDs) control and management in low and middle income settings from the health sociological perspective. It firstly sets up a conceptual framework of the "expert patient" or the patient self-management approach, showing the rhetoric of the initiative in the developed countries. Then by examining the situation of NCDs control and management in low income settings, the paper tries to evaluate the possibilities of implementing the "expert patient" approach in these countries. Kober and Van Damme's study on the relevance of the "expert patient" for an HIV/AIDS program in low income settings is critically studied to show the relevance of the developed countries' rhetoric of the "expert patient" approach for the reality of developing countries. In addition, the MoPoTsyo diabetes peer educator program is analyzed to show the challenges faced by the low income countries in implementing patient self-management programs. Finally, applications of the expert patient approach in China are discussed as well, to remind us of the possible difficulties in introducing it into rural settings.

Academic and Administrative Audit: A Parameter of Quality Education

ERIC Educational Resources Information Center

Nitonde, Rohidas; Jadhav, B. U.

2015-01-01

Academic and Administrative Audit (AAA) is a system to control and maintain high standards in the field of Higher Education. It is playing vital role in providing quality education to the learners all over the world. In addition to the developed countries, even the developing as well as underdeveloped countries, are now-a-days coming forward in…

Self-Control, Diet Concerns and Eater Prototypes Influence Fatty Foods Consumption of Adolescents in Three Countries

ERIC Educational Resources Information Center

Gerrits, Joanne H.; O'Hara, Ross E.; Piko, Bettina F.; Gibbons, Frederick X.; de Ridder, Denise T. D.; Keresztes, Noemi; Kamble, Shanmukh V.; de Wit, John B. F.

2010-01-01

As adolescent overweight has become a widespread problem in the developed world, it is timely to understand commonalities underlying dietary practices across countries. This study examines whether consumption of fruits and vegetables and fatty foods among adolescents in different countries is related to the same individual difference and social…

Occupational asthma in the developing and industrialised world: a review.

PubMed

Jeebhay, M F; Quirce, S

2007-02-01

Occupational asthma is the most common occupational lung disease in industrialised countries, and the second most common occupational lung disease reported after pneumoconioses in developing countries. The median proportion of adult cases of asthma attributable to occupational exposure is between 10% and 15%. The population attributable fraction appears to be similar in industrialised and developing countries characterised by rapid industrialisation (13-15%), but lower in less industrialised developing countries (6%). The high-risk occupations and industries associated with the development of occupational asthma vary depending on the dominant industrial sectors in a particular country. High-risk exposure to cleaning agents and pesticide exposure in developing countries appear to be as important as exposure to isocyanates, cereal flour/grain dust, welding fumes, wood dust and, more recently, hairdressing chemicals, commonly reported in industrialised countries. The reported mean annual incidence of occupational asthma in developing countries is less than 2 per 100 000 population, compared to very high rates of up to 18/100 000 in Scandinavian countries. While occupational asthma remains under-recognised, especially in developing countries, it remains poorly diagnosed and managed and inadequately compensated worldwide. Primary and secondary preventive strategies should be directed at controlling workplace exposures, accompanied by intense educational and managerial improvements. Appropriate treatment remains early removal from exposure to ensure that the worker has no further exposure to the causal agent, with preservation of income. However, up to one third of workers with occupational asthma continue to remain exposed to the causative agent or suffer prolonged work disruption, discrimination and risk of unemployment.

The niche reduction approach: an opportunity for optimal control of infectious diseases in low-income countries?

PubMed

Roche, Benjamin; Broutin, Hélène; Choisy, Marc; Godreuil, Sylvain; de Magny, Guillaume Constantin; Chevaleyre, Yann; Zucker, Jean-Daniel; Breban, Romulus; Cazelles, Bernard; Simard, Frédéric

2014-07-25

During the last century, WHO led public health interventions that resulted in spectacular achievements such as the worldwide eradication of smallpox and the elimination of malaria from the Western world. However, besides major successes achieved worldwide in infectious diseases control, most elimination/control programs remain frustrating in many tropical countries where specific biological and socio-economical features prevented implementation of disease control over broad spatial and temporal scales. Emblematic examples include malaria, yellow fever, measles and HIV. There is consequently an urgent need to develop affordable and sustainable disease control strategies that can target the core of infectious diseases transmission in highly endemic areas. Meanwhile, although most pathogens appear so difficult to eradicate, it is surprising to realize that human activities are major drivers of the current high rate of extinction among upper organisms through alteration of their ecology and evolution, i.e., their "niche". During the last decades, the accumulation of ecological and evolutionary studies focused on infectious diseases has shown that the niche of a pathogen holds more dimensions than just the immune system targeted by vaccination and treatment. Indeed, it is situated at various intra- and inter- host levels involved on very different spatial and temporal scales. After developing a precise definition of the niche of a pathogen, we detail how major advances in the field of ecology and evolutionary biology of infectious diseases can enlighten the planning and implementation of infectious diseases control in tropical countries with challenging economic constraints. We develop how the approach could translate into applied cases, explore its expected benefits and constraints, and we conclude on the necessity of such approach for pathogen control in low-income countries.

Injuries and noncommunicable diseases: emerging health problems of children in developing countries.

PubMed

Deen, J L; Vos, T; Huttly, S R; Tulloch, J

1999-01-01

The present article identifies, for children living in developing countries, the major causes of ill-health that are inadequately covered by established health programmes. Injuries and noncommunicable diseases, notably asthma, epilepsy, dental caries, diabetes mellitus and rheumatic heart disease, are growing in significance. In countries where resources are scarce it is to be expected that increasing importance will be attached to the development and implementation of measures against these problems. Their control may benefit from the application of elements of programmes directed against infectious, nutritional and perinatal disorders, which continue to predominate.

[Tuberculosis and its control--lessons from the past and future prospect].

PubMed

Shimao, Tadao

2005-06-01

Koch R reported the discovery of tubercle bacilli on March 24, 1882, and the numbers of death from phthisis were collected in the vital statistics from the latter half of 1883 in Japan. Tuberculosis death was officially adopted in the Japanese vital statistics from 1899, and there was certain disagreement existed between the numbers of death from TB and phthisis in 1899, the analysis on the trend of TB in Japan was done based on TB death. Trend of TB in Japan in the past 100 years could be divided into five phases. In phase 1 (1899-1918), TB mortality had increased with the first industrialization of Japan with main focus on the weaving industry. During this period, TB mortality of female was higher than that of male and then major victims of TB were young girls born from 1890 to 1925. In phase 2 (1918-1930), TB mortality decreased through excess death of TB cases by the influenza pandemic in 1918. This decline due to influenza pandemic was seen all over the world, and in the European countries and the U.S., the decline continued up to 1945 while in Japan, TB had increased again in the phase 3 (1930-1945) mainly due to second industrialization with main focus on heavy industry and the impact of quasi-war and war conditions. In phase 4 (1945-mid 1970s), TB started to decline fast due to the excess death of TB cases during the World War II and then, the application of modern TB control started from early 1950s. In phase 5 (from mid 1970s until now), decline of TB has showed down. Increase or slowdown of TB decline was seen nearly all countries of the world, however, its causes were different from country to country. In case of Japan, slowdown was caused by the rapid ageing of the population, in developing countries mainly by the impact of HIV epidemic and in industrialized countries, mainly by the migration of the population and partly by the HIV epidemic. Contribution of phthisiology in Japan to the global progress of phthisiology could be summarized as follows: elucidation of the pathogenesis of TB when TB was highly prevalent in Japan by high incidence of TB from primarily infected youth, the development of mass screening for TB using radiophotography technique developed in Japan, completion of the interpretation method of chest X-ray findings, first success in the mass production of freeze-dried BCG vaccine in the world, the first implementation of the TB prevalence survey using random sampling method in 1953, and the development of a new drug for TB, kanamycin. Phthisiology also contributed to the progress of international health. As the objective index to measure the magnitude of TB problem, the concept of annual risk of TB infection (ARTI) was introduced by Sutherland and Styblo, and by using ARTI, the epidemiological situation of TB could be divided into 3 categories; high prevalence country with ARTI above 1%, low prevalence country below 0.05-0.1%, and middle prevalence country inbetween. To reduce the burden of TB in high prevalence countries, so-called DOTS strategy of TB control was introduced and has been applied in most developing countries, and the gap between high and low prevalence countries has reduced in the past decade. Cooperation in global TB control has also been done actively from the government and NGOs of industrialized countries under the strong leadership of WHO. For the success of TB control, the transmission of tubercle bacilli in a community should be cut either infection, onset of TB or the progress of TB. Prevention of TB infection could be achieved by the early detection of TB cases and their cure by the treatment. To encourage early visit to doctors for those with symptoms suggesting TB and adequate examinations at medical institutions for these persons would be a major tool of early detection of TB cases in Japan in the future. In addition, there is no doubt to intensify contacts examinations and source investigations. It is hoped to elucidate recent pathogenesis of TB by applying new technologies such as QFT and RFLP. Prevention of onset of TB will be focused on the preventive use of TB drugs, however, development of new vaccine better than BCG is also encouraged for the developing countries where the risk of TB infection is remained high. TB is now a curable disease, and the duration of treatment has been shortened to 6 months. If new more potent TB drugs were developed, and the total duration of treatment could be shortened, the global TB control could be done much more easily, and also most MDRTB cases could be cured. Otsuka Pharmaceutical Company is now developing a new potent drug which has no cross resistance with existing TB drugs. This new drug is now on the clinical trial phase II, and it is hoped that Japan can make another great contribution to the global TB control. It is my sincere wish that the government continues to assist the research to develop new TB drugs and new technologies used in TB control, and in future, if it is needed to change the current policy of TB control, a new policy should be tried in a pilot area before its introduction on national level. The Japanese Society for TB is a key organization in developing further research and the training of new personnel engaging in TB research and control, and I sincerely hope further development of the Society.

[Status of research and development for control of tropical diseases: hypocrisy, indifference or lack of coordination].

PubMed

Millet, P

2006-12-01

Tropical diseases neglected by the pharmaceutical industry usually involve developing countries. Neglected diseases can now be divided into two groups. The first includes the big three infections i.e., malaria, HIV/AIDS, and tuberculosis, that present strategic and political overtones. The second group includes a host of other fatal infections including worms, trypanosomiasis, and leishmaniasis. Fundamental research on neglected diseases has been highly productive, but there has been little success in transferring research findings to a pharmaceutical industry unwilling to take the risks associated with developing new drugs on its own. However several public-private initiatives have revived hopes of developing new products with growing involvement of industries in developing countries (India and Brazil) despite the high risks associated with fluctuating demand for medicines or funding shortages. To meet the need for testing new drugs, more clinical facilities and better patient recruitment will be needed in endemic countries. Although these new efforts to control neglected diseases are encouraging, there is now a need for coordination. Clinical research in developing countries must be organized in compliance with international principles of ethics. Testing must be aimed at validating fundamental data from industrialized countries. Appropriate incentives must be given to ensure that pharmaceutical companies use research findings for new product development. In this context, the time seems ripe for the establishment of an independent laboratory for technological innovation in neglected diseases. Such a facility could not only validate scientific data but also supervise the development of clinical applications from research data.

Selective primary health care: an interim strategy for disease control in developing countries.

PubMed

Walsh, J A; Warren, K S

1979-11-01

Priorities among the infectious diseases affecting the three billion people in the less developed world have been based on prevalence, morbidity, mortality and feasibility of control. With these priorities in mind a program of selective primary health care is compared with other approaches and suggested as the most cost-effective form of medical intervention in the least developed countries. A flexible program delivered by either fixed or mobile units might include measles and diphtheria-pertussis-tetanus vaccination, treatment for febrile malaria and oral rehydration for diarrhea in children, and tetanus toxoid and encouragement of breast feeding in mothers. Other interventions might be added on the basis of regional needs and new developments. For major diseases for which control measures are inadequate, research is an inexpensive approach on the basis of cost per infected person per year.

Poor nutrition is a serious problem in children with cerebral palsy in Palawan, the Philippines.

PubMed

Socrates, C; Grantham-McGregor, S M; Harknett, S G; Seal, A J

2000-09-01

Children with cerebral palsy (CP) in developed countries have poor nutritional status; however there is little data from developing countries. In Palawan, in the Philippines, the nutritional status of 31 children with CP was compared to that of their siblings (n = 20) and a control group of neighbourhood children (n = 64), matched for age and sex. The children's weights, heights and armspans were measured. The heights of children with CP could not be measured and were estimated from their armspans using an equation relating height to armspan in siblings and controls. Haemoglobin levels of the study cases and siblings were measured. Siblings and controls had similar nutritional status. The children with CP had extremely poor nutritional status, and had significantly smaller weights for height, heights for age and weights for age than siblings or controls. Haemoglobin levels were not significantly different between the children with CP and their siblings. The nutritional status of children with quadriplegic CP was much poorer than that of similar children in the USA. The severity of malnutrition in children with CP is likely to be detrimental to their development, and a nutritional component should be incorporated into rehabilitation programmes. Also, there is a need to examine the nutritional status of children with CP in other developing countries.

Guidelines for Analysis of Communicable Disease Control Planning in Developing Countries. Volume 1: Communicable Diseases Control Planning. International Health Planning Methods Series.

ERIC Educational Resources Information Center

Chin, James

Intended to assist Agency for International Development (AID) officers, advisors, and health officials in incorporating health planning into national plans for economic development, this first of ten manuals in the International Health Planning Methods Series deals with planning and evaluation of communicable disease control programs. The first…

Equity and adequacy of international donor assistance for global malaria control: an analysis of populations at risk and external funding commitments.

PubMed

Snow, Robert W; Okiro, Emelda A; Gething, Peter W; Atun, Rifat; Hay, Simon I

2010-10-23

Financing for malaria control has increased as part of international commitments to achieve the Millennium Development Goals (MDGs). We aimed to identify the unmet financial needs that would be biologically and economically equitable and would increase the chances of reaching worldwide malaria-control ambitions. Populations at risk of stable Plasmodium falciparum or Plasmodium vivax transmission were calculated for 2007 and 2009 for 93 malaria-endemic countries to measure biological need. National per-person gross domestic product (GDP) was used to define economic need. An analysis of external donor assistance for malaria control was done for the period 2002-09 to compute overall and annualised per-person at-risk-funding commitments. Annualised malaria donor assistance was compared with independent predictions of funding needed to reach international targets of 80% coverage of best practices in case-management and effective disease prevention. Countries were ranked in relation to biological, economic, and unmet needs to examine equity and adequacy of support by 2010. International financing for malaria control has increased by 166% (from $0·73 billion to $1·94 billion) since 2007 and is broadly consistent with biological needs. African countries have become major recipients of external assistance; however, countries where P vivax continues to pose threats to control ambitions are not as well funded. 21 countries have reached adequate assistance to provide a comprehensive suite of interventions by 2009, including 12 countries in Africa. However, this assistance was inadequate for 50 countries representing 61% of the worldwide population at risk of malaria-including ten countries in Africa and five in Asia that coincidentally are some of the poorest countries. Approval of donor funding for malaria control does not correlate with GDP. Funding for malaria control worldwide is 60% lower than the US$4·9 billion needed for comprehensive control in 2010; this includes funding shortfalls for a wide range of countries with different numbers of people at risk and different levels of domestic income. More efficient targeting of financial resources against biological need and national income should create a more equitable investment portfolio that with increased commitments will guarantee sustained financing of control in countries most at risk and least able to support themselves. Wellcome Trust. Copyright © 2010 Elsevier Ltd. All rights reserved.

Equity and adequacy of international donor assistance for global malaria control: an analysis of populations at risk and external funding commitments

PubMed Central

Snow, Robert W; Okiro, Emelda A; Gething, Peter W; Atun, Rifat; Hay, Simon I

2010-01-01

Summary Background Financing for malaria control has increased as part of international commitments to achieve the Millennium Development Goals (MDGs). We aimed to identify the unmet financial needs that would be biologically and economically equitable and would increase the chances of reaching worldwide malaria-control ambitions. Methods Populations at risk of stable Plasmodium falciparum or Plasmodium vivax transmission were calculated for 2007 and 2009 for 93 malaria-endemic countries to measure biological need. National per-person gross domestic product (GDP) was used to define economic need. An analysis of external donor assistance for malaria control was done for the period 2002–09 to compute overall and annualised per-person at-risk-funding commitments. Annualised malaria donor assistance was compared with independent predictions of funding needed to reach international targets of 80% coverage of best practices in case-management and effective disease prevention. Countries were ranked in relation to biological, economic, and unmet needs to examine equity and adequacy of support by 2010. Findings International financing for malaria control has increased by 166% (from $0·73 billion to $1·94 billion) since 2007 and is broadly consistent with biological needs. African countries have become major recipients of external assistance; however, countries where P vivax continues to pose threats to control ambitions are not as well funded. 21 countries have reached adequate assistance to provide a comprehensive suite of interventions by 2009, including 12 countries in Africa. However, this assistance was inadequate for 50 countries representing 61% of the worldwide population at risk of malaria—including ten countries in Africa and five in Asia that coincidentally are some of the poorest countries. Approval of donor funding for malaria control does not correlate with GDP. Interpretation Funding for malaria control worldwide is 60% lower than the US$4·9 billion needed for comprehensive control in 2010; this includes funding shortfalls for a wide range of countries with different numbers of people at risk and different levels of domestic income. More efficient targeting of financial resources against biological need and national income should create a more equitable investment portfolio that with increased commitments will guarantee sustained financing of control in countries most at risk and least able to support themselves. Funding Wellcome Trust. PMID:20889199

Foot-and-mouth disease in pigs: current epidemiological situation and control methods.

PubMed

León, Emilio A

2012-03-01

Foot-and-mouth disease (FMD) is the paradigm of a transboundary animal disease. Beyond any doubt, it is the most serious challenge for livestock's health. Official Veterinary Services from free countries invest considerable amount of money to prevent its introduction, whereas those from endemic countries invest most of their resources in the control of the disease. A very important volume of scientific production is developed every year in different aspects of FMD, and for that reason, the current knowledge makes the diagnosis of the disease easier to a great extent. However, FMD is still endemic in about two-thirds of the countries, and periodically re-emergent in several countries. This paper is a review of recent publications, focusing mainly on control measures and current world epidemiological situation, emphasizing primarily pigs. © 2012 Blackwell Verlag GmbH.

Culinary delights and travel? A review of zoonotic cestodiases and metacestodiases.

PubMed

Ito, Akira; Budke, Christine M

2014-01-01

Due to increased globalization, food-borne parasitic infections are becoming more prevalent worldwide, including in countries where these parasites and parasitic diseases had previously been well controlled or eradicated. Improved sanitation, health education, and establishment of appropriate food safety mechanisms can go a long way towards the control of many these infections. However, food-borne parasitic infections are still common diseases in developing countries, especially in rural areas. As many of today's travelers are looking to explore more distant locations and partake in the local cuisine, they may be at greater risk of acquiring a food-borne parasitic infection, including those caused by a number of adult and larval tapeworms. This review discusses fish and meat-borne tapeworms and zoonotic metacestodiases of public health importance to both developing and developed countries, with a focus on infection prevention in travelers. Copyright © 2014 Elsevier Ltd. All rights reserved.

Controlled population-based comparative study of USA and international adult [55-74] neurological deaths 1989-2014.

PubMed

Pritchard, C; Rosenorn-Lanng, E; Silk, A; Hansen, L

2017-12-01

A population-based controlled study to determine whether adult (55-74 years) neurological disease deaths are continuing to rise and are there significant differences between America and the twenty developed countries 1989-91 and 2012-14. Total Neurological Deaths (TND) rates contrasted against control Cancer and Circulatory Disease Deaths (CDD) extrapolated from WHO data. Confidence intervals compare USA and the other countries over the period. The Over-75's TND and population increases are examined as a context for the 55-74 outcomes. Male neurological deaths rose >10% in eleven countries, the other countries average rose 20% the USA 43% over the period. Female neurological deaths rose >10% in ten counties, averaging 14%, the USA up 68%. USA male and female neurological deaths increased significantly more than twelve and seventeen countries, respectively. USA over-75s population increased by 49%, other countries 56%. Other countries TND up 187% the USA rose fourfold. Male and female cancer and CDD fell in every country averaging 26% and 21%, respectively, and 64% and 67% for CDD. Male neurological rates rose significantly more than Cancer and CCD in every country; Female neurological deaths rose significantly more than cancer in 17 countries and every country for CDD. There was no significant correlation between increases in neurological deaths and decreases in control mortalities. There are substantial increases in neurological deaths in most countries, significantly so in America. Rises in the 55-74 and over-75's rates are not primarily due to demographic changes and are a matter of concern warranting further investigation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Research Agenda for Helminth Diseases of Humans: Health Research and Capacity Building in Disease-Endemic Countries for Helminthiases Control

PubMed Central

Osei-Atweneboana, Mike Y.; Lustigman, Sara; Prichard, Roger K.; Boatin, Boakye A.; Basáñez, María-Gloria

2012-01-01

Capacity building in health research generally, and helminthiasis research particularly, is pivotal to the implementation of the research and development agenda for the control and elimination of human helminthiases that has been proposed thematically in the preceding reviews of this collection. Since helminth infections affect human populations particularly in marginalised and low-income regions of the world, they belong to the group of poverty-related infectious diseases, and their alleviation through research, policy, and practice is a sine qua non condition for the achievement of the United Nations Millennium Development Goals. Current efforts supporting research capacity building specifically for the control of helminthiases have been devised and funded, almost in their entirety, by international donor agencies, major funding bodies, and academic institutions from the developed world, contributing to the creation of (not always equitable) North–South “partnerships”. There is an urgent need to shift this paradigm in disease-endemic countries (DECs) by refocusing political will, and harnessing unshakeable commitment by the countries' governments, towards health research and capacity building policies to ensure long-term investment in combating and sustaining the control and eventual elimination of infectious diseases of poverty. The Disease Reference Group on Helminth Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR), was given the mandate to review helminthiases research and identify research priorities and gaps. This paper discusses the challenges confronting capacity building for parasitic disease research in DECs, describes current capacity building strategies with particular reference to neglected tropical diseases and human helminthiases, and outlines recommendations to redress the balance of alliances and partnerships for health research between the developed countries of the “North” and the developing countries of the “South”. We argue that investing in South–South collaborative research policies and capacity is as important as their North–South counterparts and is essential for scaled-up and improved control of helminthic diseases and ultimately for regional elimination. PMID:22545167

Can Social-Emotional Learning Reduce School Dropout in Developing Countries?

ERIC Educational Resources Information Center

Wang, Huan; Chu, James; Loyalka, Prashant; Xin, Tao; Shi, Yaojiang; Qu, Qinghe; Yang, Chu

2016-01-01

An alarming number of students drop out of junior high school in developing countries. In this study, we examine the impacts of providing a social-emotional learning (SEL) program on the dropout behavior and learning anxiety of students in the first two years of junior high. We do so by analyzing data from a randomized controlled trial involving…

Survey report; health needs of the 21st century.

PubMed

Raymond, S U

1989-01-01

Sustainability of development assistance programs depends greatly on the perceptions of priorities by recipient countries. A written survey was sent by the Catholic University of America's Institute for International Health and Development to 66 ministers of health in low-income and middle-income countries to assess their views of priority problems in health sector development. Response rate was 33%, coming from countries with highly diverse gross national products (GNPs), growth rates, mortality rates and life expectancies. Nevertheless, there was widespread agreement about priorities: 1) meeting costs of health care; 2) improving health care management and administration; and 3) extending communicable disease control. Communicable disease control and child health programs were more important to low-income countries than to middle-income countries. Costs, management and administration and the control of noncommunicable diseases were predicted to increase in importance. In demographics, urbanization, overall population growth and shift of workers from agriculture to industry and services were seen as the major problems of the past, and urbanization and the aging of populations accompanied by increasing life expectancies the major challenges of the future. Highest predicted training needs were for system managers and paramedical personnel. Government budgets, user fees and donor agencies were seen as the most important sources of past funding, with social security systems and fee-based payments increasing in importance in the future. The role of donor agencies would increase as would the need for more responsiveness. Future uncertainties include national economic growth, environmental problems, issues in ethics and changes in disease and technology.

Achieving the Framework Convention on Tobacco Control's potential by investing in national capacity.

PubMed

Wipfli, H; Stillman, F; Tamplin, S; da Costa e Silva, V Luiza; Yach, D; Samet, J

2004-12-01

May 2003 marked a critical achievement in efforts to stem the global tobacco epidemic, as the member states of the World Health Organization unanimously endorsed the Framework Convention on Tobacco Control (FCTC). However, the adoption of the FCTC signifies only the end of the beginning of effective global action to control tobacco. Over the next several years the utility of the FCTC process and the treaty itself will be tested as individual countries seek to ratify and implement the treaty's obligations. Significant barriers to the treaty's long term success exist in many countries. It is crucial that the international tobacco control community now refocuses its efforts on national capacity building and ensures that individual countries have the knowledge, tools, data, people, and organisations needed to implement the convention and develop sustained tobacco control programmes. This paper provides a model of national tobacco control capacity and offers a prioritised agenda for action.

Early accelerated senescence of circulating endothelial progenitor cells in premature coronary artery disease patients in a developing country - a case control study.

PubMed

Vemparala, Kranthi; Roy, Ambuj; Bahl, Vinay Kumar; Prabhakaran, Dorairaj; Nath, Neera; Sinha, Subrata; Nandi, Pradipta; Pandey, Ravindra Mohan; Reddy, Kolli Srinath; Manhapra, Ajay; Lakshmy, Ramakrishnan

2013-11-19

The decreased number and senescence of circulating endothelial progenitor cells (EPCs) are considered markers of vascular senescence associated with aging, atherosclerosis, and coronary artery disease (CAD) in elderly. In this study, we explore the role of vascular senescence in premature CAD (PCAD) in a developing country by comparing the numerical status and senescence of circulating EPCs in PCAD patients to controls. EPCs were measured by flow cytometry in 57 patients with angiographically documented CAD, and 57 controls without evidence of CAD, recruited from random patients ≤ 50 years of age at All India Institute of Medical Sciences. EPC senescence as determined by telomere length (EPC-TL) and telomerase activity (EPC-TA) was studied by real time polymerase chain reaction (q PCR) and PCR- ELISA respectively. The number of EPCs (0.18% Vs. 0.039% of total WBCs, p < 0.0001), and EPC-TL (3.83 Vs. 5.10 kb/genome, p = 0.009) were markedly lower in PCAD patients compared to controls. These differences persisted after adjustment for age, sex, BMI, smoking and medications. EPC-TA was reduced in PCAD patients, but was statistically significant only after adjustment for confounding factors (1.81 Vs. 2.20 IU/cell, unadjusted p = 0.057, adjusted p = 0.044). We observed an association between increased vascular cell senescence with PCAD in a sample of young patients from India. This suggests that early accelerated vascular cell senescence may play an important mechanistic role in CAD epidemic in developing countries like India where PCAD burden is markedly higher compared to developed countries.

Building capacity for implementation of the framework convention for tobacco control in Vietnam: lessons for developing countries

PubMed Central

Stillman, Frances A.; David, Annette M.; Kibria, Naseeb; Phan, Hai Thi

2014-01-01

Effective implementation of the WHO international Framework Convention on Tobacco Control (FCTC) is the key to controlling the tobacco epidemic. Within countries, strong national tobacco control capacity is the primary determinant for successful implementation of the FCTC. This case study of tobacco control policy describes the experience of building national tobacco control capacity in Vietnam under the Reduce Smoking in Vietnam Partnership project within a national capacity-building framework. In the Vietnam experience, four components of tobacco control capacity emerged as especially important to achieve ‘quality’ outputs and measurable outcomes at the implementation level: (i) organizational structure/infrastructure; (ii) leadership and expertise; (iii) partnerships and networks and (iv) data and evidence from research. The experience gained in this project helps in adapting our tobacco control capacity-building model, and the lessons that emerged from this country case study can provide guidance to global funders, tobacco control technical assistance providers and nations as governments endeavor to meet their commitment to the FCTC. PMID:23411160

Evaluation of vaccines against enteric infections: a clinical and public health research agenda for developing countries

PubMed Central

Clemens, John

2011-01-01

Enteric infections are a major cause of morbidity and mortality in developing countries. To date, vaccines have played a limited role in public health efforts to control enteric infections. Licensed vaccines exist for cholera and typhoid, but these vaccines are used primarily for travellers; and there are two internationally licensed vaccines for rotavirus, but they are mainly used in affluent countries. The reasons that enteric vaccines are little used in developing countries are multiple, and certainly include financial and political constraints. Also important is the need for more cogent evidence on the performance of enteric vaccines in developing country populations. A partial inventory of research questions would include: (i) does the vaccine perform well in the most relevant settings? (ii) does the vaccine perform well in all epidemiologically relevant age groups? (iii) is there adequate evidence of vaccine safety once the vaccines have been deployed in developing countries? (iv) how effective is the vaccine when given in conjunction with non-vaccine cointerventions? (v) what is the level of vaccine protection against all relevant outcomes? and (vi) what is the expected population level of vaccine protection, including both direct and herd vaccine protective effects? Provision of evidence addressing these questions will help expand the use of enteric vaccines in developing countries. PMID:21893543

Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control.

PubMed

Gilbert, Clare

2008-02-01

Globally at least 50,000 children are blind from retinopathy of prematurity (ROP) which is now a significant cause of blindness in many middle income countries in Latin American and Eastern Europe. Retinopathy of prematurity is also being reported from the emerging economies of India and China. The characteristics of babies developing severe disease varies, with babies in middle and low income countries having a much wider range of birth weights and gestational ages than is currently the case in industrialized countries. Rates of disease requiring treatment also tend to be higher in middle and low income countries suggesting that babies are being exposed to risk factors which are, to a large extent, being controlled in industrialised countries. The reasons for this "third epidemic" of ROP are discussed as well as strategies for control, including the need for locally relevant, evidence based criteria which ensure that all babies at risk are examined.

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

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

Veterinary vaccines and their use in developing countries.

PubMed

Lubroth, J; Rweyemamu, M M; Viljoen, G; Diallo, A; Dungu, B; Amanfu, W

2007-04-01

The burden of infectious diseases in livestock and other animals continues to be a major constraint to sustained agricultural development, food security, and participation of developing and in-transition countries in the economic benefits of international trade in livestock commodities. Targeted measures must be instituted in those countries to reduce the occurrence of infectious diseases. Quality veterinary vaccines used strategically can and should be part of government sanctioned-programmes. Vaccination campaigns must be part of comprehensive disease control programmes, which, in the case of transboundary animal diseases, require a regional approach if they are to be successful. This paper focuses on the salient transboundary animal diseases and examines current vaccine use, promising vaccine research, innovative technologies that can be applied in countries in some important developing regions of the world, and the role of public/private partnerships.

USAID steps up anti-AIDS program.

PubMed

1991-01-01

This article considers the epidemic proportion of AIDS in developing countries, and discusses the U.S. Agency for International Development's (USAID) reworked and intensified strategy for HIV infection and AIDS prevention and control over the next 5 years. Developing and launching over 650 HIV and AIDS activities in 74 developing countries since 1986, USAID is the world's largest supporter of anti-AIDS programs. Over $91 million in bilateral assistance for HIV and AIDS prevention and control have been committed. USAID has also been the largest supporter of the World Health Organization's Global Program on AIDS since 1986. Interventions have included training peer educators, working to change the norms of sex behavior, and condom promotion. Recognizing that the developing world will increasingly account for an ever larger share of the world's HIV-infected population, USAID announced an intensified program of estimated investment increasing to approximately $400 million over a 5-year period. Strategy include funding for long-term, intensive interventions in 10-15 priority countries, emphasizing the treatment of other sexually transmitted diseases which facilitate the spread of HIV, making AIDS-related policy dialogue an explicit component of the Agency's AIDS program, and augmenting funding to community-based programs aimed at reducing high-risk sexual behaviors. The effect of AIDS upon child survival, adult mortality, urban populations, and socioeconomic development in developing countries is discussed. Program examples are also presented.

Implementing Impact Evaluations of Malaria Control Interventions: Process, Lessons Learned, and Recommendations

PubMed Central

Hershey, Christine L.; Bhattarai, Achuyt; Florey, Lia S.; McElroy, Peter D.; Nielsen, Carrie F.; Yé, Yazoume; Eckert, Erin; Franca-Koh, Ana Cláudia; Shargie, Estifanos; Komatsu, Ryuichi; Smithson, Paul; Thwing, Julie; Mihigo, Jules; Herrera, Samantha; Taylor, Cameron; Shah, Jui; Mouzin, Eric; Yoon, Steven S.; Salgado, S. René

2017-01-01

Abstract. As funding for malaria control increased considerably over the past 10 years resulting in the expanded coverage of malaria control interventions, so did the need to measure the impact of these investments on malaria morbidity and mortality. Members of the Roll Back Malaria (RBM) Partnership undertook impact evaluations of malaria control programs at a time when there was little guidance in terms of the process for conducting an impact evaluation of a national-level malaria control program. The President’s Malaria Initiative (PMI), as a member of the RBM Partnership, has provided financial and technical support for impact evaluations in 13 countries to date. On the basis of these experiences, PMI and its partners have developed a streamlined process for conducting the evaluations with a set of lessons learned and recommendations. Chief among these are: to ensure country ownership and involvement in the evaluations; to engage stakeholders throughout the process; to coordinate evaluations among interested partners to avoid duplication of efforts; to tailor the evaluation to the particular country context; to develop a standard methodology for the evaluations and a streamlined process for completion within a reasonable time; and to develop tailored dissemination products on the evaluation for a broad range of stakeholders. These key lessons learned and resulting recommendations will guide future impact evaluations of malaria control programs and other health programs. PMID:28990921

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

PubMed

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

2017-06-01

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

Global Budgeting in the OECD Countries

PubMed Central

Wolfe, Patrice R.; Moran, Donald W.

1993-01-01

Many of the Organization for Economic Cooperation and Development countries use global budgeting to control all or certain portions of their health care expenditures. Although the use of global budgets as a cost-containment tool has not been implemented in the United States in any comprehensive way, recent health care reform initiatives have increased the need for research into such tools. In general, the structure, process, and effectiveness of global budgets vary enormously from country to country, in part because the underlying social welfare system of each country is unique. PMID:10130584

Cross-National Analysis of the Associations among Mental Disorders and Suicidal Behavior: Findings from the WHO World Mental Health Surveys

PubMed Central

Nock, Matthew K.; Hwang, Irving; Sampson, Nancy; Kessler, Ronald C.; Angermeyer, Matthias; Beautrais, Annette; Borges, Guilherme; Bromet, Evelyn; Bruffaerts, Ronny; de Girolamo, Giovanni; de Graaf, Ron; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hu, Chiyi; Huang, Yueqin; Karam, Elie G.; Kawakami, Norito; Kovess, Viviane; Levinson, Daphna; Posada-Villa, Jose; Sagar, Rajesh; Tomov, Toma; Viana, Maria Carmen; Williams, David R.

2009-01-01

Background Suicide is a leading cause of death worldwide. Mental disorders are among the strongest predictors of suicide; however, little is known about which disorders are uniquely predictive of suicidal behavior, the extent to which disorders predict suicide attempts beyond their association with suicidal thoughts, and whether these associations are similar across developed and developing countries. This study was designed to test each of these questions with a focus on nonfatal suicide attempts. Methods and Findings Data on the lifetime presence and age-of-onset of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) mental disorders and nonfatal suicidal behaviors were collected via structured face-to-face interviews with 108,664 respondents from 21 countries participating in the WHO World Mental Health Surveys. The results show that each lifetime disorder examined significantly predicts the subsequent first onset of suicide attempt (odds ratios [ORs] = 2.9–8.9). After controlling for comorbidity, these associations decreased substantially (ORs = 1.5–5.6) but remained significant in most cases. Overall, mental disorders were equally predictive in developed and developing countries, with a key difference being that the strongest predictors of suicide attempts in developed countries were mood disorders, whereas in developing countries impulse-control, substance use, and post-traumatic stress disorders were most predictive. Disaggregation of the associations between mental disorders and nonfatal suicide attempts showed that these associations are largely due to disorders predicting the onset of suicidal thoughts rather than predicting progression from thoughts to attempts. In the few instances where mental disorders predicted the transition from suicidal thoughts to attempts, the significant disorders are characterized by anxiety and poor impulse-control. The limitations of this study include the use of retrospective self-reports of lifetime occurrence and age-of-onset of mental disorders and suicidal behaviors, as well as the narrow focus on mental disorders as predictors of nonfatal suicidal behaviors, each of which must be addressed in future studies. Conclusions This study found that a wide range of mental disorders increased the odds of experiencing suicide ideation. However, after controlling for psychiatric comorbidity, only disorders characterized by anxiety and poor impulse-control predict which people with suicide ideation act on such thoughts. These findings provide a more fine-grained understanding of the associations between mental disorders and subsequent suicidal behavior than previously available and indicate that mental disorders predict suicidal behaviors similarly in both developed and developing countries. Future research is needed to delineate the mechanisms through which people come to think about suicide and subsequently progress from ideation to attempts. Please see later in the article for Editors' Summary PMID:19668361

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

Not Available

Developing nations that are not members of the Organization of Petroleum Exporting Countries (OPEC) are not expected to suffer as much economic disruption from oil price increases and a US recession as happened during the 1973--1975 period. The latest price increase represents about 0.7 percent of their gross national product (GNP) compared to 2.5 percent in the earlier period. More non-OPEC developing countries are producing commercial quantities of oil and at least 14 are now net exporters. The effects of a US recession may not be as severe this time because it will not be synchronized with the business cyclesmore » of the major industrial countries. Developing countries can counteract a US recession by tightening their monetary policies, imposing import control, and other measures. Most of these countries have improved their balance of payments since 1975 and are in a position to handle disruptions.« less

International collaboration, funding and association with burden of disease in randomized controlled trials in Africa.

PubMed Central

Swingler, George H.; Pillay, Victoria; Pienaar, Elizabeth D.; Ioannidis, John P. A.

2005-01-01

OBJECTIVE: This study aimed to assess whether randomized controlled trials conducted in Africa with collaborators from outside Africa were more closely associated with health conditions that have a burden of disease that is of specific importance to Africa than with conditions of more general global importance or with conditions important to developed countries. We also assessed whether the source of funding influenced a study's relevance to Africa. METHODS: We compared randomized controlled trials performed in Africa that looked at diseases specifically relevant to Africa (as determined by burden of disease criteria) with trials classified as looking at diseases of global importance or diseases important to developed countries in order to assess differences in collaboration and funding. FINDINGS: Of 520 trials assessed, 347 studied diseases that are specifically important to Africa; 99 studied globally important diseases and 74 studied diseases that are important to developed countries. The strongest independent predictor of whether a study was of specifically African or global importance was the corresponding author's country of origin: African importance was negatively associated with a corresponding author being from South Africa (odds ratio (OR) = 0.04; 95% confidence interval (CI) = 0.02-0.10) but there was little difference between corresponding authors from other African countries and corresponding authors from countries outside Africa. The importance of a study to Africa was independently associated with having more non-African authors (OR per author = 1.31; 95% CI = 1.08-1.58), fewer trial sites (OR per site = 0.69; 95% CI = 0.50-0.96), and reporting of funding (OR = 2.14; 95% CI = 1.15-4.00). Similar patterns were present in the comparisons of trials studying diseases important to Africa versus those studying diseases important to developed countries with stronger associations overall. When funding was reported, private industry funding was negatively associated with African importance compared with global importance (OR = 0.31, P= 0.008 for African importance and OR = 0.51, P= 0.57 for importance for developed countries). CONCLUSION: The relevance to Africa of trials conducted in Africa was not adversely affected by collaboration with non-African researchers but funding from private industry was associated with a decreased emphasis on diseases relevant to Africa. PMID:16175825

Transcutaneous Electrical Nerve Stimulation (TENS) A Possible Aid for Pain Relief in Developing Countries?

PubMed Central

Tashani, O; Johnson, MI

2009-01-01

Transcutaneous electrical nerve stimulation (TENS) refers to the delivery of electrical currents through the skin to activate peripheral nerves. The technique is widely used in developed countries to relieve a wide range of acute and chronic pain conditions, including pain resulting from cancer and its treatment. There are many systematic reviews on TENS although evidence is often inconclusive because of shortcomings in randomised control trials methodology. In this overview the basic science behind TENS will be discussed, the evidence of its effectiveness in specific clinical conditions analysed and a case for its use in pain management in developing countries will be made. PMID:21483510

Preconception optimization of glycaemic control in diabetes.

PubMed

Islam, Najmul

2016-09-01

The prevalence of Diabetes Mellitus is increasing worldwide. In developing countries 25% of adult females with diabetes are in the reproductive age. Thus in developing countries increased number of pregnancies are complicated by diabetes. Uncontrolled diabetes in pregnancy is associated with increased risk for both mother and foetus. These risks can be minimized by good control of diabetes before and during pregnancy. Management in the preconception period is discussed in this review article. Detailed management involves general advice of lifestyle modification followed by specific details of screening for complications of diabetes. Changes in the drugs for both glycaemic control and other co-morbid conditions are discussed. The recommended insulin regimen in the preconception period and monitoring of glycaemic control by self-monitoring of blood glucose (SMBG) and HbA1C has also been highlighted.

WHO at country level.

PubMed

Lucas, A

1998-03-07

WHO's activities at country level have earned the organisation both criticism and praise. The organisation's technical publications are esteemed as authoritative guidelines for disease control. Successful disease-control programmes and contributions to health research have heightened WHO's reputation. The organisation has also provided the focus for evolution of important ideas, such as primary health care and the relevance of equity and other ethical issues. But WHO has been criticised for not adapting rapidly and logically to changes in the health field. With increasing national capacity in the more advanced developing countries, and with the involvement of new participants in the health sphere, the organisation needs to reassess its role at country level. My recommendation is that WHO improves its analytical capacity so that its programmes take into consideration the health needs of the country, its national capacity, and the contributions from other external agencies.

Understanding well-being and learning of Nigerian nurses: a job demand control support model approach.

PubMed

van Doorn, Yvonne; van Ruysseveldt, Joris; van Dam, Karen; Mistiaen, Wilhelm; Nikolova, Irina

2016-10-01

This study investigated whether Nigerian nurses' emotional exhaustion and active learning were predicted by job demands, control and social support. Limited research has been conducted concerning nurses' work stress in developing countries, such as Nigeria. Accordingly, it is not clear whether work interventions for improving nurses' well-being in these countries can be based on work stress models that are developed in Western countries, such as the job demand control support model, as well as on empirical findings of job demand control support research. Nurses from Nurses Across the Borders Nigeria were invited to complete an online questionnaire containing validated scales; 210 questionnaires were fully completed and analysed. Multiple regression analysis was used to test the hypotheses. Emotional exhaustion was higher for nurses who experienced high demands and low supervisor support. Active learning occurred when nurses worked under conditions of high control and high supervisor support. The findings suggest that the job demand control support model is applicable in a Nigerian nursing situation; the model indicates which occupational stressors contribute to poor well-being in Nigerian nurses and which work characteristics may boost nurses' active learning. Job (re)design interventions can enhance nurses' well-being and learning by guarding nurses' job demands, and stimulating job control and supervisor support. © 2016 John Wiley & Sons Ltd.

Training infection control and hospital hygiene professionals in Europe, 2010: agreed core competencies among 33 European countries.

PubMed

Brusaferro, S; Cookson, B; Kalenic, S; Cooper, T; Fabry, J; Gallagher, R; Hartemann, P; Mannerquist, K; Popp, W; Privitera, G; Ruef, C; Viale, P; Coiz, F; Fabbro, E; Suetens, C; Varela Santos, C

2014-12-11

The harmonisation of training programmes for infection control and hospital hygiene (IC/HH) professionals in Europe is a requirement of the Council recommendation on patient safety. The European Centre for Disease Prevention and Control commissioned the 'Training Infection Control in Europe' project to develop a consensus on core competencies for IC/HH professionals in the European Union (EU). Core competencies were drafted on the basis of the Improving Patient Safety in Europe (IPSE) project's core curriculum (CC), evaluated by questionnaire and approved by National Representatives (NRs) for IC/HH training. NRs also re-assessed the status of IC/HH training in European countries in 2010 in comparison with the situation before the IPSE CC in 2006. The IPSE CC had been used to develop or update 28 of 51 IC/HH courses. Only 10 of 33 countries offered training and qualification for IC/HH doctors and nurses. The proposed core competencies are structured in four areas and 16 professional tasks at junior and senior level. They form a reference for standardisation of IC/HH professional competencies and support recognition of training initiatives.

Classification of worldwide bovine tuberculosis risk factors in cattle: a stratified approach

PubMed Central

Humblet, Marie-France; Boschiroli, Maria Laura; Saegerman, Claude

2009-01-01

The worldwide status of bovine tuberculosis (bTB) as a zoonosis remains of great concern. This article reviews the main risk factors for bTB in cattle based on a three-level classification: animal, herd and region/country level. A distinction is also made, whenever possible, between situations in developed and developing countries as the difference of context might have consequences in terms of risk of bTB. Recommendations are suggested to animal health professionals and scientists directly involved in the control and prevention of bTB in cattle. The determination of Millenium Development Goals for bTB is proposed to improve the control/eradication of the disease worldwide. PMID:19497258

Development of a novel controllable, multidirectional, reusable metallic port with a wide working space.

PubMed

Hosaka, Seiji; Ohdaira, Takeshi; Umemoto, Satoshi; Hashizume, Makoto; Kawamoto, Shunji

2013-12-01

Endoscopic surgery is currently a standard procedure in many countries. Furthermore, conventional four-port laparoscopic cholecystectomy is developing into a single-port procedure. However, in many developing countries, disposable medical products are expensive and adequate medical waste disposable facilities are absent. Advanced medical treatments such as laparoscopic or single-port surgeries are not readily available in many areas of developing countries, and there are often no other sterilization methods besides autoclaving. Moreover, existing reusable metallic ports are impractical and are thus not widely used. We developed a novel controllable, multidirectional single-port device that can be autoclaved, and with a wide working space, which was employed in five patients. In all patients, laparoscopic cholecystectomy was accomplished without complications. Our device facilitates single-port surgery in areas of the world with limited sterilization methods and offers a novel alternative to conventional tools for creating a smaller incision, decrease postoperative pain, and improve cosmesis. This novel device can also lower the cost of medical treatment and offers a promising tool for major surgeries requiring a wide working space.

Taeniasis/cysticercosis trend worldwide and rationale for control.

PubMed

Montresor, Antonio; Palmer, Kevin

2006-01-01

Pig production has increased significantly worldwide in recent years. Small-scale pig husbandry has become a popular source of income in rural and resource-poor communities in most of developing countries. A parallel increase of human Taenia carrier and human cysticercosis is expected but detailed data are not available. However, Taenia solium is considered responsible for over 10% of acute case admission to the neurological ward of countries where it is endemic. The control strategy that seems at the moment more promising is a combination of the different tools available and includes the identification of areas at high risk and the presumptive treatment of the suspected cases and their families. This active finding and treatment of probable tapeworm carriers should be accompanied by health education and control swine cysticercosis. WHO invites all endemic countries to recognize the importance of taeniasis/cysticercosis control and to collect epidemiological data and to adopt policies and strategies for its control.

Taeniasis/cysticercosis trend worldwide and rationale for control

PubMed Central

Montresor, Antonio; Palmer, Kevin

2017-01-01

Pig production has increased significantly worldwide in the recent years. Small-scale pig husbandry has become a popular source of income in rural and resource-poor communities in most of developing countries. A parallel increase of human Taenia carrier and human cysticercosis is expected but detailed data are not available. However, Taenia solium is considered responsible of over 10% of acute case admission to the neurological ward of countries where it is endemic. The control strategy that seems at the moment more promising is a combination of the different tools available and includes the identification of areas at high risk and the presumptive treatment of the suspected cases and their families. This active finding and treatment of probable tapeworm carries should be accompanied by health education and control swine cysticercosis. WHO invite all endemic countries to recognize the importance of taeniasis/cysticercosis control and to collect epidemiological data and to adopt policies and strategies for its control. PMID:16337431

Poison control centers in developing countries and Asia's need for toxicology education

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

Makalinao, Irma R.; Awang, Rahmat

2005-09-01

Poison control centers (PCCs) in developing countries have been set up in response to the challenge of decreasing mortality and morbidity from poisoning. The services range from poison information to actual clinical treatment mostly of acute cases. Lately, PCCs have expanded from their traditional role to one that actively engages in community health studies, toxicovigilance along with treatment of chronic poisoning. Recognizing that types of poisoning and specific needs may vary from country to country, toxicology education that addresses these unique regional issues has become more necessary. Toxicology education, both formal and informal, exists in various stages of development inmore » Asia. Clearly, there are gaps that need to be addressed especially in areas where there are no poison centers or where strengthening is necessary. Collaboration between PCCs in developing countries can help augment available resources including human, analytical and technical expertise. The critical mass of trained toxicologists will fill in the demand for clinical and regulatory specialists and educators as well. This paper highlights the experiences and resources available to the Philippine and Malaysian poison centers and the strengths generated by networking and collaboration. The role of Asia Pacific Association of Medical Toxicology (APAMT) as the Science NGO representative to the Intergovernmental Forum on Chemical Safety (IFCS) forum standing committee in promoting chemical safety at the regional level will be discussed. The 'Clearinghouse on the Sound Management of Chemicals', a platform for engaging multi-stakeholder and interdisciplinary partnerships, will be described as a possible model for capacity building to advance chemical safety through education and training not only in developing countries in Asia but globally as well.« less

Socioeconomic gradients in child development in very young children: Evidence from India, Indonesia, Peru, and Senegal

PubMed Central

Fernald, Lia C. H.; Kariger, Patricia; Hidrobo, Melissa; Gertler, Paul J.

2012-01-01

Gradients across socio-economic position exist for many measures of children's health and development in higher-income countries. These associations may not be consistent, however, among the millions of children living in lower- and middle-income countries. Our objective was to examine child development and growth in young children across socio-economic position in four developing countries. We used cross-sectional surveys, child development assessments, measures of length (LAZ), and home stimulation (Family Care Index) of children in India, Indonesia, Peru, and Senegal. The Extended Ages and Stages Questionnaire (EASQ) was administered to parents of all children ages 3–23 mo in the household (n =8,727), and length measurements were taken for all children 0–23 mo (n = 11,102). Household wealth and maternal education contributed significantly and independently to the variance in EASQ and LAZ scores in all countries, while controlling for child's age and sex, mother's age and marital status, and household size. Being in the fifth wealth quintile in comparison with the first quintile was associated with significantly higher EASQ scores (0.27 to 0.48 of a standardized score) and higher LAZ scores (0.37 to 0.65 of a standardized score) in each country, while controlling for maternal education and covariates. Wealth and education gradients increased over the first two years in most countries for both EASQ and LAZ scores, with larger gradients seen in 16–23-mo-olds than in 0–7mo-olds. Mediation analyses revealed that parental home stimulation activities and LAZ were significant mediating variables and explained up to 50% of the wealth effects on the EASQ. PMID:23045688

Emerging Burden of Cardiovascular Diseases in Bangladesh.

PubMed

Al Mamun, Mohammad; Rumana, Nahid; Pervin, Kumkum; Azad, Muhammad Chanchal; Shahana, Nahid; Choudhury, Sohel Reza; Zaman, M Mostafa; Turin, Tanvir Chowdhury

2016-01-01

As a result of an epidemiological transition from communicable to non-communicable diseases for last few decades, cardiovascular diseases (CVD) are being considered as an important cause of mortality and morbidity in many developing countries including Bangladesh. Performing an extensive literature search, we compiled, summarized, and categorized the existing information about CVD mortality and morbidity among different clusters of Bangladeshi population. The present review reports that the burden of CVD in terms of mortality and morbidity is on the rise in Bangladesh. Despite a few non-communicable disease prevention and control programs currently running in Bangladesh, there is an urgent need for well-coordinated national intervention strategies and public health actions to minimize the CVD burden in Bangladesh. As the main challenge for CVD control in a developing country is unavailability of adequate epidemiological data related to various CVD events, the present review attempted to accumulate such data in the current context of Bangladesh. This may be of interest to all stakeholder groups working for CVD prevention and control across the country and globe.

[Brucellosis: a zoonosis of importance in Mexico].

PubMed

Guzmán-Hernández, Rosa Lilia; Contreras-Rodríguez, Araceli; Ávila-Calderón, Eric Daniel; Morales-García, M Rosario

2016-12-01

Brucellosis is one of the most frequent zoonosis in most parts of the world. This zoonosis remains a great problem to public health in developing countries, although developed countries have successfully controlled it. Mexico still shows a high annual brucellosis incidence in humans; thus, the country is considered around the world as an endemic brucellosis country. To describe the connection/association between this zoonosis and the current epidemiological situation in the Mexican population. Perusal of research reports, epidemiological studies and veterinarian reviews performed in Mexico, using data bases such as PubMed, Thompson Reuters, Mesh research. The risk of infection by Brucella in Mexico is associated with the consumption of unpasteurized dairy products, mainly fresh cheeses.

Leptospirosis in the Asia Pacific region

PubMed Central

2009-01-01

Background Leptospirosis is a worldwide zoonotic infection that has been recognized for decades, but the problem of the disease has not been fully addressed, particularly in resource-poor, developing countries, where the major burden of the disease occurs. This paper presents an overview of the current situation of leptospirosis in the region. It describes the current trends in the epidemiology of leptospirosis, the existing surveillance systems, and presents the existing prevention and control programs in the Asia Pacific region. Methods Data on leptospirosis in each member country were sought from official national organizations, international public health organizations, online articles and the scientific literature. Papers were reviewed and relevant data were extracted. Results Leptospirosis is highly prevalent in the Asia Pacific region. Infections in developed countries arise mainly from occupational exposure, travel to endemic areas, recreational activities, or importation of domestic and wild animals, whereas outbreaks in developing countries are most frequently related to normal daily activities, over-crowding, poor sanitation and climatic conditions. Conclusion In the Asia Pacific region, predominantly in developing countries, leptospirosis is largely a water-borne disease. Unless interventions to minimize exposure are aggressively implemented, the current global climate change will further aggravate the extent of the disease problem. Although trends indicate successful control of leptospirosis in some areas, there is no clear evidence that the disease has decreased in the last decade. The efficiency of surveillance systems and data collection varies significantly among the countries and areas within the region, leading to incomplete information in some instances. Thus, an accurate reflection of the true burden of the disease remains unknown. PMID:19732423

The impact of mobile health interventions on chronic disease outcomes in developing countries: a systematic review.

PubMed

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

2014-01-01

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

The Health Impact of Rabies in Haiti and Recent Developments on the Path Toward Elimination, 2010–2015

PubMed Central

Wallace, Ryan; Etheart, Melissa; Ludder, Fleurinord; Augustin, Pierre; Fenelon, Natael; Franka, Richard; Crowdis, Kelly; Dely, Patrick; Adrien, Paul; Pierre-Louis, J.; Osinubi, Modupe; Orciari, Lillian; Vigilato, Marco; Blanton, Jesse; Patel, Roopal; Lowrance, David; Liverdieu, Andrecy; Coetzer, Andre; Boone, John; Lindenmayer, Joanne; Millien, M.

2017-01-01

Abstract. Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs, surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health and Population and key health development partners (including the Pan-American Health Organization) to provide technical expertise and funding for general disease surveillance systems, laboratory capacity, and selected disease control programs; including rabies. In 2011, a cross-ministerial rabies consortium was convened with participation from multiple international rabies experts to develop a strategy for successful rabies control in Haiti. The consortium focused on seven pillars: 1) enhancement of laboratory diagnostic capacity, 2) development of comprehensive animal surveillance system, 3) development of comprehensive human rabies surveillance system, 4) educational outreach, 5) sustainable human rabies biologics supply, 6) achievement of sustained canine vaccination rates of ≥ 70%, and 7) finalization of a national rabies control strategy. From 2010 until 2015, Haiti has seen improvements in the program infrastructure for canine rabies control. The greatest improvements were seen in the area of animal rabies surveillance, in support of which an internationally recognized rabies laboratory was developed thereby leading to an 18-fold increase in the detection of rabid animals. Canine rabies vaccination practices also improved, from a 2010 level of approximately 12% to a 2015 dog population coverage level estimated to be 45%. Rabies vaccine coverage is still below the goal of 70%, however, the positive trend is encouraging. Gaps exist in the capacity to conduct national surveillance for human rabies cases and access to human rabies vaccine is lacking in many parts of the country. However, control has improved over the past 5 years as a result of the efforts of Haiti’s health and agriculture sectors with assistance from multiple international organizations. Haiti is well situated to eliminate canine-mediated human rabies deaths in the near future and should serve as a great example to many developing countries struggling with similar barriers and limitations. PMID:29064363

The Health Impact of Rabies in Haiti and Recent Developments on the Path Toward Elimination, 2010-2015.

PubMed

Wallace, Ryan; Etheart, Melissa; Ludder, Fleurinord; Augustin, Pierre; Fenelon, Natael; Franka, Richard; Crowdis, Kelly; Dely, Patrick; Adrien, Paul; Pierre-Louis, J; Osinubi, Modupe; Orciari, Lillian; Vigilato, Marco; Blanton, Jesse; Patel, Roopal; Lowrance, David; Liverdieu, Andrecy; Coetzer, Andre; Boone, John; Lindenmayer, Joanne; Millien, M

2017-10-01

Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs, surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health and Population and key health development partners (including the Pan-American Health Organization) to provide technical expertise and funding for general disease surveillance systems, laboratory capacity, and selected disease control programs; including rabies. In 2011, a cross-ministerial rabies consortium was convened with participation from multiple international rabies experts to develop a strategy for successful rabies control in Haiti. The consortium focused on seven pillars: 1) enhancement of laboratory diagnostic capacity, 2) development of comprehensive animal surveillance system, 3) development of comprehensive human rabies surveillance system, 4) educational outreach, 5) sustainable human rabies biologics supply, 6) achievement of sustained canine vaccination rates of ≥ 70%, and 7) finalization of a national rabies control strategy. From 2010 until 2015, Haiti has seen improvements in the program infrastructure for canine rabies control. The greatest improvements were seen in the area of animal rabies surveillance, in support of which an internationally recognized rabies laboratory was developed thereby leading to an 18-fold increase in the detection of rabid animals. Canine rabies vaccination practices also improved, from a 2010 level of approximately 12% to a 2015 dog population coverage level estimated to be 45%. Rabies vaccine coverage is still below the goal of 70%, however, the positive trend is encouraging. Gaps exist in the capacity to conduct national surveillance for human rabies cases and access to human rabies vaccine is lacking in many parts of the country. However, control has improved over the past 5 years as a result of the efforts of Haiti's health and agriculture sectors with assistance from multiple international organizations. Haiti is well situated to eliminate canine-mediated human rabies deaths in the near future and should serve as a great example to many developing countries struggling with similar barriers and limitations.

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

PubMed

Osibanjo, O; Nnorom, I C

2007-12-01

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

Medical tourism: globalization of the healthcare marketplace.

PubMed

Horowitz, Michael D; Rosensweig, Jeffrey A; Jones, Christopher A

2007-11-13

The citizens of many countries have long traveled to the United States and to the developed countries of Europe to seek the expertise and advanced technology available in leading medical centers. In the recent past, a trend known as medical tourism has emerged wherein citizens of highly developed countries choose to bypass care offered in their own communities and travel to less developed areas of the world to receive a wide variety of medical services. Medical tourism is becoming increasingly popular, and it is projected that as many as 750,000 Americans will seek offshore medical care in 2007. This phenomenon is driven by marketplace forces and occurs outside of the view and control of the organized healthcare system. Medical tourism presents important concerns and challenges as well as potential opportunities. This trend will have increasing impact on the healthcare landscape in industrialized and developing countries around the world.

Disaster risk, social vulnerability, and economic development.

PubMed

Ward, Patrick S; Shively, Gerald E

2017-04-01

This paper examines the extent to which economic development decreases a country's risk of experiencing climate-related disasters as well as the societal impacts of those events. The paper proceeds from the underlying assumption that disasters are not inherently natural, but arise from the intersection of naturally-occurring hazards within fragile environments. It uses data from the International Disaster Database (EM-DAT), representing country-year-level observations over the period 1980-2007. The study finds that low-income countries are significantly more at risk of climate-related disasters, even after controlling for exposure to climate hazards and other factors that may confound disaster reporting. Following the occurrence of a disaster, higher income generally diminishes a country's social vulnerability to such happenings, resulting in lower levels of mortality and morbidity. This implies that continued economic development may be a powerful tool for lessening social vulnerability to climate change. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Medical Tourism: Globalization of the Healthcare Marketplace

PubMed Central

Horowitz, Michael D.; Rosensweig, Jeffrey A.; Jones, Christopher A.

2007-01-01

The citizens of many countries have long traveled to the United States and to the developed countries of Europe to seek the expertise and advanced technology available in leading medical centers. In the recent past, a trend known as medical tourism has emerged wherein citizens of highly developed countries choose to bypass care offered in their own communities and travel to less developed areas of the world to receive a wide variety of medical services. Medical tourism is becoming increasingly popular, and it is projected that as many as 750,000 Americans will seek offshore medical care in 2007. This phenomenon is driven by marketplace forces and occurs outside of the view and control of the organized healthcare system. Medical tourism presents important concerns and challenges as well as potential opportunities. This trend will have increasing impact on the healthcare landscape in industrialized and developing countries around the world. PMID:18311383

Type 2 diabetes self-management education programs in high and low mortality developing countries: a systematic review.

PubMed

Dube, Loveness; Van den Broucke, Stephan; Housiaux, Marie; Dhoore, William; Rendall-Mkosi, Kirstie

2015-02-01

Although self-management education is a key factor in the care for diabetes patients, its implementation in developing countries is not well documented. This systematic review considers the published literature on diabetes self-management education in high and low mortality developing countries. The aim is to provide a state of the art of current practices and assess program outcomes, cultural sensitivity, and accessibility to low literate patients. The Cochrane Library, PubMed, MEDLINE, PsycInfo, and PsycArticles databases were searched for peer-reviewed articles on type 2 diabetes published in English between 2009 and 2013. The World Bank and WHO burden of disease criteria were applied to distinguish between developing countries with high and low mortality. Information was extracted using a validated checklist. Three reviews and 23 primary studies were identified, 18 of which were from low mortality developing countries. Studies from high mortality countries were mostly quasi-experimental, those from low mortality countries experimental. Interventions were generally effective on behavior change and patients' glycemic control in the short term (≤9 months). While 57% of the studies mentioned cultural tailoring of interventions, only 17% reported on training of providers, and 39% were designed to be accessible for people with low literacy. The limited studies available suggest that diabetes self-management education programs in developing countries are effective in the short term but must be tailored to conform to the cultural aspects of the target population. © 2014 The Author(s).

Regional Seminars to Address Current Nuclear Export Control Issues

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

Killinger, Mark H.

2002-07-01

The control of nuclear-related exports, a critical component of the nonproliferation regime, is facing several opportunities and challenges. As countries sign and ratify the International Atomic Energy Agency's (IAEA) safeguards Additional Protocol (AP), they will begin to report far more export information, including exports of a list of items similar to the Nuclear Supplier Group's Trigger List that existed when the AP was developed in the mid-1990s. This positive development contrasts with challenges such as globalization, transshipments, and tracking of end-uses. Pacific Northwest National Laboratory is proposing that the US Department of Energy (DOE) develop regional seminars that address thesemore » types of issues related to export/import controls. The DOE seminars would be designed to supplement regional seminars sponsored by the IAEA and member states on topics related to the Additional Protocol (referred to as "IAEA seminars"). The topic of nuclear export/import controls is not thoroughly addressed in the IAEA seminars. The proposed DOE seminars would therefore have two objectives: familiarizing countries with the export/import provisions of the Additional Protocol, and addressing challenges such as those noted above. The seminars would be directed particularly at countries that have not ratified the AP, and at regions where export-related problems are particularly prevalent. The intent is to encourage governments to implement more effective nuclear export control systems that meet the challenges of the 21st century.« less

Diarrhoeal diseases in developing countries: a situational analysis.

PubMed

Kumar, S G; Subitha, L

2012-01-01

Recent data showed that there is no much reduction in diarrhoea related morbidity in developing countries. This is important in view of the Millennium Developmental Goal (MDG) to be achieved by 2015. This study reviewed and analyzed after gathering the recent literature information from Pubmed, internet and other sources. The authors discussed public health issues related to diarrhoeal diseases that include problem burden, determinants, intervention strategies, management, prevention and recent developments for control of diarrhoea among under-five children in developing countries. The study emphasizes the need for strengthening of comprehensive diarrhoeal disease prevention strategy at primary level including improvement of water quality, hygiene and sanitation, along with provision of oral rehydration solution and zinc supplements, and research in the field of vaccine and cost effective interventions.

The economic impact of foot and mouth disease and its control in South-East Asia: a preliminary assessment with special reference to Thailand.

PubMed

Perry, B D; Kalpravidh, W; Coleman, P G; Horst, H S; McDermott, J J; Randolph, T F; Gleeson, L J

1999-08-01

A pilot study of the economic impact of foot and mouth disease (FMD) in the countries and region of South-East Asia is described. Previous economic impact assessments are reviewed and summarised and a synthesis of these contributions is constructed. A framework for the future economic impact of the disease is then developed, incorporating analyses at the sectoral (production system), national and regional levels. Data requirements for such studies are also identified. Integrated epidemiological and economic models for impact assessment were developed and applied to the case study country of Thailand. The models were used to evaluate the economic viability of FMD control programmes in the country. Scenarios evaluated include the effect of improving vaccination coverage and thus reducing productivity losses, and the effect of eventual eradication of the disease. The results indicate that economic returns to the high expenditures incurred in FMD control could be achieved in the short term if greater international trade in pork products was made possible and export prices higher than those in the domestic market could be attained. If FMD were to be eradicated from Thailand in 2010, the eradication would be economically viable, even without exports, with a predicted benefit-cost ratio of 3.73. With additional exports, the economic justification for control becomes much stronger with a benefit-cost ratio of up to 15:1 being achieved. If eradication is not achieved until 2020, returns remain positive without exports, but at a lower rate. The authors propose that the integrated epidemiological and economic models developed be applied to other countries of the region to gain a more accurate insight into the future benefits of FMD control and eradication in the region.

Educate the Women and You Change the World: Investing in the Education of Women Is the Best Investment in a Country's Growth and Development

ERIC Educational Resources Information Center

Jackson, Leah Witcher

2009-01-01

An extensive body of research indicates a significant correlation between gender equality and the level of economic and social development of a country. Gender inequities have been found to influence the way members of the family spend their time and resources. Evidence suggests that women with more control over resources will spend more money on…

Casting off vaccine supply charity -- the pace quickens. CVI goal: quality vaccines for all children.

PubMed

1995-10-01

Several proposals are offered for production of high-quality vaccines within developing countries. The World Health Organization's Vaccine Supply and Quality (VSQ) team from the Global Program for Vaccines and Immunization (GPV) visited 10 countries (Bangladesh, Brazil, Egypt, India, Indonesia, Iran, Mexico, Pakistan, Philippines, and South Africa) out of 14 priority countries (China, Russia, Thailand, and Vietnam were not visited) producing vaccines and found only two with a quality control system that was acceptable. Vaccine-producing countries are urged to consider the full costs of production that include necessary infrastructure, an independent national control authority and laboratory, manufacturers with managerial autonomy, and manufacturers with good management, a qualified staff, and adequate technology. UNICEF has urged both private and public sectors to combine forces in bringing down the price of new vaccines for distribution to a very large market. Some imaginative proposals were made by some manufacturers for vaccine production and supply for a range of less traditional vaccines. The Director of the Massachusetts Public Health Biologic Laboratories proposed the formation of a consortium of vaccine manufacturers who would support public health priorities for market-affordable, simple vaccines against the major childhood diseases. The aim would be international validation of high-quality local vaccine production in developing countries, ease of research collaboration, improvement in information exchange between countries, and structured assistance. Lack of political commitment has been blamed for poor quality local production. A small cooperative effort among some Latin American countries, the Pan American Association's Regional Vaccine System for Latin America (SIREVA), is backed by the Children's Vaccine Initiative. SIREVA is a consortium of manufacturers in Brazil, Chile, and Mexico that plans joint development of some vaccines. Donor assistance is suggested for UNICEF's new targeting strategy and global vaccine fund for well-defined and specific needs. UNICEF is the main distributor of vaccines to developing countries and aims for program sustainability and distribution of the new vaccines.

A hugh marketing research task: birth control.

PubMed

Simon, J L

1968-02-01

Research in underdeveloped countries to sell family planning is discussed. The article also aims at pinpointing other possible research areas. Census reports were actually the earliest work relevant to birth control. Later came the research on psychosocial factors affecting family size in developed countries. After World War I, client oriented research into family planning began. The history of this type of research is discussed with more emphasis on the surveys of the knowledge, attitude and contraception practices (KAP) in various countries. The author claims the KAP surveys to be the largest worldwide market research job ever done. Propagands campaigns, contraceptive costs, bonuses for contraceptive practices, and effectiveness of persuasion techniques are discussed.

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

PubMed

Garrafa, Volnei; Lorenzo, Claudio

2008-10-01

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

A historical and socioeconomic analysis of occupational safety and health in India.

PubMed

Vilanilam, J V

1980-01-01

Workers in poor countries of the so-called Third World are more likely to be affected by the dangers of high technology than their counterparts in wealthier countries. Owing to their lack of education, most workers in the "developing" world are unaware of the hazards of their occupations. Moreover, their general backwardness in sanitation and nutrition and climatic proneness of their geographic region to epidemics cause diseases contracted from the work environment to be aggravated. occupational diseases are often misconstrued as diseases resulting from the general environment. Since unemployment in underdeveloped countries is of a very high order, workers are prepared to accept any job, irrespective of the dangers involved. Labor is cheap and easily replaceable, so employers see no need for improving occupational safety and health. Labor unions are mostly controlled by full-time politicians who consider health a political issue, especially when their party controls the country's government. The seriousness of all these factors is heightened by the existing socioeconomic order in poor countries, in which national medievalism and multinational modernism play a crucial role. In order to understand the prevailing socioeconomic order, one has to analyze the social structures of poor countries in the context of today's world economic structure. India is taken as an example of a "developing" country where all the above-mentioned factors and many others are in operation: backwardness of the worker; poor nutrition; lack of concern for public health; proneness to epidemics; and indifference on the part of employers, politicians, and unions toward occupational health; high unemployment, control of the local economy by multinational corporations; and control of the mass media by feudalistic vested interests. This article attempts to analyze the occupational health and safety issue in India from a historical perspective, and stresses the vital need of structural changes in various fields so that workers can have a safe and healthy working environment.

Building capacity for implementation of the framework convention for tobacco control in Vietnam: lessons for developing countries.

PubMed

Stillman, Frances A; David, Annette M; Kibria, Naseeb; Phan, Hai Thi

2014-09-01

Effective implementation of the WHO international Framework Convention on Tobacco Control (FCTC) is the key to controlling the tobacco epidemic. Within countries, strong national tobacco control capacity is the primary determinant for successful implementation of the FCTC. This case study of tobacco control policy describes the experience of building national tobacco control capacity in Vietnam under the Reduce Smoking in Vietnam Partnership project within a national capacity-building framework. In the Vietnam experience, four components of tobacco control capacity emerged as especially important to achieve 'quality' outputs and measurable outcomes at the implementation level: (i) organizational structure/infrastructure; (ii) leadership and expertise; (iii) partnerships and networks and (iv) data and evidence from research. The experience gained in this project helps in adapting our tobacco control capacity-building model, and the lessons that emerged from this country case study can provide guidance to global funders, tobacco control technical assistance providers and nations as governments endeavor to meet their commitment to the FCTC. © The Author (2013). Published by Oxford University Press.

Nobody Seems to Speak English Here Today: Enhancing Assessment and Training in Aviation English

ERIC Educational Resources Information Center

Douglas, Dan

2014-01-01

In 2003 the International Civil Aviation Organization (ICAO) strengthened the provisions that English be made available for international radiotelephony communication. ICAO also developed standards for English proficiency for international pilots and air traffic controllers. However, these standards are applied variably from country to country and…

Policy Support and Resources Mobilization for the National Schistosomiasis Control Programme in The People's Republic of China.

PubMed

Zhu, H; Yap, P; Utzinger, J; Jia, T-W; Li, S-Z; Huang, X-B; Cai, S-X

2016-01-01

Schistosomiasis remains a public health problem in many developing countries around the world. After the founding of The People's Republic of China, from 1949 till date, all levels of government, from central to local, have been attaching great importance to schistosomiasis control in The People's Republic of China. With considerable policy support and resources mobilization, the national schistosomiasis control programmes have been implemented during the past 65years. Here, we summarize the successful experience of schistosomiasis control during the process. Recommendations for the future management of the Chinese national schistosomiasis elimination programme are put forward after considering the remaining challenges, shortcomings and lessons learnt from 65years of schistosomiasis control drives in The People's Republic of China. They will help to sustain past achievements, foster the attainment of the ultimate goal of schistosomiasis elimination for the country and provide reference for schistosomiasis control programme in other countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mapping tobacco industry strategies in South East Asia for action planning and surveillance

PubMed Central

Stillman, F; Hoang, M; Linton, R; Ritthiphakdee, B; Trochim, W

2008-01-01

Objective: To develop a comprehensive conceptual framework of tobacco industry tactics in four countries in South East Asia for the purpose of: (1) generating consensus on key areas of importance and feasibility for regional and cross country tobacco industry monitoring and surveillance; (2) developing measures to track and monitor the effects of the tobacco industry and to design counterstrategies; and (3) building capacity to improve tobacco control planning in the participating countries. Design: A structured conceptualisation methodology known as concept mapping was used. The process included brainstorming, sorting and rating of statements describing industry activities. Statistical analyses used multidimensional scaling and cluster analysis. Interpretation of the maps was participatory, using regional tobacco control researchers, practitioners, and policy makers during a face to face meeting. Participants: 31 participants in this study come from the four countries represented in the project along with six people from the Johns Hopkins Blomberg School of Public Health. Conclusions: The map shows eight clusters of industry activities within the four countries. These were arranged into four general sectors: economics, politics, public relations and deception. For project design purposes, the map indicates areas of importance and feasibility for monitoring tobacco industry activities and serves as a basis for an initial discussion about action planning. Furthermore, the development of the map used a consensus building process across different stakeholders or stakeholder agencies and is critical when developing regional, cross border strategies for tracking and surveillance. PMID:18218787

Cognitive and Socioemotional Caregiving in Developing Countries

PubMed Central

Bornstein, Marc H.; Putnick, Diane L.

2011-01-01

Enriching caregiving practices foster the course and outcome of child development. We studied two developmentally significant domains of positive caregiving -- cognitive and socioemotional -- in more than 127,000 families with under-5 year children from 28 developing countries. Mothers varied widely in cognitive and socioemotional caregiving and engaged in more socioemotional than cognitive activities. More than half of mothers played with their children and took them outside, but only a third or fewer read books and told stories to their children. The GDP of countries related to caregiving after controlling for life expectancy and education. The majority of mothers report that they do not leave their under-5s alone. Policy and intervention recommendations are elaborated. PMID:22277006

Energy efficiency and conservation in the developing world. World Bank policy paper. Energia: Eficiencia y conservacion en el mundo en desarrollo

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

Not Available

1993-01-01

Energy demand and production in developing countries are up, but efficiency of production and consumption are falling behind. The paper explores that issue and reviews the Bank's participation in energy projects. The paper conveys the Bank's strategy to promote efficiency through such means as transferring modern technology from the industrial countries and lending more selectively to energy-supply enterprises. The Bank identifies four factors that account for the differences in efficiency between the industrial and developing countries: energy pricing policies, control of energy supply enterprises, protection of energy-using industry from competition, and barriers to the productive functioning of markets.

Problem solving for breast health care delivery in low and middle resource countries (LMCs): consensus statement from the Breast Health Global Initiative.

PubMed

Harford, Joe B; Otero, Isabel V; Anderson, Benjamin O; Cazap, Eduardo; Gradishar, William J; Gralow, Julie R; Kane, Gabrielle M; Niëns, Laurens M; Porter, Peggy L; Reeler, Anne V; Rieger, Paula T; Shockney, Lillie D; Shulman, Lawrence N; Soldak, Tanya; Thomas, David B; Thompson, Beti; Winchester, David P; Zelle, Sten G; Badwe, Rajendra A

2011-04-01

International collaborations like the Breast Health Global Initiative (BHGI) can help low and middle income countries (LMCs) to establish or improve breast cancer control programs by providing evidence-based, resource-stratified guidelines for the management and control of breast cancer. The Problem Solving Working Group of the BHGI 2010 Global Summit met to develop a consensus statement on problem-solving strategies addressing breast cancer in LMCs. To better assess breast cancer burden in poorly studied populations, countries require accurate statistics regarding breast cancer incidence and mortality. To better identify health care system strengths and weaknesses, countries require reasonable indicators of true health system quality and capacity. Using qualitative and quantitative research methods, countries should formulate cancer control strategies to identify both system inefficiencies and patient barriers. Patient navigation programs linked to public advocacy efforts feed and strengthen functional early detection and treatment programs. Cost-effectiveness research and implementation science are tools that can guide and expand successful pilot programs. Copyright © 2011 Elsevier Ltd. All rights reserved.

Diffusion of innovations theory applied to global tobacco control treaty ratification.

PubMed

Valente, Thomas W; Dyal, Stephanie R; Chu, Kar-Hai; Wipfli, Heather; Fujimoto, Kayo

2015-11-01

This study applies diffusion of innovations theory to understand network influences on country ratification of an international health treaty, the Framework Convention for Tobacco Control (FCTC). From 2003 to 2014 approximately 90% of United Nations member countries ratified the FCTC. We hypothesized that communication between tobacco control advocates on GLOBALink, a 7000-member online communication forum in existence from 1992 to 2012, would be associated with the timing of treaty ratification. We further hypothesized dynamic network influences such that external influence decreased over time, internal influence increased over time, and the role of opinion leader countries varied over time. In addition we develop two concepts: Susceptibility and influence that uncover the micro-level dynamics of network influence. Statistical analyses lend support to the influence of co-subscriptions on GLOBALink providing a conduit for inter-country influences on treaty ratification and some support for the dynamic hypotheses. Analyses of susceptibility and infection indicated particularly influential countries. These results have implications for the study of policy diffusion as well as dynamic models of behavior change. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Global cancer statistics, 2012.

PubMed

Torre, Lindsey A; Bray, Freddie; Siegel, Rebecca L; Ferlay, Jacques; Lortet-Tieulent, Joannie; Jemal, Ahmedin

2015-03-01

Cancer constitutes an enormous burden on society in more and less economically developed countries alike. The occurrence of cancer is increasing because of the growth and aging of the population, as well as an increasing prevalence of established risk factors such as smoking, overweight, physical inactivity, and changing reproductive patterns associated with urbanization and economic development. Based on GLOBOCAN estimates, about 14.1 million new cancer cases and 8.2 million deaths occurred in 2012 worldwide. Over the years, the burden has shifted to less developed countries, which currently account for about 57% of cases and 65% of cancer deaths worldwide. Lung cancer is the leading cause of cancer death among males in both more and less developed countries, and has surpassed breast cancer as the leading cause of cancer death among females in more developed countries; breast cancer remains the leading cause of cancer death among females in less developed countries. Other leading causes of cancer death in more developed countries include colorectal cancer among males and females and prostate cancer among males. In less developed countries, liver and stomach cancer among males and cervical cancer among females are also leading causes of cancer death. Although incidence rates for all cancers combined are nearly twice as high in more developed than in less developed countries in both males and females, mortality rates are only 8% to 15% higher in more developed countries. This disparity reflects regional differences in the mix of cancers, which is affected by risk factors and detection practices, and/or the availability of treatment. Risk factors associated with the leading causes of cancer death include tobacco use (lung, colorectal, stomach, and liver cancer), overweight/obesity and physical inactivity (breast and colorectal cancer), and infection (liver, stomach, and cervical cancer). A substantial portion of cancer cases and deaths could be prevented by broadly applying effective prevention measures, such as tobacco control, vaccination, and the use of early detection tests. © 2015 American Cancer Society.

Polymerase Chain Reaction/Rapid Methods Are Gaining a Foothold in Developing Countries.

PubMed

Ragheb, Suzan Mohammed; Jimenez, Luis

Detection of microbial contamination in pharmaceutical raw materials and finished products is a critical factor to guarantee their safety, stability, and potency. Rapid microbiological methods-such as polymerase chain reaction-have been widely applied to clinical and food quality control analysis. However, polymerase chain reaction applications to pharmaceutical quality control have been rather slow and sporadic. Successful implementation of these methods in pharmaceutical companies in developing countries requires important considerations to provide sensitive and robust assays that will comply with good manufacturing practices. In recent years several publications have encouraged the application of molecular techniques in the microbiological assessment of pharmaceuticals. One of these techniques is polymerase chain reaction (PCR). The successful application of PCR in the pharmaceutical industry in developing countries is governed by considerable factors and requirements. These factors include the setting up of a PCR laboratory and the choice of appropriate equipment and reagents. In addition, the presence of well-trained analysts and establishment of quality control and quality assurance programs are important requirements. The pharmaceutical firms should take into account these factors to allow better chances for regulatory acceptance and wide application of this technique. © PDA, Inc. 2014.

Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries

PubMed Central

Drain, Paul K; Halperin, Daniel T; Hughes, James P; Klausner, Jeffrey D; Bailey, Robert C

2006-01-01

Background Both religious practices and male circumcision (MC) have been associated with HIV and other sexually-transmitted infectious diseases. Most studies have been limited in size and have not adequately controlled for religion, so these relationships remain unclear. Methods We evaluated relationships between MC prevalence, Muslim and Christian religion, and 7 infectious diseases using country-specific data among 118 developing countries. We used multivariate linear regression to describe associations between MC and cervical cancer incidence, and between MC and HIV prevalence among countries with primarily sexual HIV transmission. Results Fifty-three, 14, and 51 developing countries had a high (>80%), intermediate (20–80%), and low (<20%) MC prevalence, respectively. In univariate analyses, MC was associated with lower HIV prevalence and lower cervical cancer incidence, but not with HSV-2, syphilis, nor, as expected, with Hepatitis C, tuberculosis, or malaria. In multivariate analysis after stratifying the countries by religious groups, each categorical increase of MC prevalence was associated with a 3.65/100,000 women (95% CI 0.54-6.76, p = 0.02) decrease in annual cervical cancer incidence, and a 1.84-fold (95% CI 1.36-2.48, p < 0.001) decrease in the adult HIV prevalence among sub-Saharan African countries. In separate multivariate analyses among non-sub-Saharan African countries controlling for religion, higher MC prevalence was associated with a 8.94-fold (95% CI 4.30-18.60) decrease in the adult HIV prevalence among countries with primarily heterosexual HIV transmission, but not, as expected, among countries with primarily homosexual or injection drug use HIV transmission (p = 0.35). Conclusion Male circumcision was significantly associated with lower cervical cancer incidence and lower HIV prevalence in sub-Saharan Africa, independent of Muslim and Christian religion. As predicted, male circumcision was also strongly associated with lower HIV prevalence among countries with primarily heterosexual HIV transmission, but not among countries with primarily homosexual or injection drug use HIV transmission. These findings strengthen the reported biological link between MC and some sexually transmitted infectious diseases, including HIV and cervical cancer. PMID:17137513

Exporting DBCP and other banned pesticides: consideration of ethical issues.

PubMed

Lowry, L K; Frank, A L

1999-01-01

Many developed countries permit the export of pesticides that are banned, restricted, or unregistered within their own borders. This practice, which leads to the exposure of agricultural workers in developing countries to high levels of pesticides that are not permitted in the country of manufacture, raises many ethical issues as well as economic, social, political, and public health issues. Worldwide attempts to control export of such pesticides, through the FAO/UNEP Prior Informed Consent program, moves this issue in the right direction. This article explores the current U.S. and international practices, using the specific example of export of DBCP to banana-producing countries. The actions taken by multinational corporations, manufacturers of the pesticides, and public health officials in both the exporting and importing countries are explored, along with the impacts on workers, local economies, governments, and the environment.

Cancer registries in four provinces in Turkey: a case study

PubMed Central

2012-01-01

Background The burden of cancer affects all countries; while high-income countries have the capacity and resources to establish comprehensive cancer control programs, low and middle-income countries have limited resources to develop such programs. This paper examines factors associated with the development of cancer registries in four provinces in Turkey. It looks at the progress made by these registries, the challenges they faced, and the lessons learned. Other countries with similar resources can benefit from the lessons identified in this case study. Methods A mix of qualitative case study methods including key informant interviews, document review and questionnaires was used. Results This case study showed that surveillance systems that accurately report current cancer-related data are essential components of a country’s comprehensive cancer control program. At the initial stages, Turkey established one cancer registry with international support, which was used as a model for other registries. The Ministry of Health recognized the value of the registry data and its contribution to the country’s cancer control program and is supporting sustainability of these registries as a result. Conclusions This study demonstrates how Turkey was able to use resources from multiple sources to enhance its population based cancer registry system in four provinces. With renewed international interest in non-communicable diseases and cancer following the 2011 UN high-level meeting on NCDs, low- and middle- income countries can benefit from Turkey’s experience. Other countries can utilize lessons learned from Turkey as they address cancer burden and establish their own registries. PMID:23110989

Heterogeneity of Rotavirus Vaccine Efficacy Among Infants in Developing Countries.

PubMed

Gruber, Joann F; Hille, Darcy A; Liu, G Frank; Kaplan, Susan S; Nelson, Micki; Goveia, Michelle G; Mast, T Christopher

2017-01-01

Rotavirus is the leading cause of severe diarrhea worldwide in young children. Although rotavirus vaccine efficacy is high in developed countries, efficacy is lower in developing countries. Here, we investigated heterogeneity of rotavirus vaccine efficacy by infant characteristics in developing countries. An exploratory, post hoc analysis was conducted using randomized controlled trial data of the pentavalent rotavirus vaccine (RV5) conducted in Africa and Asia (NCT00362648). Infants received either 3 doses of vaccine/placebo and were followed for up to 2 years. Within subgroups, vaccine efficacies and 95% confidence intervals (CIs) against rotavirus gastroenteritis (RVGE) were estimated using Poisson regression. We assessed heterogeneity of efficacy by age at first dose, gender, breastfeeding status and nutrition status. African children receiving the first dose at <8 weeks had lower efficacy (23.7%; 95% CI: -8.2%-46.3%) than those vaccinated at ≥8 weeks (59.1%; 95% CI: 34.0%-74.6%). Marginally statistically significant differences were observed by age at first dose, gender and underweight status in Ghana and gender in Asian countries. Heterogeneity of efficacy was observed for age at first dose in African countries. This was an exploratory analysis; additional studies are needed to validate these results.

Parental Control: A Second Cross-Cultural Research on Parenting and Psychological Adjustment of Children

ERIC Educational Resources Information Center

Dwairy, Marwan; Achoui, Mustafa

2010-01-01

Parental control is among the important factors influencing the psychological development of children. In addition to other questionnaires, a questionnaire of father and mother control was administered to adolescents in nine countries. The results showed that parental control differs across cultures. Parental control was higher in the eastern than…

Spatial and Temporal Trends in Global Emissions of Nitrogen Oxides from 1960 to 2014.

PubMed

Huang, Tianbo; Zhu, Xi; Zhong, Qirui; Yun, Xiao; Meng, Wenjun; Li, Bengang; Ma, Jianmin; Zeng, Eddy Y; Tao, Shu

2017-07-18

The quantification of nitrogen oxide (NO x ) emissions is critical for air quality modeling. Based on updated fuel consumption and emission factor databases, a global emission inventory was compiled with high spatial (0.1° × 0.1°), temporal (monthly), and source (87 sources) resolutions for the period 1960 to 2014. The monthly emission data have been uploaded online ( http://inventory.pku.edu.cn ), along with a number of other air pollutant and greenhouse gas data for free download. Differences in source profiles, not global total quantities, between our results and those reported previously were found. There were significant differences in total and per capita emissions and emission intensities among countries, especially between the developing and developed countries. Globally, the total annual NO x emissions finally stopped increasing in 2013 after continuously increasing over several decades, largely due to strict control measures taken in China in recent years. Nevertheless, the peak year of NO x emissions was later than for many other major air pollutants. Per capita emissions, either among countries or over years, follow typical inverted U-shaped environmental Kuznets curves, indicating that the emissions increased during the early stage of development and were restrained when socioeconomic development reached certain points. Although the trends are similar among countries, the turning points of developing countries appeared sooner than those of developed countries in terms of development status, confirming late-move advantages.

Organization of population-based cancer control programs: Europe and the world.

PubMed

Otter, Renée; Qiao, You-Lin; Burton, Robert; Samiei, Massoud; Parkin, Max; Trapido, Edward; Weller, David; Magrath, Ian; Sutcliffe, Simon

2009-01-01

As cancer is to a large extent avoidable and treatable, a cancer control program should be able to reduce mortality and morbidity and improve the quality of life of cancer patients and their families. However, the extent to which the goals of a cancer control program can be achieved will depend on the resource constraints a country faces. Such population-based cancer control plans should prioritize effective interventions and programs that are beneficial to the largest part of the population, and should include activities devoted to prevention, screening and early detection, treatment, palliation and end-of-life care, and rehabilitation. In order to develop a successful cancer control program, leadership and the relevant stakeholders, including patient organizations, need to be identified early on in the process so that all partners can take ownership and responsibility for the program. Various tools have been developed to aid them in the planning and implementation process. However, countries developing a national cancer control program would benefit from a discussion of different models for planning and delivery of population-based cancer control in settings with differing levels of resource commitment, in order to determine how best to proceed given their current level of commitment, political engagement and resources. As the priority assigned to different components of cancer control will differ depending on available resources and the burden and pattern of cancer, it is important to consider the relative roles of prevention, early detection, diagnosis, treatment, rehabilitation and palliative care in a cancer control program, as well as how to align available resources to meet prioritized needs. Experiences from countries with differing levels of resources are presented and serve to illustrate the difficulties in developing and implementing cancer control programs, as well as the innovative strategies that are being used to maximize available resources and enhance the quality of care provided to cancer patients around the world.

Gender Inequity Associated with Increased Child Physical Abuse and Neglect: a Cross-Country Analysis of Population-Based Surveys and Country-Level Statistics.

PubMed

Klevens, Joanne; Ports, Katie A

2017-11-01

Gender inequity is proposed as a societal-level risk factor for child maltreatment. However, most cross-national research examining this association is limited to developing countries and has used limited measures of gender inequity and child homicides as a proxy for child maltreatment. To examine the relationship between gender inequity and child maltreatment, we used caregivers' reported use of severe physical punishment (proxy for physical abuse) and children under 5 left alone or under the care of another child younger than 10 years of age (supervisory neglect) and three indices of gender inequity (the Social and Institutional Gender Index, the Gender Inequality Index, and the Gender Gap Index) from 57 countries, over half of which were developing countries. We found all three gender inequity indices to be significantly associated with physical abuse and two of the three to be significantly associated with neglect, after controlling for country-level development. Based on these findings, efforts to prevent child abuse and neglect might benefit from reducing gender inequity.

A review of human biomonitoring in selected Southeast Asian countries.

PubMed

Barnett-Itzhaki, Zohar; Esteban López, Marta; Puttaswamy, Naveen; Berman, Tamar

2018-07-01

Rapid development and industrialization in Southeast (SE) Asia has led to environmental pollution, potentially exposing the general population to environmental contaminants. Human biomonitoring (HBM), measurement of chemical and/or their metabolites in human tissues and fluids, is an important tool for assessing cumulative exposure to complex mixtures of chemicals and for monitoring chemical exposures in the general population. While there are national HBM programs in several developed countries, there are no such national programs in most of the SE Asian countries. However, in recent years there has been progress in the field of HBM in many of the SE Asian countries. In this review, we present recent HBM studies in five selected SE Asian countries: Bangladesh, Indonesia, Malaysia, Myanmar and Thailand. While there is extensive HBM research in several SE Asian countries, such as Thailand, in other countries HBM studies are limited and focus on traditional environmental pollutants (such as lead, arsenic and mercury). Further development of this field in SE Asia would be benefited by establishment of laboratory capacity, improving quality control and assurance, collaboration with international experts and consortiums, and sharing of protocols and training both for pre-analytical and analytical phases. This review highlights the impressive progress in HBM research in selected SE Asian countries and provides recommendations for development of this field. Copyright © 2018 Elsevier Ltd. All rights reserved.

How well are malaria maps used to design and finance malaria control in Africa?

PubMed

Omumbo, Judy A; Noor, Abdisalan M; Fall, Ibrahima S; Snow, Robert W

2013-01-01

Rational decision making on malaria control depends on an understanding of the epidemiological risks and control measures. National Malaria Control Programmes across Africa have access to a range of state-of-the-art malaria risk mapping products that might serve their decision-making needs. The use of cartography in planning malaria control has never been methodically reviewed. An audit of the risk maps used by NMCPs in 47 malaria endemic countries in Africa was undertaken by examining the most recent national malaria strategies, monitoring and evaluation plans, malaria programme reviews and applications submitted to the Global Fund. The types of maps presented and how they have been used to define priorities for investment and control was investigated. 91% of endemic countries in Africa have defined malaria risk at sub-national levels using at least one risk map. The range of risk maps varies from maps based on suitability of climate for transmission; predicted malaria seasons and temperature/altitude limitations, to representations of clinical data and modelled parasite prevalence. The choice of maps is influenced by the source of the information. Maps developed using national data through in-country research partnerships have greater utility than more readily accessible web-based options developed without inputs from national control programmes. Although almost all countries have stratification maps, only a few use them to guide decisions on the selection of interventions allocation of resources for malaria control. The way information on the epidemiology of malaria is presented and used needs to be addressed to ensure evidence-based added value in planning control. The science on modelled impact of interventions must be integrated into new mapping products to allow a translation of risk into rational decision making for malaria control. As overseas and domestic funding diminishes, strategic planning will be necessary to guide appropriate financing for malaria control.

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

PubMed Central

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

2014-01-01

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

[International trade in living penaeid shrimp between countries in the Pacific and the Atlantic areas and in Europe].

PubMed

Michel, A

1996-06-01

The tremendous development of penaeid shrimp culture across the world over the past twenty years has led to international trade in eggs, larvae and spawners of the best shrimp species for aquaculture. Trade has involved, in particular, the following species: -Penaeus japonicus from Japan to Europe, the Pacific Islands and South America -P. monodon from South-East Asia to almost all tropical countries -P. vannamei and P. stylirostris from countries along the Pacific coast of South and central America to the United States of America, the islands of the South Pacific, countries along the Atlantic coast of the Americas and certain countries in Africa. In the 1980s, research conducted by American and French teams enabled the breeding of stocks of spawners in captivity. This resulted in the establishment of lines of captive broodstock outside natural areas of distribution, and the development of new breeding farms in previously unproductive regions. Trade related to movements of these species is facilitated by the absence of legislation in most countries; even when such legislation does exist, it is not always applied. These practices have led to the rapid development of world shrimp production, but have also contributed to the dissemination of pathogens. In recent years, the occurrence of serious epizootics - occasioning heavy losses world-wide - has led to a more cautious approach involving trade of post-larvae obtained from captive broodstock in which thorough control measures have been implemented for known diseases. Trade in wild shrimp will probably be abandoned progressively, to avoid the risk of introducing new pathogens. The main challenges for research in the near future are the development of diagnostic tools, to enable continuous control of captive broodstock, and the selection of strains which are resistant to the principal pathogens affecting these species.

An international comparison of stakeholder motivation to implement liver cancer control.

PubMed

Bridges, John F P; Joy, Susan M; Blauvelt, Barri M; Yan, Weili; Marsteller, Jill A

2015-06-01

The World Health Organization offers clear guidance on the development of national cancer control programmes based on a country's level of resources, yet the motivation to implement such programmes may be driven by factors other than resources. To compare stakeholder motivation to implement a national liver cancer control programme and assess if variation in motivation was associated with stakeholder characteristics or with national indicators of need and resources. Relevant stakeholders were purposively selected from 13 countries (Australia, China, France, Germany, Italy, Japan, Nigeria, South Korea, Spain, Taiwan, Thailand, Turkey and USA) to participate in a structured survey on liver cancer control. Respondents included 12 individuals working in clinical, 5 in policy and 3 in advocacy roles from each country. Stakeholders' motivation was measured using a scale grounded in expectancy theory and knowledge gained during previous qualitative interviews. Comparisons across countries and respondent characteristics were conducted using hierarchical regression. Country level motivation scores, holding constant individual level covariates, were correlated with indicators of need and resources and tested using Pearson's correlation coefficients. In total, 260 stakeholders, equally drawn from the study countries, completed the survey (45% response rate). At the national level, motivation was highest in Nigeria, Thailand and China (P < 0.001), and lowest in Italy (P < 0.001) and Germany (P = 0.003). Higher motivation was observed among stakeholders working at the international level relative to the local level (P = 0.017). Motivation was positively associated with a country's relative burden of liver cancer (P = 0.015) and negatively associated with their level of resources (P = 0.018). This study provides the first empirical evidence on the motivation of stakeholders to implement national cancer control programmes. Furthermore, we demonstrate that motivation is more clearly associated with a country's cancer control needs rather than resources. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Investment in preventing and preparing for biological emergencies and disasters: social and economic costs of disasters versus costs of surveillance and response preparedness.

PubMed

Rushton, J; Upton, M

2006-04-01

Biological emergencies such as the appearance of an exotic transboundary or emerging disease can become disasters. The question that faces Veterinary Services in developing countries is how to balance resources dedicated to active insurance measures, such as border control, surveillance, working with the governments of developing countries, and investing in improving veterinary knowledge and tools, with passive measures, such as contingency funds and vaccine banks. There is strong evidence that the animal health situation in developed countries has improved and is relatively stable. In addition, through trade with other countries, developing countries are becoming part of the international animal health system, the status of which is improving, though with occasional setbacks. However, despite these improvements, the risk of a possible biological disaster still remains, and has increased in recent times because of the threat of bioterrorism. This paper suggests that a model that combines decision tree analysis with epidemiology is required to identify critical points in food chains that should be strengthened to reduce the risk of emergencies and prevent emergencies from becoming disasters.

Systems Science for Caribbean Health: the development and piloting of a model for guiding policy on diabetes in the Caribbean.

PubMed

Guariguata, L; Guell, C; Samuels, T A; Rouwette, E A J A; Woodcock, J; Hambleton, I R; Unwin, N

2016-10-26

Diabetes is highly prevalent in the Caribbean, associated with a high morbidity and mortality and is a recognised threat to economic and social development. Heads of Government in the Caribbean Community came together in 2007 and declared their commitment to reducing the burden of non-communicable diseases (NCDs), including diabetes, by calling for a multi-sectoral, systemic response. To facilitate the development of effective policies, policymakers are being engaged in the development and use of a system dynamics (SD) model of diabetes for Caribbean countries. Previous work on a diabetes SD model from the United States of America (USA) is being adapted to a local context for three countries in the region using input from stakeholders, a review of existing qualitative and quantitative data, and collection of new qualitative data. Three country models will be developed using one-on-one stakeholder engagement and iterative revision. An inter-country model will also be developed following a model-building workshop. Models will be compared to each other and to the USA model. The inter-country model will be used to simulate policies identified as priorities by stakeholders and to develop targets for prevention and control. The model and model-building process will be evaluated by stakeholders and a manual developed for use in other high-burden developing regions. SD has been applied with success for health policy development in high-income country settings. The utility of SD in developing countries as an aid to policy decision-making related to NCDs has not been tested. This study represents the first of its kind.

The global impact of noncommunicable diseases: estimates and projections.

PubMed

Manton, K G

1988-01-01

With the aging of populations in developing countries there is both a demographic and an epidemiological transition which affects the impact of chronic degenerative diseases on the health status of the populations. Demographic transition takes place in countries where there are effective programmes of disease control which allow for survival during the early years of childhood and adolescence. This results in an increase in life expectancy which places larger proportions of the population in the age range (60 years and older) in which chronic degenerative diseases become the major determinants of health status. Epidemiological transition in diseases may also be brought about by shifts in social and economic patterns which favour detrimental changes in risk factors for the chronic degenerative diseases. Such changes may include health-related behaviour which augments dietary consumption of fats and alcohol, increases obesity, increases smoking and decreases physical activity. Such changes in risk-factor levels increase the prevalence of chronic degenerative diseases which manifest themselves at later ages, and for which early preventive actions could be cost-effective. In order to illustrate the impact of both demographic and risk-factor effects, analyses are made of the impact of increases in life expectancy on cause-specific mortality in both developing and developed countries. It is shown that there is great similarity in the effect of major noncommunicable diseases on the life expectancy of adults in both developed and developing countries. The major differences are seen to be in the proportions of deaths expected from such diseases as cancer, diabetes, heart disease, stroke and cirrhosis; but not in the distribution of age at death which is the better measure of disease impact. Demographic analyses, computing indirect estimates of mortality, also demonstrate that there are currently more chronic disease deaths in developing than developed countries and that as expectation of life increases in developing countries the global chronic disease burden will be greatly concentrated in the developing countries. Analyses of risk-factor reduction by feasible intervention strategies, e.g. smoking cessation campaigns, treatment of high blood pressure, using relationships between risk factors and diseases established in longitudinal studies carried out in developed countries, point out that the effect of risk-factor control in long-living populations can be hidden by the dependency of risk factors and various related causes of death, e.g. smoking has an impact on lung cancer, ischaemic heart disease and emphysema, but at different ages.(ABSTRACT TRUNCATED AT 400 WORDS)

A cross-cultural investigation of inhibitory control, generative fluency, and anxiety symptoms in Romanian and Russian preschoolers.

PubMed

Cheie, Lavinia; Veraksa, Aleksander; Zinchenko, Yuri; Gorovaya, Alexandra; Visu-Petra, Laura

2015-01-01

The current study focused on the early development of inhibitory control in 5- to 7-year-old children attending kindergarten in two Eastern-European countries, Romania and Russia. These two countries share many aspects of child-rearing and educational practices, previously documented to influence the development of inhibitory control. Using the Lurian-based developmental approach offered by the Developmental Neuropsychological Assessment battery, the study aimed to contribute to cross-cultural developmental neuropsychology by exploring (a) early interrelationships between subcomponents of inhibitory control (response suppression and attention control) and generative fluency (verbal and figural) in these two cultures, as well as (b) the predictive value of external factors (culture and maternal education) and individual differences (age, gender, nonverbal intelligence, trait anxiety) on inhibitory control and fluency outcomes in children from both countries. First, findings in both culture samples suggest that even at this young age, the construct of inhibitory control cannot be considered a unitary entity. Second, differences in maternal education were not predictive of either inhibitory control or fluency scores. However, children's attention control performance varied as a function of culture, and the direction of these cultural effects differed by whether the target outcome involved performance accuracy versus efficiency as an output. Findings also confirmed the previously documented intensive developmental improvement in preschoolers' inhibitory control during this period, influencing measures of response suppression and particularly attention control. Finally, the results further stress the importance of individual differences effects in trait anxiety on attention control efficiency across cultures.

Prevention and control of avian influenza: the need for a paradigm shift in pandemic influenza preparedness.

PubMed

Martinot, A; Thomas, J; Thiermann, A; Dasgupta, N

2007-03-10

Avian influenza presents both challenges and opportunities to leaders around the world engaged in pandemic influenza preparedness planning. Most resource-poor countries will be unable to stockpile antivirals or have access to eventual human vaccines for pandemic flu. Preparedness plans, directed at controlling avian influenza at the source, enable countries simultaneously to promote national and global health, animal welfare and international development. Improving the veterinary infrastructure and capacity of resource-poor countries is one way to prevent potential pandemic flu deaths in resource-rich countries. In this article, Amanda Martinot, James Thomas, Alejandro Thiermann and Nabarun Dasgupta argue that national health leaders need to consider more comprehensive strategies that incorporate veterinary surveillance and improvements in veterinary infrastructure for the control of avian influenza epizootics as part of national pandemic preparedness planning. This, they argue, will require a shift in attitude, from thinking in terms of preparation for an inevitable pandemic to pre-emption of the potential pandemic through prevention measures in the animal population.

A Critical Analysis of the Brazilian Response to HIV/AIDS: Lessons Learned for Controlling and Mitigating the Epidemic in Developing Countries

PubMed Central

Berkman, Alan; Garcia, Jonathan; Muñoz-Laboy, Miguel; Paiva, Vera; Parker, Richard

2005-01-01

The Brazilian National AIDS Program is widely recognized as the leading example of an integrated HIV/AIDS prevention, care, and treatment program in a developing country. We critically analyze the Brazilian experience, distinguishing those elements that are unique to Brazil from the programmatic and policy decisions that can aid the development of similar programs in other low- and middle-income and developing countries. Among the critical issues that are discussed are human rights and solidarity, the interface of politics and public health, sexuality and culture, the integration of prevention and treatment, the transition from an epidemic rooted among men who have sex with men to one that increasingly affects women, and special prevention and treatment programs for injection drug users. PMID:15933232

The International Conference on Indochinese Refugees and Its Aftermath. Refugee Policy Group Issue Brief.

ERIC Educational Resources Information Center

Knowles, Michael

A conference on Indochinese refugees, attended by representatives of Southeast Asian countries of first asylum and Western resettlement countries, has developed a Comprehensive Plan of Action (CPA) prescribing new measures to address continuing emigration from Vietnam and Laos. The CPA calls for the following measures: (1) controls on departures…

The Impact of Computerization on Archival Finding Aids: A RAMP Study.

ERIC Educational Resources Information Center

Kitching, Christopher

This report is based on a questionnaire sent to 32 selected National Archives and on interviews with archivists from eight countries. Geared to the needs of developing countries, the report covers: (1) the impact of computerization on finding aids; (2) advantages and problems of computerization, including enhanced archival control, integration of…

Rotavirus vaccine RIX4414 (Rotarix™): a pharmacoeconomic review of its use in the prevention of rotavirus gastroenteritis in developing countries.

PubMed

Plosker, Greg L

2011-11-01

This article provides an overview of the clinical profile of rotavirus vaccine RIX4414 (Rotarix™) in the prevention of rotavirus gastroenteritis (RVGE) in developing countries, followed by a comprehensive review of pharmacoeconomic analyses with the vaccine in low- and middle-income countries. RVGE is associated with significant morbidity and mortality among children <5 years of age in developing countries. The protective efficacy of a two-dose oral series of rotavirus vaccine RIX4414 has been demonstrated in several well designed clinical trials conducted in developing countries, and the 'real-world' effectiveness of the vaccine has also been shown in naturalistic and case-control trials after the introduction of universal vaccination programmes with RIX4414 in Latin American countries. The WHO recommends universal rotavirus vaccination programmes for all countries. Numerous modelled cost-effectiveness analyses have been conducted with rotavirus vaccine RIX4414 across a wide range of low- and middle-income countries. Although data sources and assumptions varied across studies, results of the analyses consistently showed that the introduction of the vaccine as part of a national vaccination programme would be very (or highly) cost effective compared with no rotavirus vaccination programme, according to widely used cost-effectiveness thresholds for developing countries. Vaccine price was not known at the time the analyses were conducted and had to be estimated. In sensitivity analyses, rotavirus vaccine RIX4414 generally remained cost effective at the highest of a range of possible vaccine prices considered. Despite these favourable results, decisions regarding the implementation of universal vaccination programmes with RIX4414 may also be contingent on budgetary and other factors, underscoring the importance of subsidized vaccination programmes for poor countries through the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunization).

Direct-acting Antivirals and Host-targeting Agents against the Hepatitis A Virus

PubMed Central

Kanda, Tatsuo; Nakamoto, Shingo; Wu, Shuang; Nakamura, Masato; Jiang, Xia; Haga, Yuki; Sasaki, Reina; Yokosuka, Osamu

2015-01-01

Hepatitis A virus (HAV) infection is a major cause of acute hepatitis and occasionally leads to acute liver failure in both developing and developed countries. Although effective vaccines for HAV are available, the development of new antivirals against HAV may be important for the control of HAV infection in developed countries where no universal vaccination program against HAV exists, such as Japan. There are two forms of antiviral agents against HAV: direct-acting antivirals (DAAs) and host-targeting agents (HTAs). Studies using small interfering ribonucleic acid (siRNA) have suggested that the HAV internal ribosomal entry site (IRES) is an attractive target for the control of HAV replication and infection. Among the HTAs, amantadine and interferon-lambda 1 (IL-29) inhibit HAV IRES-mediated translation and HAV replication. Janus kinase (JAK) inhibitors inhibit La protein expression, HAV IRES activity, and HAV replication. Based on this review, both DAAs and HTAs may be needed to control effectively HAV infection, and their use should continue to be explored. PMID:26623267

From malaria control to eradication: The WHO perspective.

PubMed

Mendis, Kamini; Rietveld, Aafje; Warsame, Marian; Bosman, Andrea; Greenwood, Brian; Wernsdorfer, Walther H

2009-07-01

Efforts to control malaria have been boosted in the past few years with increased international funding and greater political commitment. Consequently, the reported malaria burden is being reduced in a number of countries throughout the world, including in some countries in tropical Africa where the burden of malaria is greatest. These achievements have raised new hopes of eradicating malaria. This paper summarizes the outcomes of a World Health Organization's expert meeting on the feasibility of such a goal. Given the hindsight and experience of the Global Malaria Eradication Programme of the 1950s and 1960s, and current knowledge of the effectiveness of antimalarial tools and interventions, it would be feasible to effectively control malaria in all parts of the world and greatly reduce the enormous morbidity and mortality of malaria. It would also be entirely feasible to eliminate malaria from countries and regions where the intensity of transmission is low to moderate, and where health systems are strong. Elimination of malaria requires a re-orientation of control activity, moving away from a population-based coverage of interventions, to one based on a programme of effective surveillance and response. Sustained efforts will be required to prevent the resurgence of malaria from where it is eliminated. Eliminating malaria from countries where the intensity of transmission is high and stable such as in tropical Africa will require more potent tools and stronger health systems than are available today. When such countries have effectively reduced the burden of malaria, the achievements will need to be consolidated before a programme re-orientation towards malaria elimination is contemplated. Malaria control and elimination are under the constant threat of the parasite and vector mosquito developing resistance to medicines and insecticides, which are the cornerstones of current antimalarial interventions. The prospects of malaria eradication, therefore, rest heavily on the outcomes of research and development for new and improved tools. Malaria control and elimination are complementary objectives in the global fight against malaria.

Controlling water pollution in developing and transition countries--lessons from three successful cases.

PubMed

Kathuria, Vinish

2006-03-01

The policy prescription for solving environmental problems of developing countries and countries-in-transition (CIT) is slowly getting polarized into two viewpoints. One group of researchers and policy advocates including multilateral organizations upholds extensive use of market based instruments (MBIs) in these countries. The other group argues that institutions need to be built first or the policy makers should select the incremental or tiered approach taking into account the existing capabilities. The group also insists that the financial, institutional and political constraints make environmental regulation in these countries more problematic than in industrialized countries. In the short-run, the immediate needs of the developing countries can be addressed effectively by learning lessons from the difficulties encountered by a few successful cases and accordingly evolving an appropriate policy instrument. In this paper an attempt has been made to highlight three such cases from three different parts of the world--Malaysia (Asia-pacific), Poland (Eastern Europe) and Colombia (Latin America). The paper looks into what policy instruments led to a fall in water pollution levels in these countries and what role did MBIs play in this pollution mitigation? The case studies suggest that it is a combination of instruments--license fee, standards, charge and subsidies--reinforced by active enforcement that led to an overall improvement in environment compliance.

The Canadian effort to prevent and control hypertension: can other countries adopt Canadian strategies?

PubMed

Campbell, Norm R C; Sheldon, Tobe

2010-07-01

To indicate the key elements of current Canadian programs to treat and control hypertension. In the early 1990s Canada had a hypertension treatment and control rate of 13%. A Canadian strategy to prevent and control hypertension was developed and a coalition of national organizations and volunteers formed to develop increasingly extensive programs. The Canadian effort was largely based on annually updated hypertension management recommendations, an integrated and extensive hypertension knowledge translation program and an increasingly comprehensive outcomes assessment program. After the start of the annual process in 1999, there were very large increases in diagnosis and hypertension treatment coupled with dropping rates of cardiovascular disease. More recent initiatives include an extensive education program for the public and people with hypertension, a program to reduce dietary salt and a funded leadership position. The treatment and control rate increased to 66% when last assessed (2007-2009). The study describes important aspects of the Canadian hypertension management programs to aid those wishing to develop similar programs. Many of the programs could be fully or partially implemented by other countries.

Safety assessment of foods from genetically modified crops in countries with developing economies.

PubMed

Delaney, Bryan

2015-12-01

Population growth particularly in countries with developing economies will result in a need to increase food production by 70% by the year 2050. Biotechnology has been utilized to produce genetically modified (GM) crops for insect and weed control with benefits including increased crop yield and will also be used in emerging countries. A multicomponent safety assessment paradigm has been applied to individual GM crops to determine whether they as safe as foods from non-GM crops. This paper reviews methods to assess the safety of foods from GM crops for safe consumption from the first generation of GM crops. The methods can readily be applied to new products developed within country and this paper will emphasize the concept of data portability; that safety data produced in one geographic location is suitable for safety assessment regardless of where it is utilized. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Investing in improved performance of national tuberculosis programs reduces the tuberculosis burden: analysis of 22 high-burden countries, 2002-2009.

PubMed

Akachi, Yoko; Zumla, Alimuddin; Atun, Rifat

2012-05-15

To assess the impact of investment in national tuberculosis programs (NTPs) on NTP performance and tuberculosis burden in 22 high-burden countries, as determined by the World Health Organization (WHO). Estimates of annual tuberculosis burden and NTP performance indicators and control variables during 2002-2009 were obtained from the Organization for Economic Cooperation and Development, the WHO, the World Bank, and the Penn World Table for the 22 high-burden countries. Panel data analysis was performed using the outcome variables tuberculosis incidence, prevalence, and mortality and the key explanatory variables Partnership case detection rate and treatment success rate, controlling for gross domestic product per capita, population structure, and human immunodeficiency virus (HIV) prevalence. A $1 per capita (general population) higher NTP budget (including domestic and external sources) was associated with a 1.9% (95% confidence interval, .12%-3.6%) higher estimated case detection rate the following year for the 22 high-burden countries between 2002 and 2009. In the final models, which corrected for autocorrelation and heteroskedasticity, achieving the STOP TB Partnership case detection rate target of >70% was associated with significantly (P < .01) lower tuberculosis incidence, prevalence, and mortality the following year, even when controlling for general economic development and HIV prevalence as potential confounding variables. Increased investment in NTPs was significantly associated with improved performance and with a downward trend in the tuberculosis burden in the 22 high-burden countries during 2002-2009.

Are greenhouse gas emissions and cognitive skills related? Cross-country evidence.

PubMed

Omanbayev, Bekhzod; Salahodjaev, Raufhon; Lynn, Richard

2018-01-01

Are greenhouse gas emissions (GHG) and cognitive skills (CS) related? We attempt to answer this question by exploring this relationship, using cross-country data for 150 countries, for the period 1997-2012. After controlling for the level of economic development, quality of political regimes, population size and a number of other controls, we document that CS robustly predict GHG. In particular, when CS at a national level increase by one standard deviation, the average annual rate of air pollution changes by nearly 1.7% (slightly less than one half of a standard deviation). This significance holds for a number of robustness checks. Copyright © 2017 Elsevier Inc. All rights reserved.

A focus on adolescence to reduce neurological, mental health and substance-use disability.

PubMed

Davidson, Leslie L; Grigorenko, Elena L; Boivin, Michael J; Rapa, Elizabeth; Stein, Alan

2015-11-19

Globally, there is a crucial need to prioritize research directed at reducing neurological, mental health and substance-use disorders in adolescence, which is a pivotal age for the development of self-control and regulation. In adolescence, behaviour optimally advances towards adaptive long-term goals and suppresses conflicting maladaptive short-lived urges to balance impulsivity, exploration and defiance, while establishing effective societal participation. When self-control fails to develop, violence, injury and neurological, mental health and substance-use disorders can result, further challenging the development of self-regulation and impeding the transition to a productive adulthood. Adolescent outcomes, positive and negative, arise from both a life-course perspective and within a socioecological framework. Little is known about the emergence of self-control and regulation in adolescents in low- and middle-income countries where enormous environmental threats are more common (for example, poverty, war, local conflicts, sex trafficking and slavery, early marriage and/or pregnancy, and the absence of adequate access to education) than in high-income countries and can threaten optimal neurodevelopment. Research must develop or adapt appropriate assessments of adolescent ability and disability, social inclusion and exclusion, normative development, and neurological, mental health and substance-use disorders. Socioecological challenges in low- and middle-income countries require innovative strategies to prevent mental health, neurological and substance-use disorders and develop effective interventions for adolescents at risk, especially those already living with these disorders and the consequent disability.

Gathering time-series data for evaluating behavior-change campaigns in developing countries: reactivity of diaries and interviews.

PubMed

Tobias, Robert; Inauen, Jennifer

2010-10-01

Gathering time-series data of behaviors and psychological variables is important to understand, guide, and evaluate behavior-change campaigns and other change processes. However, repeated measurement can affect the phenomena investigated, particularly frequent face-to-face interviews, which are often the only option in developing countries. This article presents three intervention control studies to investigate this issue. Daily diaries in Cuba did not affect behavior or attitudes for persons with intervention but reduced attitudes for persons without intervention. Reactivity of face-to-face interviews in Bolivia was negligible if applied weekly, but strong if applied twice per week. The article concludes with recommendations for gathering time-series data in developing countries.

The global cancer burden and human development: A review.

PubMed

Fidler, Miranda M; Bray, Freddie; Soerjomataram, Isabelle

2018-02-01

This review examines the links between human development and cancer overall and for specific types of cancer, as well as cancer-related risk-factors and outcomes, such as disability and life expectancy. To assess human development, the Human Development Index was utilized continuously and according to four levels (low, medium, high, very high), where the low and very high categories include the least and most developed countries, respectively. All studies that assessed aspects of the global cancer burden using this measure were reviewed. Although the present cancer incidence burden is greater in higher Human Development Index countries, a greater proportion of the global mortality burden is observed in less developed countries, with a higher mean fatality rate in the latter countries. Further, the future cancer burden is expected to disproportionally affect less developed regions; in particular, it has been estimated that low and medium Human Development Index countries will experience a 100% and 81% increase in cancer incidence from 2008 to 2030, respectively. Disparities were also observed in risk factors and average health outcomes, such as a greater number of years of life lost prematurely and fewer cancer-related gains in life expectancy observed in lower versus higher Human Development Index settings. From a global perspective, there remain clear disparities in the cancer burden according to national Human Development Index scores. International efforts are needed to aid countries in social and economic transition in order to efficiently plan, implement and evaluate cancer control initiatives as a means to reduce the widening gap in cancer occurrence and survival worldwide.

The relationship between parity and overweight varies with household wealth and national development.

PubMed

Kim, Sonia A; Yount, Kathryn M; Ramakrishnan, Usha; Martorell, Reynaldo

2007-02-01

Recent studies support a positive relationship between parity and overweight among women of developing countries; however, it is unclear whether these effects vary by household wealth and national development. Our objective was to determine whether the association between parity and overweight [body mass index (BMI) > or =25 kg/m(2)] in women living in developing countries varies with levels of national human development and/or household wealth. We used data from 28 nationally representative, cross-sectional surveys conducted between 1996 and 2003 (n = 275 704 women, 15-49 years). The relationship between parity and overweight was modelled using logistic regression, controlling for several biological and sociodemographic factors and national development, as reflected by the United Nations' Human Development Index. We also modelled the interaction between parity and national development, and the three-way interaction between parity, household wealth and national development. Parity had a weak, positive association with overweight, which varied by household wealth and national development. Among the poorest women and women in the second tertile of household wealth, parity was positively related to overweight only in the most developed countries. Among the wealthiest women, parity was positively related to overweight regardless of the level of national development. As development increases, the burden of parity-related overweight shifts to include poor as well as wealthy women. In the least-developed countries, programmes to prevent parity-related overweight should target wealthy women, whereas such programmes should be provided to all women in more developed countries.

Initiating malaria control programs in the third world: directives for short- and long-term solutions.

PubMed

Basu, Sanjay

2002-01-01

Although malaria is a growing problem affecting several hundred million people each year, many malarial countries lack successful disease control programs. Worldwide malaria incidence rates are dramatically increasing, generating fear among many people who are witnessing malaria control initiatives fail. In this paper, we explore two options for malaria control in poor countries: (1) the production and distribution of a malaria vaccine and (2) the control of mosquitoes that harbor the malaria parasite. We first demonstrate that the development of a malaria vaccine is indeed likely, although it will take several years to produce because of both biological obstacles and insufficient research support. The distribution of such a vaccine, as suggested by some economists, will require that wealthy states promise a market to pharmaceutical companies who have traditionally failed to investigate diseases affecting the poorest of nations. But prior to the development of a malaria vaccine, we recommend the implementation of vector control pro- grams, such as those using Bti toxin, in regions with low vector capacity. Our analysis indicates that both endogenous programs in malarial regions and molecular approaches to parasite control will provide pragmatic solutions to the malaria problem. But the successful control of malaria will require sustained support from wealthy nations, without whom vaccine development and vector control programs will likely fail.

[Malaria research for developing countries: the PAL+ program].

PubMed

Agid, F

2003-01-01

Despite extensive national and international intervention, little progress has been made in controlling, malaria and other communicable diseases afflicting many developing countries in the world. In response to the need to pursue and enhance investigation, the French Ministry of Research launched the PAL+ program in 1999 with the purpose of promoting concerted "research on malaria and other communicable diseases afflicting developing countries". The program is focused on developing methods of prevention and treatment for countries in Sub-Saharan Africa, Southeast Asia, and Latin America. Advancement of these scientific goals is further by a determined efforts (i) to provide means for national coordination and scientific organization of malaria research in France and (ii) to revive the spirit and mechanisms that characterized previous operations of cooperation between France and countries in the southern hemisphere. This new vision of cooperation is based on two organizational approaches. The first involves integrated programs in which training and transfer of knowledge are essential. The second involves joint projects in which networks maintained by a continuous exchange in operational seminars contribute to establishing a permanent dialogue between the North and South. Priority research areas have been encouraged to respond to specific public health issues with emphasis on establishing a balance between work in the field and development of knowledge. The priority areas include (i) responding to the increasing incidence of drug resistance by identifying of new antimalarial drugs and defining new therapeutic strategies; (ii) understanding the implications of the pathophysiology and physiopathology mechanisms underlying severe malaria manifestations for development of a malaria vaccine; (iii) finding new opportunities for prevention of malaria based on more effective vector control; (iv) using social anthropology to factor population behaviour and habits into the design of effective malaria control measures. The PAL+ program was founded on a commitment to provide participating countries with the means necessary to improve their research capability and to coordinate and structure scientific research by creating enduring partnerships between investigators in France and southern hemisphere countries. For this purpose the PAL+ workshop program involving regular encounters between northern and southern hemisphere researchers has been set up to encourage discussion, interaction, and multidisciplinary projects. The exceptionally instructive impact of these workshops has proven to be an essential element in the overall PAL+ program that has greatly stimulated malaria research. This program has been successful in creating a new spirit of intervention and has provided a rarely equalled vehicle for collaboration. By bringing the whole research community together over the major research programs now under way in the North/South networks, the PAL+ program represents a new and decisive step in achieving the long-sought goal of meaningful scientific cooperation between northern and southern hemisphere countries in the domain of public health.

Can context justify an ethical double standard for clinical research in developing countries?

PubMed Central

Landes, Megan

2005-01-01

Background The design of clinical research deserves special caution so as to safeguard the rights of participating individuals. While the international community has agreed on ethical standards for the design of research, these frameworks still remain open to interpretation, revision and debate. Recently a breach in the consensus of how to apply these ethical standards to research in developing countries has occurred, notably beginning with the 1994 placebo-controlled trials to reduce maternal to child transmission of HIV-1 in Africa, Asia and the Caribbean. The design of these trials sparked intense debate with the inclusion of a placebo-control group despite the existence of a 'gold standard' and trial supporters grounded their justifications of the trial design on the context of scarcity in resource-poor settings. Discussion These 'contextual' apologetics are arguably an ethical loophole inherent in current bioethical methodology. However, this convenient appropriation of 'contextual' analysis simply fails to acknowledge the underpinnings of feminist ethical analysis upon which it must stand. A more rigorous analysis of the political, social, and economic structures pertaining to the global context of developing countries reveals that the bioethical principles of beneficence and justice fail to be met in this trial design. Conclusion Within this broader, and theoretically necessary, understanding of context, it becomes impossible to justify an ethical double standard for research in developing countries. PMID:16045801

[The European countries confronting cancer: a set of indicators assessing public health status].

PubMed

Borella, Laurent

2008-11-01

We now know that efficient public policies for cancer control need to be global and take into account each and all the factors involved: economics and level of development, style of life and risk factors, access to screening, effectiveness of the care-providing system. A very simple scorecard is proposed, based on publicized public health indicators, which allows a comparison between European countries. We extracted 49 indicators from public databases and literature concerning 22 European countries. We made correlation calculations in order to identify relevant indicators from which a global score was extracted. Using a hierarchical clustering method we were then able to identify subsets of homogeneous countries. A 7 indicator scorecard was drawn up: national gross product, scientific production, smoking rate, breast screening participating rate, all cancer mortality rate (male population), 5 years relative survival for colorectal cancer and life expectancy at birth. A global score shows: 1) the better positioned countries: Switzerland, Sweden, Finland and France; 2) the countries where cancer control is less effective: Estonia, Hungary, Poland and Slovakia. Three subsets of countries with a fairly similar profile were identified: a high level of means and results group; a high level of means but a medium level of results group; and a low level of means and results group. This work emphasizes dramatically heterogeneous situations between countries. A follow-up, using a reduced but regularly updated set of public health indicators, would help induce an active European policy for cancer control.

Global time trends in PAH emissions from motor vehicles

PubMed Central

Shen, Huizhong; Tao, Shu; Wang, Rong; Wang, Bin; Shen, Guofeng; Li, Wei; Su, Shenshen; Huang, Ye; Wang, Xilong; Liu, Wenxin; Li, Bengang; Sun, Kang

2013-01-01

Emission from motor vehicles is the most important source of polycyclic aromatic hydrocarbons (PAHs) in urban areas. Emission factors of individual PAHs for motor vehicles reported in the literature varied 4 to 5 orders of magnitude, leading to high uncertainty in emission inventory. In this study, key factors affecting emission factors of PAHs (EFPAH) for motor vehicles were evaluated quantitatively based on thousands of EFPAH measured in 16 countries for over 50 years. The result was used to develop a global emission inventory of PAHs from motor vehicles. It was found that country and vehicle model year are the most important factors affecting EFPAH, which can be quantified using a monovariate regression model with per capita gross domestic production (purchasing power parity) as a sole independent variable. On average, 29% of variation in log-transformed EFPAH could be explained by the model, which was equivalent to 90% reduction in overall uncertainty on arithmetic scale. The model was used to predict EFPAH and subsequently PAH emissions from motor vehicles for various countries in the world during a period from 1971 to 2030. It was estimated that the global emission reached its peak value of approximate 101 Gg in 1978 and decreased afterwards due to emission control in developed countries. The annual emission picked up again since 1990 owing to accelerated energy consumption in China and other developing countries. With more and more rigid control measures taken in the developing world, global emission of PAHs is currently passing its second peak. It was predicted that the emission would decrease from 77 Gg in 2010 to 42 Gg in 2030. PMID:24198716

Agency leads in family planning assistance.

PubMed

1989-01-01

The US Agency for International Development (USAID) is the main source of family planning assistance for the developing countries of the world. It accounts for 45% of the funding for population programs worldwide. USAID's policy promotes expanded family planning services, providing a broad range of birth control methods, promotes consumer delivery systems, and urges private sector assistance. Since the program began in the 1960's the number of people in the developing world using family planning increased from 15 million to 200 million. In 1959 there was only 1 country with a population policy, India, now there are 63 developing countries with policies. USAID has brought $567.7 million worth of contraceptives for distribution in 75 countries including 6.9 billion condoms, 1.6 billion cycles of pills, 49.7 million IUD's, and 16.5 vaginal foam tablets. USAID has funded research in contraceptives including the Hulka clip, laparoscopic sterilization, low-estrogen pills, progestin pills, Copper-T IUD, NORPLANT and NORPLANT 2. In addition, funding for a 3-month injectable and a 12 month pellet is being provided. The agency has also worked with the entertainment industry to produce songs to warn of the dangers of early pregnancy. They have also conducted the largest survey research program, using data from 149 surveys in 65 countries to assess the demand for family planning and analyze population dynamics. The number of women of reproductive age will increase 45% by the year 2000 increasing the demand for family planning dramatically. The resources needed by 2000 are estimated to be $5 billion and $7 billion by the year 2010. This will require efforts from government, private industry, and private voluntary organizations. USAID has developed a contraceptive marketing project worldwide to promote birth control sales and family planning. Another program helps private sector companies promote their own family planning services.

Is Child Labor a Barrier to School Enrollment in Low- and Middle-Income Countries?

PubMed Central

Putnick, Diane L.; Bornstein, Marc H.

2015-01-01

Achieving universal primary education is one of the Millennium Development Goals. In low- and middle-income developing countries (LMIC), child labor may be a barrier. Few multi-country, controlled studies of the relations between different kinds of child labor and schooling are available. This study employs 186,795 families with 7- to 14-year-old children in 30 LMIC to explore relations of children’s work outside the home, family work, and household chores with school enrollment. Significant negative relations emerged between each form of child labor and school enrollment, but relations were more consistent for family work and household chores than work outside the home. All relations were moderated by country and sometimes by gender. These differentiated findings have nuanced policy implications. PMID:26034342

Radio frequency energy for postharvest control of pests in dry nuts and legumes

USDA-ARS?s Scientific Manuscript database

Methyl bromide (MeBr) is widely used as a fumigant in insect control, but it is harmful to the environment and a concern to human health. The Montreal Protocol on Substances that Deplete the Ozone Layer calls for the elimination of MeBr by 2005 in developed countries and by 2015 in developing countr...

Prosopis: a global assessment of the biogeography, benefits, impacts and management of one of the world's worst woody invasive plant taxa

PubMed Central

Shackleton, Ross T.; Le Maitre, David C.; Pasiecznik, Nick M.; Richardson, David M.

2014-01-01

Invasive species cause ecological, economic and social impacts and are key drivers of global change. This is the case for the genus Prosopis (mesquite; Fabaceae) where several taxa are among the world's most damaging invasive species. Many contentious issues (‘conflicts of interest’) surround these taxa, and management interventions have not yet sustainably reduced the negative impacts. There is an urgent need to better understand the factors that drive invasions and shape management actions, and to compare the effectiveness of different management approaches. This paper presents a global review of Prosopis, focusing on its distribution, impacts, benefits and approaches to management. Prosopis was found to occur in a 129 countries globally and many more countries are climatically suitable. All areas with naturalized or invasive Prosopis species at present are suitable for more taxa and many Asian and Mediterranean countries with no records of Prosopis are bioclimatically suitable. Several Prosopis species have substantial impacts on biodiversity, ecosystem services, and local and regional economies in their native and even more so in their invasive ranges; others provide multiple benefits to local communities. Management efforts are underway in only a small part of the invaded range. Countries where more research has been done are more likely to implement formal management than those where little published research is available. Management strategies differ among countries; developed nations use mainly mechanical and chemical control whereas developing nations tend to apply control through utilization approaches. A range of countries are also using biological control. Key gaps in knowledge and promising options for management are highlighted. PMID:24899150

[The road to elimination: an overview of neglected infectious diseases in Latin America and the Caribbean].

PubMed

Ault, Steven Kenyon; Catalá Pascual, Laura; Grados-Zavala, Maria Elena; Gonzálvez García, Guillermo; Castellanos, Luis Gerardo

2014-04-01

Neglected infectious diseases (NID) affect mainly isolated populations living in isolation and in poor socioeconomic conditions. These diseases, by their chronic and silent nature, often affect communities with a weak political voice. This translates into very little attention or political priority; which is reflected in minimal and insufficient preventive measures, monitoring and control. However, there is evidence this situation is changing favorably in some countries of the Americas. In recent years, several resolutions (official agreement of the member countries of the Pan American Health Organization / World Health Organization-PAHO / WHO), regional and global agreements on public health; with a greater commitment from the pharmaceutical industry, and other donors and international partners in combination with the development and use of integrated action plans have allowed countries to intensify public interventions to control these diseases and thus achieve target elimination of NID. Onchocerciasis, lymphatic filariasis, Chagas disease, leprosy and trachoma blindness, among others, have been eliminated in several countries and endemic areas, regardless of the level of development of the country or geographical area where they are located. The political decision reflected in adequate financial resources in the next decade will be crucial to achieving the goals of elimination of NID (regional and national).

Transport jet aircraft noise abatement in foreign countries: Growth, structure, impact. Volume 1: Europe, July 1980

NASA Technical Reports Server (NTRS)

Spencer, F. A.

1980-01-01

The development and implementation of aircraft noise control regulations in various European states are described. The countries include the United Kingdom, France, Switzerland, Federal Republic of Germany, Sweden, Denmark, and the Netherlands. Topics discussed include noise monitoring, airport curfews, land use planning, and the government structure for noise regulation.

Opportunities for the power industry in South Africa

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

Lynch, R.W.; Pinkney, C.; Feld, L.

1996-11-01

South Africa is a country in the midst of transformation. Political changes within the country, and the ensuing empowerment of the black majority, have created a situation where dramatic improvements are needed in the country`s infrastructure in order to enable it to meet the needs of all its people over the coming decades. Largely as a result of the international embargo placed on South Africa during the apartheid era, the South African government became heavily involved in the country`s energy sector. This involvement included development of a synfuels program, price controls in the oil sector, monopolies in both upstream andmore » downstream oil sectors, and a strong centralized electric power company. In 1994, South Africa became the eleventh member of the Southern Africa Development Community (SADC), an organization which was established in 1980 to synchronize development plans for its member countries. SADC is presently working to formulate a regional energy development plan, and coordinate technical information exchanges and joint research needs. Each of the SADC nations have also begun to develop their regional electricity grids and other parts of their energy infrastructure to plan for the growing needs of the 500 million people who live in sub-Saharan Africa. South Africa, in particular, must make significant changes in each of its energy sectors in the near future, to keep up with its growing energy requirements. These changes translate to opportunity for the US Power Industry.« less

Space technology transfer to developing countries: opportunities and difficulties

NASA Astrophysics Data System (ADS)

Leloglu, U. M.; Kocaoglan, E.

Space technology, with its implications on science, economy and security, is mostly chosen as one of the priority areas for technological development by developing countries. Most nations aspiring to begin playing in the space league prefer technology transfer programs as a first step. Decreasing initial costs by small satellite technology made this affordable for many countries. However, there is a long way from this first step to establishment of a reliable space industry that can both survive in the long term with limited financial support from the government and meet national needs. This is especially difficult when major defense companies of industrialized countries are merging to sustain their competitiveness. The prerequisites for the success are implementation of a well-planned space program and existence of industrialization that can support basic testing and manufacturing activities and supply qualified manpower. In this study, the difficulties to be negotiated and the vicious circles to be broken for latecomers, that is, developing countries that invest on space technologies are discussed. Especially, difficulties in the technology transfer process itself, brain drain from developing countries to industrialized countries, strong competition from big space companies for domestic needs, costs of establishing and maintaining an infrastructure necessary for manufacturing and testing activities, and finally, the impact of export control will be emphasized. We will also try to address how and to what extent collaboration can solve or minimize these problems. In discussing the ideas mentioned above, lessons learned from the BILSAT Project, a technology transfer program from the UK, will be referred.

Contributions of the US Centers for Disease Control and Prevention in Implementing the Global Health Security Agenda in 17 Partner Countries.

PubMed

Fitzmaurice, Arthur G; Mahar, Michael; Moriarty, Leah F; Bartee, Maureen; Hirai, Mitsuaki; Li, Wenshu; Gerber, A Russell; Tappero, Jordan W; Bunnell, Rebecca

2017-12-01

The Global Health Security Agenda (GHSA), a partnership of nations, international organizations, and civil society, was launched in 2014 with a mission to build countries' capacities to respond to infectious disease threats and to foster global compliance with the International Health Regulations (IHR 2005). The US Centers for Disease Control and Prevention (CDC) assists partner nations to improve IHR 2005 capacities and achieve GHSA targets. To assess progress through these CDC-supported efforts, we analyzed country activity reports dating from April 2015 through March 2017. Our analysis shows that CDC helped 17 Phase I countries achieve 675 major GHSA accomplishments, particularly in the cross-cutting areas of public health surveillance, laboratory systems, workforce development, and emergency response management. CDC's engagement has been critical to these accomplishments, but sustained support is needed until countries attain IHR 2005 capacities, thereby fostering national and regional health protection and ensuring a world safer and more secure from global health threats.

Combining Google Earth and GIS mapping technologies in a dengue surveillance system for developing countries

PubMed Central

Chang, Aileen Y; Parrales, Maria E; Jimenez, Javier; Sobieszczyk, Magdalena E; Hammer, Scott M; Copenhaver, David J; Kulkarni, Rajan P

2009-01-01

Background Dengue fever is a mosquito-borne illness that places significant burden on tropical developing countries with unplanned urbanization. A surveillance system using Google Earth and GIS mapping technologies was developed in Nicaragua as a management tool. Methods and Results Satellite imagery of the town of Bluefields, Nicaragua captured from Google Earth was used to create a base-map in ArcGIS 9. Indices of larval infestation, locations of tire dumps, cemeteries, large areas of standing water, etc. that may act as larval development sites, and locations of the homes of dengue cases collected during routine epidemiologic surveying were overlaid onto this map. Visual imagery of the location of dengue cases, larval infestation, and locations of potential larval development sites were used by dengue control specialists to prioritize specific neighborhoods for targeted control interventions. Conclusion This dengue surveillance program allows public health workers in resource-limited settings to accurately identify areas with high indices of mosquito infestation and interpret the spatial relationship of these areas with potential larval development sites such as garbage piles and large pools of standing water. As a result, it is possible to prioritize control strategies and to target interventions to highest risk areas in order to eliminate the likely origin of the mosquito vector. This program is well-suited for resource-limited settings since it utilizes readily available technologies that do not rely on Internet access for daily use and can easily be implemented in many developing countries for very little cost. PMID:19627614

A longitudinal ecological study of the influences of political, economic, and health services characteristics on under-five mortality in less-developed countries.

PubMed

Chuang, Ying-Chih; Sung, Pei-Wei; Chao, Hsing Jasmine; Bai, Chyi-Huey; Chang, Chia-Jung

2013-09-01

This study used a longitudinal dataset and lagged dependent-variable panel regression models to examine whether political and economic characteristics directly predict under-5-year mortality rates (U5MR), and moderate the effects of health services and environment on U5MR. We used a sample of 46 less-developed countries from 1980 to 2009. Our results showed that the effects of political and economic characteristics on U5MR varied by non-sub-Saharan and sub-Saharan countries. After controlling for baseline U5MR and other socioeconomic variables, while foreign investment and health services were negatively associated U5MR, democracy was positively associated with U5MR in nonsub-Saharan countries. In contrast, debt was positively associated with and democracy and foreign investment were negatively associated with U5MR in sub-Saharan countries. The interaction analyses indicated that for sub-Saharan countries, the effects of health services on U5MR only existed for countries with low foreign investment. Copyright © 2013 Elsevier Ltd. All rights reserved.

Integration of Care in Management of CKD in Resource-Limited Settings.

PubMed

Okpechi, Ikechi G; Bello, Aminu K; Ameh, Oluwatoyin I; Swanepoel, Charles R

2017-05-01

The prevalence of noncommunicable diseases, including chronic kidney disease (CKD), continues to increase worldwide, and mortality from noncommunicable diseases is projected to surpass communicable disease-related mortality in developing countries. Although the treatment of CKD is expensive, unaffordable, and unavailable in many developing countries, the current structure of the health care system in such countries is not set up to deliver comprehensive care for patients with chronic conditions, including CKD. The World Health Organization Innovative Care for Chronic Conditions framework could be leveraged to improve the care of CKD patients worldwide, especially in resource-limited countries where high cost, low infrastructure, limited workforce, and a dearth of effective health policies exist. Some developing countries already are using established health systems for communicable disease control to tackle noncommunicable diseases such as hypertension and diabetes, therefore existing systems could be leveraged to integrate CKD care. Decision makers in developing countries must realize that to improve outcomes for patients with CKD, important factors should be considered, including enhancing CKD prevention programs in their communities, managing the political environment through involvement of the political class, involving patients and their families in CKD care delivery, and effective use of health care personnel. Copyright © 2017 Elsevier Inc. All rights reserved.

Global approach to reducing lead exposure and poisoning.

PubMed

Meyer, Pamela A; Brown, Mary Jean; Falk, Henry

2008-01-01

Lead poisoning is an important environmental disease that can have life-long adverse health effects. Most susceptible are children, and most commonly exposed are those who are poor and live in developing countries. Studies of children's blood-lead levels (BLLs) are showing cognitive impairment at increasingly lower BLLs. Lead is dangerous at all levels in children. The sources of lead exposure vary among and within countries depending on past and current uses. Sources of lead may be from historic contamination, recycling old lead products, or from manufacturing new products. In all countries that have banned leaded gasoline, average population BLLs have declined rapidly. In many developing countries where leaded gasoline is no longer used, many children and workers are exposed to fugitive emissions and mining wastes. Unexpected lead threats, such as improper disposal of electronics and children's toys contaminated with lead, continue to emerge. The only medical treatment available is chelation, which can save lives of persons with very high BLLs. However, chelating drugs are not always available in developing countries and have limited value in reducing the sequelae of chronic low dose lead exposure. Therefore, the best approach is to prevent exposure to lead. Because a key strategy for preventing lead poisoning is to identify and control or eliminate lead sources, this article highlights several major sources of lead poisoning worldwide. In addition, we recommend three primary prevention strategies for lead poisoning: identify sources, eliminate or control sources, and monitor environmental exposures and hazards.

[Research development on disinfection technology for viruses in drinking water].

PubMed

Zhang, Yun; Zhang, Qiang; Liu, Yan; Dai, Ruihua; Liu, Xiang

2010-09-01

With the deterioration of water source pollution, the quality requirements for drinking water of countries will become stricter and stricter, and the microbe index has been one of the important aspects. The introduction of the virus index and the development of disinfection technology focusing on virus have significant importance for the improvement of the drinking water standards and for the protection of people health in every country. To be familiar with the domestic and abroad research development of the disinfection control technology focusing on virus provides certain theory guidance and technological support for continuously improving drinking water standard in our country and for establishing safer drinking water processing technologies. So, this article will comprehensively describes 4 aspects: resistance comparison of virus over every disinfection technology, influential factors of disinfection, research development of new technology, and the mechanisms.

Development and technology transfer of Haemophilus influenzae type b conjugate vaccines for developing countries.

PubMed

Beurret, Michel; Hamidi, Ahd; Kreeftenberg, Hans

2012-07-13

This paper describes the development of a Haemophilus influenzae type b (Hib) conjugate vaccine at the National Institute for Public Health and the Environment/Netherlands Vaccine Institute (RIVM/NVI, Bilthoven, The Netherlands), and the subsequent transfer of its production process to manufacturers in developing countries. In 1998, at the outset of the project, the majority of the world's children were not immunized against Hib because of the high price and limited supply of the conjugate vaccines, due partly to the fact that local manufacturers in developing countries did not master the Hib conjugate production technology. To address this problem, the RIVM/NVI has developed a robust Hib conjugate vaccine production process based on a proven model, and transferred this technology to several partners in India, Indonesia, Korea and China. As a result, emerging manufacturers in developing countries acquired modern technologies previously unavailable to them. This has in turn facilitated their approach to producing other conjugate vaccines. As an additional spin-off from the project, a World Health Organization (WHO) Hib quality control (QC) course was designed and conducted at the RIVM/NVI, resulting in an increased regulatory capacity for conjugate vaccines in developing countries at the National Regulatory Authority (NRA) level. For the local populations, this has translated into an increased and sustainable supply of affordable Hib conjugate-containing combination vaccines. During the course of this project, developing countries have demonstrated their ability to produce large quantities of high-quality modern vaccines after a successful transfer of the technology. Copyright © 2012 Elsevier Ltd. All rights reserved.

Geographical Distribution of Taenia asiatica and Related Species

PubMed Central

Jeon, Hyeong-Kyu; Rim, Han-Jong

2009-01-01

Geographical information of Taenia asiatica is reviewed together with that of T. solium and T. saginata. Current distribution of T. asiatica was found to be mostly from Asian countries: the Republic of Korea, China, Taiwan, Indonesia, and Thailand. Molecular genotypic techniques have found out more countries with T. asiatica from Japan, the Philippines, and Vietnam. Specimens used in this paper were collected from around the world and mostly during international collaboration projects of Korean foundations for parasite control activities (1995-2009) in developing countries. PMID:19885327

Exploring the implementation of the framework convention on tobacco control in four small island developing states of the Pacific: a qualitative study

PubMed Central

Martin, Erik; de Leeuw, Evelyne

2013-01-01

Objectives To determine what variables influence the implementation of the Framework Convention on Tobacco Control (FCTC) in small island developing states of the Pacific and how they affect its success or failure. To explore how barriers can be overcome and opportunities utilised to ensure an effective FCTC implementation in the Pacific Islands. Design A mixed methods, multiple case study consisting of primarily qualitative data in the form of semistructured interviews, document analysis and opportunistic observation. Setting Field visits were undertaken to collect data in the Cook Islands, Vanuatu, Palau and Nauru. The key informants were interviewed in the major cities or islands of each respective country: Rarotonga, Port Vila, Koror and Nauru. Participants Purposive sampling was used to select 39 informants, whose roles were associated with FCTC implementation. Most of the participants worked in health-oriented positions in the government and non-government organisations. Results Each country made a significant progress towards FCTC implementation. Overall, strong policy content, public support and limited pro-tobacco coalition activity were conducive to FCTC implementation, but the challenges were evident in the form of limited capacity, limited antitobacco coalition activity and limited political commitment outside the ministries of health in each country. Conclusions Further efforts are needed for full FCTC implementation, through building capacity and using resources effectively, growing commitment to FCTC beyond the health sector, fostering growth in antitobacco coalition activity, exploiting the limited pro-tobacco activity that may be present and garnering public support for tobacco control. These lessons may be particularly important for other small island developing states in the Pacific and developing countries elsewhere. PMID:24327364

Tuberculosis in Asia and the pacific: the role of socioeconomic status and health system development.

PubMed

Wu, Jie; Dalal, Koustuv

2012-01-01

To identify the relationship between socioeconomic status, health system development and the incidence, prevalence and mortality of tuberculosis in Asia and the Pacific. Incidence, prevalence and mortality rates of tuberculosis and 20 variables of socioeconomic, health system and biological-behavioral issues were included in the study involving all 46 countries of the Asian Development Bank region (2007 data). Both univariate and multivariate linear regressions were used. The worst three tuberculosis affected countries were Cambodia, India and Indonesia, while the least affected was Australia. Tuberculosis incidence, prevalence and mortality rate were higher in countries with lower human development index, corruption perception index, gross domestic product (GDP) per capita and countries with more people under minimum food supplements. Among the health system variables, total health expenditure per capita, governmental health expenditure per capita, hospital beds, and access to improved water and sanitation were strongly associated with tuberculosis. Socioeconomic determinants and health system development have significant effect on the control of tuberculosis in Asia and the Pacific region. The study has some policy implications by means of lowering the corruption and improving the sanitation.

Immunological changes at rectal mucosa in appendectomised subjects and inhabitants of developing countries.

PubMed

Olivares, David; Gisbert, Javier P; Gamallo, Carlos; Maté-Jiménez, José

2007-02-01

It has been suggested that appendicitis protects against ulcerative colitis. We hypothesize that early poor hygiene protects against ulcerative colitis (UC) and predisposes to appendicitis. Our aim was to elucidate the immunological characteristics of rectal mucosa in two populations protected against UC development: appendectomised subjects and inhabitants of developing countries. this was an age-matched prospective case-control study. Each consecutive individual case appendectomised (group A) was compared to another control from a developing country (group B) and to a control from the general population (group C). Four biopsies from rectal mucosa were taken from all subjects, two for histological and two for histochemical study; specific antibodies were used for T lymphocytes CD3+, CD4+, CD8+ and B lymphocytes CD20+ populations. Mucosa samples of 45 non-smoker healthy subjects were studied, of which 15 were from group A, 15 from group B and 15 from group C. In appendectomised subjects, the proportion of CD8+ cells was higher than in the control group (p<0.001), but similar to that in B group. The proportion of CD3+ and CD20+ cells was significatively lower than in Ecuadorians, but similar to the control group. In Ecuadorians, the proportion of CD3+ and CD8+ cells was significatively higher than in the control group (p<0.001), and were similar to that of CD20+. There were no significant differences in the proportion of CD4+. Appendectomy and deficient environmental hygiene are associated with an increase of CD8+ T lymphocytes in the rectal mucosa. Moreover, deficient environmental hygiene is associated with an increase of CD3+ and CD8+ lymphocytes. The CD8+ increase is the only common significant alteration in the mucosa of both groups protected against the development of ulcerative colitis, suggesting that the factors causing changes in lamina propria lymphocytes of both groups are different.

Targeting populations at higher risk for malaria: a survey of national malaria elimination programmes in the Asia Pacific.

PubMed

Wen, Shawn; Harvard, Kelly E; Gueye, Cara Smith; Canavati, Sara E; Chancellor, Arna; Ahmed, Be-Nazir; Leaburi, John; Lek, Dysoley; Namgay, Rinzin; Surya, Asik; Thakur, Garib D; Whittaker, Maxine Anne; Gosling, Roly D

2016-05-10

Significant progress has been made in reducing the malaria burden in the Asia Pacific region, which is aggressively pursuing a 2030 regional elimination goal. Moving from malaria control to elimination requires National Malaria Control Programmes (NMCPs) to target interventions at populations at higher risk, who are often not reached by health services, highly mobile and difficult to test, treat, and track with routine measures, and if undiagnosed, can maintain parasite reservoirs and contribute to ongoing transmission. A qualitative, free-text questionnaire was developed and disseminated among 17 of the 18 partner countries of the Asia Pacific Malaria Elimination Network (APMEN). All 14 countries that responded to the survey identified key populations at higher risk of malaria in their respective countries. Thirteen countries engage in the dissemination of malaria-related Information, Education, and Communication (IEC) materials. Eight countries engage in diagnostic screening, including of mobile and migrant workers, military staff, and/or overseas workers. Ten countries reported distributing or recommending the use of long-lasting insecticide-treated nets (LLINs) among populations at higher risk with fewer countries engaging in other prevention measures such as indoor residual spraying (IRS) (two countries), spatial repellents (four countries), chemoprophylaxis (five countries), and mass drug administration (MDA) (three countries). Though not specifically tailored to populations at higher risk, 11 countries reported using mass blood surveys as a surveillance tool and ten countries map case data. Most NMCPs lack a monitoring and evaluation structure. Countries in the Asia Pacific have identified populations at higher risk and targeted interventions to these groups but there is limited information on the effectiveness of these interventions. Platforms like APMEN offer the opportunity for the sharing of protocols and lessons learned related to finding, targeting and successfully clearing malaria from populations at higher risk. The sharing of programme data across borders may further strengthen national and regional efforts to eliminate malaria. This exchange of real-life experience is invaluable to NMCPs when scarce scientific evidence on the topic exists to aid decision-making and can further support NMCPs to develop strategies that will deliver a malaria-free Asia Pacific by 2030.

International Charitable Connections: the Growth in Number, and the Countries of Operation, of English and Welsh Charities Working Overseas.

PubMed

Clifford, David

2016-07-01

This paper provides new empirical evidence about English and Welsh charities operating internationally. It answers basic questions unaddressed in existing work: how many charities work overseas, and how has this number changed over time? In which countries do they operate, and what underlies these geographical patterns? It makes use of a unique administrative dataset which records every country in which each charity operates. The results show a sizeable increase in the number of charities working overseas since the mid-1990s. They show that charities are much more likely to work in countries with colonial and linguistic ties to the UK, and less likely to work in countries with high levels of instability or corruption. This considerable geographical unevenness, even after controlling for countries' population size and poverty, illustrates the importance of supply-side theories and of institutional factors to an understanding of international voluntary activity. The paper also serves to provide a new perspective on international charitable operation: while it is the large development charities that are household names, the results reveal the extent of small-scale 'grassroots' registered charitable activity that links people and places internationally, and the extent of activity in 'developed' as well as 'developing' country contexts.

Association between body mass index and body fat in 9-11-year-old children from countries spanning a range of human development.

PubMed

Katzmarzyk, P T; Barreira, T V; Broyles, S T; Chaput, J-P; Fogelholm, M; Hu, G; Kuriyan, R; Kurpad, A; Lambert, E V; Maher, C; Maia, J; Matsudo, V; Olds, T; Onywera, V; Sarmiento, O L; Standage, M; Tremblay, M S; Tudor-Locke, C; Zhao, P; Church, T S

2015-12-01

The purpose was to assess associations between body mass index (BMI) and body fat in a multinational sample of 9-11-year-old children. The sample included 7265 children from countries ranging in human development. Total body fat (TBF) and percentage body fat (PBF) were measured with a Tanita SC-240 scale and BMI z-scores (BMIz) and percentiles were computed using reference data from the World Health Organization and the U.S. Centers for Disease Control and Prevention, respectively. Mean PBF at BMIz values of -1, 0 and +1 were estimated using multilevel models. Correlations between BMI and TBF were >0.90 in all countries, and correlations between BMI and PBF ranged from 0.76 to 0.96. Boys from India had higher PBF than boys from several other countries at all levels of BMIz. Kenyan girls had lower levels of PBF than girls from several other countries at all levels of BMIz. Boys and girls from Colombia had higher values of PBF at BMIz=-1, whereas Colombian boys at BMIz 0 and +1 also had higher values of PBF than boys in other countries. Our results show a consistently high correlation between BMI and adiposity in children from countries representing a wide range of human development.

Software Agents as Facilitators of Coherent Coalition Operations

DTIC Science & Technology

2001-06-01

In this regard, an important output from DARPA’s CoABS programme is the CoABS Grid - a middleware layer based on Java / Jini technology that provides...2 The C3I Group, Technical Panel 9. 6 developed between two countries who are fighting for control of Binni. To the north is Gao - which has...well developed and fundamentalist country. Gao has managed to annex an area of land, called it Binni and has put in its own puppet government. This

International variations and trends in renal cell carcinoma incidence and mortality.

PubMed

Znaor, Ariana; Lortet-Tieulent, Joannie; Laversanne, Mathieu; Jemal, Ahmedin; Bray, Freddie

2015-03-01

Renal cell carcinoma (RCC) incidence rates are higher in developed countries, where up to half of the cases are discovered incidentally. Declining mortality trends have been reported in highly developed countries since the 1990s. To compare and interpret geographic variations and trends in the incidence and mortality of RCC worldwide in the context of controlling the future disease burden. We used data from GLOBOCAN, the Cancer Incidence in Five Continents series, and the World Health Organisation mortality database to compare incidence and mortality rates in more than 40 countries worldwide. We analysed incidence and mortality trends in the last 10 yr using joinpoint analyses of the age-standardised rates (ASRs). RCC incidence in men varied in ASRs (World standard population) from approximately 1/100,000 in African countries to >15/100,000 in several Northern and Eastern European countries and among US blacks. Similar patterns were observed for women, although incidence rates were commonly half of those for men. Incidence rates are increasing in most countries, most prominently in Latin America. Although recent mortality trends are stable in many countries, significant declines were observed in Western and Northern Europe, the USA, and Australia. Southern European men appear to have the least favourable RCC mortality trends. Although RCC incidence is still increasing in most countries, stabilisation of mortality trends has been achieved in many highly developed countries. There are marked absolute differences and opposing RCC mortality trends in countries categorised as areas of higher versus lower human development, and these gaps appear to be widening. Renal cell cancer is becoming more commonly diagnosed worldwide in both men and women. Mortality is decreasing in the most developed settings, but not in low- and middle-income countries, where access to and the availability of optimal therapies are likely to be limited. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Epidemiology of foodborne diseases: a worldwide review.

PubMed

Todd, E C

1997-01-01

Acute foodborne disease infections and intoxications are much more of a concern to governments and the food industry today than a few decades ago. Some of the factors that have led to this include the identification of new agents that have caused life-threatening conditions; the finding that traditional agents are being associated with foods that were of no concern previously: an increasing number of large outbreaks being reported; the impact of foodborne disease on children, the aging population and the immunocompromised; migrant populations demanding their traditional foods in the countries of settlement; the ease of worldwide shipment of fresh and frozen food; and the development of new food industries, including aquaculture. However, to meaningfully monitor increases or decreases in foodborne disease requires an effective surveillance system at the local, national and international levels. To date, resources have been limited for most countries and regions to do this, and our current knowledge is based, for the most part, on passive reporting mechanisms. Laboratory isolation data and reports of notifiable diseases have some value in observing timely changes in case numbers of some enteric diseases, but they usually do not indicate the reasons for these trends. Special epidemiological studies are useful for the area covered, but it is often questionable whether they can be extrapolated to other areas or countries. Outbreak investigations tell us that a certain set of circumstances led to illness and that another outbreak may occur under similar but not necessarily identical conditions. Control programmes have often been triggered by the conclusions from investigations of specific outbreaks. Unfortunately, the agent/ food combination leading to illness in many of the reported incidents were not predicted from existing databases, and no doubt foodborne agents will continue to surprise food control agencies in the foreseeable future. Nevertheless, data from around the world do show some common elements. Salmonella is still the most important agent causing acute foodborne disease, with Salmonella enteritidis and S. typhimurium being of most concern. Foods of animal origin, particularly, meat and eggs, were most often implicated. Desserts, ice cream and confectionery items were products also mentioned, but some of these would have egg as a raw or incompletely cooked ingredient. Incidents most frequently occurred in homes or restaurants, and the main factors contributing to outbreaks were poor temperature control in preparing, cooking and storing food. Clostridium botulinum, Salmonella and VTEC are more frequently documented in industrialized than in developing countries. ETEC, EPEC, Shigella, Vibrio cholerae and parasites are the main scourges in developing countries, but it is uncertain how many cases are attributed to food, to water or to person-to-person transmission. The apparent decrease of S. aureus and C. perfringens outbreaks in industrialized countries may be related to improved temperature control in the kitchen. An increasing number of illnesses are international in scope, with contamination in a commercial product occurring in one country and affecting persons in several other countries, or tourists being infected abroad and possibly transmitting the pathogen to others at home. For Salmonella, a rapid alert and response coordination is being encouraged through Salm-Net and other international programs. However, unless such a network is worldwide, tracking clusters of illnesses is going to fall on the countries where the first cases occur, and some of these have very limited resources for investigation and control. It was heartening to see funds recently being allocated to foodborne disease surveillance and control in several industrialized countries, but the same commitment is required by the World Health Organization for the international community.

[Family planning programs and birth control in the third world].

PubMed

Wohlschlagl, H

1991-01-01

The population explosion has been abating since the 2nd half of the 1960s. The birth rate of the 3rd World dropped from 45/1000 during 1950-55 to 31/1000 during 1985-90. From the 1st half of the 1960s to the 1st half of the 1980s the total fertility of such countries dropped from 6.1 to 4.2 children/woman. In Taiwan, Singapore, Hong Kong, South Korea, and Malaysia living standards improved as a result of industrialization, and fertility decreased significantly. In Sri Lanka, China, North Vietnam, and Thailand the drop of fertility is explained by cultural and religious factors. In 1982 about 78% of the population of developing countries lived in 39 states that followed an official policy aimed at reducing the population. Another 16% lived in countries supporting the concept of a desired family size. However, World Bank data showed that in the mid-1980s in 27 developing countries no state family planning (FP) programs existed. India adopted an official FP program in 1952, Pakistan followed suit in 1960, South Korea in 1961, and China in 1962. In Latin America a split policy manifested itself: in Brazil birth control was rejected, only Colombia had a FP policy. In 1986 the governments of 68 of 131 developing countries representing 3.1 billion people considered the number of children per woman too high. 31 of these countries followed concrete population control policies. On the other hand, in 1986 24 countries of Africa with 40% of the continent's population took no measures to influence population growth. In Latin America and the Caribbean 18 of 33 countries were idle, except for Mexico that had a massive state FP program. These programs also improve maternal and child health with birth spacing of at least 2 years, and the prevention of pregnancies of too young women or those over 40. The evaluation of rapidly spreading FP programs in the 1970s was carried out by the World Fertility Survey in 41 countries. The impact of FP programs was more substantial than socioeconomic factors. Contraceptive use increased in Mexico from 13% in 1973 to 41% in 1978 among women of fertile age. According to 1984 and 1988 UN data modern methods of contraception were used by 70% of women in China, 60-65% in Southeast Asia, Costa Rica, and Puerto Rico. In contrast, less than 5% used them in most countries of Africa, 15-20% in West Asia, 25-30% in South Asia, and 40% in Latin America. The pill was the most popular method. From the early 1980s in South and East Asia 1/5 of women got sterilized after attaining the desired family size. Less than 10% of women used IUDs in developing countries. FP programs have benefited from higher education levels and economic incentives and sanctions and exemplified in Singapore, China, South Korea, Thailand, and Taiwan.

Development and assessment of national performance indicators for infection prevention and control and antimicrobial stewardship in European long-term care facilities.

PubMed

Cookson, B; Mackenzie, D; Kafatos, G; Jans, B; Latour, K; Moro, M L; Ricchizzi, E; Van de Mortel, M; Suetens, C; Fabry, J

2013-09-01

Healthcare-associated infections in long-term care facilities (LTCFs) are of increasing importance. To develop consensus national performance indicators (NPIs) for infection control (ICPI) and antimicrobial stewardship (ASPI) in LTCFs, and assess the performance of 32 European countries against these NPIs. Previously established European standards were the basis for consensus and the same iterative approach with national representatives from the 32 countries. A World Health Organization scoring system recorded how close each country was to implementing each standard. The 42 agreed component indicators were grouped into six NPI categories: 'national programme', 'guidelines', 'expert advice', 'IC structure' (not present in the ASPI), 'surveillance' and 'composite'. 'Guidelines' scored the highest mean total possible score (60%, range 20-100%), followed by 'composite' (53%, range 30-100%), 'expert advice' (48%, range 20-100%), 'surveillance' (47%, range 20-83%), 'national programme' (42%, range 20-100%) and 'IC structure' (39%, range 20-100%). Although several scores were low, some countries were able to implement all NPIs, indicating that this was feasible. Most NPIs were very significantly related, indicating that they were considered to be important by the countries. 'Guidelines' and 'IC structure' were significantly related to European region (P ≤ 0.05). Accreditation/inspection was not evident in seven (22%) countries, nine (28%) countries had accreditation/inspection that included IC assessments, and seven (22%) countries had accreditation/inspection that included IC and antimicrobial stewardship assessments. Multi-variable analysis found that only the NPI and the ICPI 'expert advice' were associated with accreditation/inspection which included IC and antimicrobial stewardship. The identified gaps represent significant potential patient safety issues. The NPIs should serve as a basis for monitoring improvements over the coming years. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Global resources outlook. [Requires best leadership of U. S. and other countries

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

Bovay, H.E. Jr.

Worldwide resource planning that is rational and equitable will dictate an orderly flow of materials between nations and require the best leadership the U.S. and other nations can develop. Resource trends show that the developing nations have begun asserting their power as suppliers of essential resources and that proliferation of nuclear materials could lead to wars of redistribution as competition for basic commodities intensifies. The trend in recent years has been toward the interdependence of nations, with most having some resources and depending on other nations for the rest of their needs. Since consumption trends for minerals, metals, and energymore » parallel the gross national product, developing countries will be increasing their consumption levels to raise their standard of living. Population projections indicate the lowest growth in the developed countries and a steep increase in the Third World, where living standards must be raised before effective birth control can take hold. Food production in developing countries has kept pace with population growth, but only the developed countries are able to develop a surplus. South America and Africa both contain large areas of land that is arable if the technology for clearing and cultivating is available. Other trends are outlined to show the need for new management of fishing, the use and dependency of minerals and fuels, metals, and the environment and technology as resources. (DCK)« less

Dengue Contingency Planning: From Research to Policy and Practice.

PubMed

Runge-Ranzinger, Silvia; Kroeger, Axel; Olliaro, Piero; McCall, Philip J; Sánchez Tejeda, Gustavo; Lloyd, Linda S; Hakim, Lokman; Bowman, Leigh R; Horstick, Olaf; Coelho, Giovanini

2016-09-01

Dengue is an increasingly incident disease across many parts of the world. In response, an evidence-based handbook to translate research into policy and practice was developed. This handbook facilitates contingency planning as well as the development and use of early warning and response systems for dengue fever epidemics, by identifying decision-making processes that contribute to the success or failure of dengue surveillance, as well as triggers that initiate effective responses to incipient outbreaks. Available evidence was evaluated using a step-wise process that included systematic literature reviews, policymaker and stakeholder interviews, a study to assess dengue contingency planning and outbreak management in 10 countries, and a retrospective logistic regression analysis to identify alarm signals for an outbreak warning system using datasets from five dengue endemic countries. Best practices for managing a dengue outbreak are provided for key elements of a dengue contingency plan including timely contingency planning, the importance of a detailed, context-specific dengue contingency plan that clearly distinguishes between routine and outbreak interventions, surveillance systems for outbreak preparedness, outbreak definitions, alert algorithms, managerial capacity, vector control capacity, and clinical management of large caseloads. Additionally, a computer-assisted early warning system, which enables countries to identify and respond to context-specific variables that predict forthcoming dengue outbreaks, has been developed. Most countries do not have comprehensive, detailed contingency plans for dengue outbreaks. Countries tend to rely on intensified vector control as their outbreak response, with minimal focus on integrated management of clinical care, epidemiological, laboratory and vector surveillance, and risk communication. The Technical Handbook for Surveillance, Dengue Outbreak Prediction/ Detection and Outbreak Response seeks to provide countries with evidence-based best practices to justify the declaration of an outbreak and the mobilization of the resources required to implement an effective dengue contingency plan.

Chinese Anti-Cancer Association as a non-governmental organization undertakes systematic cancer prevention work in China.

PubMed

Xu, Tingting

2015-08-01

Cancer has become the first leading cause of death in the world, particularly in low- and middle-income countries. Facing the increasing trend of cancer incidence and mortality, China issued and implemented "three-early (early prevention, early diagnosis and early treatment)" national cancer prevention plan. As the main body and dependence of social governance, non-governmental organizations (NGOs) take over the role of government in the field of cancer prevention and treatment. American Cancer Society (ACS) made a research on cancer NGOs and civil society in cancer control and found that cancer NGOs in developing countries mobilize civil society to work together and advocate governments in their countries to develop policies to address the growing cancer burden. Union for International Cancer Control (UICC), Cancer Council Australia (CCA), and Malaysian cancer NGOs are the representatives of cancer NGOs in promoting cancer control. Selecting Chinese Anti-Cancer Association (CACA) as an example in China, this article is to investigate how NGOs undertake systematic cancer prevention work in China. By conducting real case study, we found that, as a NGO, CACA plays a significant role in intensifying the leading role of government in cancer control, optimizing cancer outcomes, decreasing cancer incidence and mortality rates and improving public health.

Chinese Anti-Cancer Association as a non-governmental organization undertakes systematic cancer prevention work in China

PubMed Central

2015-01-01

Cancer has become the first leading cause of death in the world, particularly in low- and middle-income countries. Facing the increasing trend of cancer incidence and mortality, China issued and implemented “three-early (early prevention, early diagnosis and early treatment)” national cancer prevention plan. As the main body and dependence of social governance, non-governmental organizations (NGOs) take over the role of government in the field of cancer prevention and treatment. American Cancer Society (ACS) made a research on cancer NGOs and civil society in cancer control and found that cancer NGOs in developing countries mobilize civil society to work together and advocate governments in their countries to develop policies to address the growing cancer burden. Union for International Cancer Control (UICC), Cancer Council Australia (CCA), and Malaysian cancer NGOs are the representatives of cancer NGOs in promoting cancer control. Selecting Chinese Anti-Cancer Association (CACA) as an example in China, this article is to investigate how NGOs undertake systematic cancer prevention work in China. By conducting real case study, we found that, as a NGO, CACA plays a significant role in intensifying the leading role of government in cancer control, optimizing cancer outcomes, decreasing cancer incidence and mortality rates and improving public health. PMID:26361412

Sectoral output, energy use, and CO2 emission in middle-income countries.

PubMed

Sohag, Kazi; Al Mamun, Md; Uddin, Gazi Salah; Ahmed, Ali M

2017-04-01

Middle-income countries are currently undergoing massive structural changes towards more industrialized economies. In this paper, we carefully examine the impact of these transformations on the environmental quality of middle-income countries. Specifically, we examine the role of sector value addition to GDP on CO 2 emission nexus for middle-income economies controlling for the effects of population growth, energy use, and trade openness. Using recently developed panel methods that consider cross-sectional dependence and allow for heterogeneous slope coefficients, we show that energy use and growth of industrial and service sectors positively explain CO 2 emissions in middle-income economies. We also find that population growth is insignificantly associated with CO 2 emission. Hence, our paper provides a solid ground for developing a sustainable and pro-growth policy for middle-income countries.

State-Controlled Multimedia Education for All? Science Programs in Early German Radio

ERIC Educational Resources Information Center

Schirrmacher, Arne

2012-01-01

While science education and popularization by means of print media developed in quite similar forms in many nations, the advent of radio resulted in initiatives to bring science on the air that were rather heterogeneous from country to country. The German case stands out with respect to quantity, variety and ambition, and also for its special…

15 CFR 744.6 - Restrictions on certain activities of U.S. persons.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS CONTROL POLICY: END-USER AND END-USE BASED § 744.6 Restrictions on certain activities of U.S... item where that person knows that such item: (A) Will be used in the design, development, production, or use of nuclear explosive devices in or by a country listed in Country Group D:2 (see supplement no...

Control programme for cystic echinococcosis in Uruguay.

PubMed

Irabedra, Pilar; Ferreira, Ciro; Sayes, Julio; Elola, Susana; Rodríguez, Miriam; Morel, Noelia; Segura, Sebastian; Santos, Estela Dos; Guisantes, Jorge A

2016-05-24

Cystic echinococcosis is a highly endemic parasitic zoonosis that is present in the Southern Cone countries of America. For several decades, various prevention and control programmes have been implemented in different countries and regions, with varying results. In Uruguay, a new control programme was implemented in 2006 that employed new strategies for canine diagnosis and treatment, dog population control, diagnosis in humans, epidemiological surveillance, and health education, including community participation. The control programme in Uruguay addresses the control and surveillance of the disease from a holistic perspective based on Primary Health Care, which has strengthened the community's participation in developing and coordinating activities in an interdisciplinary manner. Similarly, the control programme that is currently implemented is based on a risk-focused approach. The surveillance and control measures were focused on small villages and extremely poor urban areas. In this study, the strategies used and the results obtained from 2008-2013 are analysed and discussed.

Some Problems in Educational Administration

ERIC Educational Resources Information Center

Lyons, Raymond F.

1977-01-01

Educational administration problems in developing countries are discussed. Possible solutions to problems of decision-making, decision implementation, communications, task definition, and financial control are suggested. (Author/DB)

Durably controlling bovine hypodermosis.

PubMed

Boulard, Chantal

2002-01-01

Cattle hypodermosis, due to insect larvae, is widely spread over the northern hemisphere. Very efficient insecticides are available and their use in most countries are done on an individual level but never cover the whole cattle population of a country. Untreated animals remain the reservoir of the disease and annually re-infest the cattle population. The economic effects of this disease on animal production (meat, milk and the leather industry) but also on the general cattle health status, have led many European countries to launch organised control programs. The first example of definitive hypodermosis control goes back one hundred years ago when Danish farmers eradicated hypodermosis from the Danish islands by manual elimination of the warbles. Since then, more and more European countries have considered the feasibility and economic returns of such programs. The various factors which foster these programs are related to (i) biological factors, (parasite cattle specificity, synchronous biological cycles of both species of insects involved), (ii) the development of more and more efficient insecticides used only once a year by systemic application, with high efficiency at very low dosages against the first larval stage of Hypoderma spp., (iii) the development of acute techniques of detection of the disease for the monitoring of hypodermosis free countries and (iv) the durable successful results obtained in more and more European countries. Although the programs were imposed by different partners of the livestock channel production (farmers, dairy industry, leather industry) and have been engaged within the last 50 years in many European countries (Denmark, The Netherlands, Ireland, the United Kingdom, the Czech Republic, Germany, France and Switzerland) common features have emerged among these different eradication programs. They all need a preliminary statement of the economic impact of this pest and the farmers' awareness of the economic returns of such programs. The programs' efficacy depends: (i) on a good knowledge ofthe epidemiology of the parasites, (ii) on the simultaneous implementation of the control program on the whole national cattle population whatever the structure monitoring the treatments (veterinary services, farmers association), (iii) on a national Warble fly legislation making the treatments compulsory and (iv) on an acute epidemiological survey as soon as the status of a hypodermosis free country is reached and the treatments are suspended. The sanitary and financial returns of such programs are a benefit to all the partners of livestock production, to the quality of the environment and to the consumers.

How do policy advisors and practitioners prioritise the protection of children from secondhand smoke exposure in a country with advanced tobacco control policy?

PubMed

Ritchie, Deborah Doreen; Amos, Amanda; Shaw, April; O'Donnell, Rachel; Semple, Sean; Turner, Steve; Martin, Claudia

2015-01-01

The aim is to extend understanding of the policy and practice discourses that inform the development of national tobacco control policy to protect children from secondhand smoke exposure (SHSE) in the home, particularly in a country with successful implementation of smoke-free public places legislation. The Scottish experience will contribute to the tobacco control community, particularly those countries at a similar level of tobacco control, as normalising discourses about protecting children from SHSE are becoming more widespread. Case study design using qualitative interviews and focus groups (FGs) with policy makers, health and childcare practitioners during which they were presented with the findings of the Reducing Families' Exposure to Secondhand Smoke (REFRESH) intervention and discussed the implications for their policy and practice priorities. Scotland, UK PARTICIPANTS: Qualitative interviews and FGs were conducted with 30 policy makers and practitioners who were purposively recruited. Participants accepted the harm of SHSE to children; however, action is limited by political expedience due to-the perception of a shift of the public health priority from smoking to alcohol, current financial constraints, more immediate child protection concerns and continuing unresolved ethical arguments. In a country, such as Scotland, with advanced tobacco control strategies, there continue to be challenges to policy and practice development in the more contentious arena of the home. Children's SHSE in their homes is unequivocally accepted as an important health priority, but it is not currently perceived to be a top public health priority in Scotland. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Global time trends in PAH emissions from motor vehicles

NASA Astrophysics Data System (ADS)

Shen, Huizhong; Tao, Shu; Wang, Rong; Wang, Bin; Shen, Guofeng; Li, Wei; Su, Shenshen; Huang, Ye; Wang, Xilong; Liu, Wenxin; Li, Bengang; Sun, Kang

2011-04-01

Emission from motor vehicles is the most important source of polycyclic aromatic hydrocarbons (PAHs) in urban areas. Emission factors of individual PAHs for motor vehicles reported in the literature varied 4 to 5 orders of magnitude, leading to high uncertainty in emission inventory. In this study, key factors affecting emission factors of PAHs (EF PAH) for motor vehicles were evaluated quantitatively based on thousands of EF PAH measured in 16 countries for over 50 years. The result was used to develop a global emission inventory of PAHs from motor vehicles. It was found that country and vehicle model year are the most important factors affecting EF PAH, which can be quantified using a monovariate regression model with per capita gross domestic production (purchasing power parity) as a sole independent variable. On average, 29% of variation in log-transformed EF PAH could be explained by the model, which was equivalent to 90% reduction in overall uncertainty on arithmetic scale. The model was used to predict EF PAH and subsequently PAH emissions from motor vehicles for various countries in the world during a period from 1971 to 2030. It was estimated that the global emission reached its peak value of approximate 101 Gg in 1978 and decreased afterwards due to emission control in developed countries. The annual emission picked up again since 1990 owing to accelerated energy consumption in China and other developing countries. With more and more rigid control measures taken in the developing world, global emission of PAHs is currently passing its second peak. It was predicted that the emission would decrease from 77 Gg in 2010 to 42 Gg in 2030.

Alcohol Control Policies in 46 African Countries: Opportunities for Improvement.

PubMed

Ferreira-Borges, Carina; Esser, Marissa B; Dias, Sónia; Babor, Thomas; Parry, Charles D H

2015-07-01

There is little information on the extent to which African countries are addressing alcohol consumption and alcohol-related harm, which suggests that evaluations of national alcohol policies are needed in this region. The aim of this article is to examine the strength of a mix of national alcohol control policies in African countries, as well as the relationship between alcohol policy restrictiveness scores and adult alcohol per capita consumption (APC) among drinkers at the national level. We examined national alcohol policies of 46 African countries, as of 2012, in four regulatory categories (price, availability, marketing and drink-driving), and analyzed the restrictiveness of national alcohol policies using an adapted Alcohol Policy Index (API). To assess the validity of the policy restrictiveness scores, we conducted correlational analyses between policy restrictiveness scores and APC among drinkers in 40 countries. Countries attained a mean score of 44.1 of 100 points possible, ranging from 9.1 (Sao Tomé and Principe) to 75.0 (Algeria), with low scores indicating low policy restrictiveness. Policy restrictiveness scores were negatively correlated with and APC among drinkers (rs = -0.353, P = 0.005). There is great variation in the strength of alcohol control policies in countries throughout the African region. Tools for comparing the restrictiveness of alcohol policies across countries are available and are an important instrument to monitor alcohol policy developments. The negative correlation between policy restrictiveness and alcohol consumption among drinkers suggests the need for stronger alcohol policies as well as increased training and capacity building at the country level. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Impact of a multidimensional infection control strategy on catheter-associated urinary tract infection rates in the adult intensive care units of 15 developing countries: findings of the International Nosocomial Infection Control Consortium (INICC).

PubMed

Rosenthal, V D; Todi, S K; Álvarez-Moreno, C; Pawar, M; Karlekar, A; Zeggwagh, A A; Mitrev, Z; Udwadia, F E; Navoa-Ng, J A; Chakravarthy, M; Salomao, R; Sahu, S; Dilek, A; Kanj, S S; Guanche-Garcell, H; Cuéllar, L E; Ersoz, G; Nevzat-Yalcin, A; Jaggi, N; Medeiros, E A; Ye, G; Akan, Ö A; Mapp, T; Castañeda-Sabogal, A; Matta-Cortés, L; Sirmatel, F; Olarte, N; Torres-Hernández, H; Barahona-Guzmán, N; Fernández-Hidalgo, R; Villamil-Gómez, W; Sztokhamer, D; Forciniti, S; Berba, R; Turgut, H; Bin, C; Yang, Y; Pérez-Serrato, I; Lastra, C E; Singh, S; Ozdemir, D; Ulusoy, S

2012-10-01

We aimed to evaluate the impact of a multidimensional infection control strategy for the reduction of the incidence of catheter-associated urinary tract infection (CAUTI) in patients hospitalized in adult intensive care units (AICUs) of hospitals which are members of the International Nosocomial Infection Control Consortium (INICC), from 40 cities of 15 developing countries: Argentina, Brazil, China, Colombia, Costa Rica, Cuba, India, Lebanon, Macedonia, Mexico, Morocco, Panama, Peru, Philippines, and Turkey. We conducted a prospective before-after surveillance study of CAUTI rates on 56,429 patients hospitalized in 57 AICUs, during 360,667 bed-days. The study was divided into the baseline period (Phase 1) and the intervention period (Phase 2). In Phase 1, active surveillance was performed. In Phase 2, we implemented a multidimensional infection control approach that included: (1) a bundle of preventive measures, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of CAUTI rates, and (6) feedback of performance. The rates of CAUTI obtained in Phase 1 were compared with the rates obtained in Phase 2, after interventions were implemented. We recorded 253,122 urinary catheter (UC)-days: 30,390 in Phase 1 and 222,732 in Phase 2. In Phase 1, before the intervention, the CAUTI rate was 7.86 per 1,000 UC-days, and in Phase 2, after intervention, the rate of CAUTI decreased to 4.95 per 1,000 UC-days [relative risk (RR) 0.63 (95% confidence interval [CI] 0.55-0.72)], showing a 37% rate reduction. Our study showed that the implementation of a multidimensional infection control strategy is associated with a significant reduction in the CAUTI rate in AICUs from developing countries.

Current situation of pests targeted by Bt crops in Latin America.

PubMed

Blanco, C A; Chiaravalle, W; Dalla-Rizza, M; Farias, J R; García-Degano, M F; Gastaminza, G; Mota-Sánchez, D; Murúa, M G; Omoto, C; Pieralisi, B K; Rodríguez, J; Rodríguez-Maciel, J C; Terán-Santofimio, H; Terán-Vargas, A P; Valencia, S J; Willink, E

2016-06-01

Transgenic crops producing Bacillus thuringiensis- (Bt) insecticidal proteins (Bt crops) have provided useful pest management tools to growers for the past 20 years. Planting Bt crops has reduced the use of synthetic insecticides on cotton, maize and soybean fields in 11 countries throughout Latin America. One of the threats that could jeopardize the sustainability of Bt crops is the development of resistance by targeted pests. Governments of many countries require vigilance in measuring changes in Bt-susceptibility in order to proactively implement corrective measures before Bt-resistance is widespread, thus prolonging the usefulness of Bt crops. A pragmatic approach to obtain information on the effectiveness of Bt-crops is directly asking growers, crop consultants and academics about Bt-resistance problems in agricultural fields, first-hand information that not necessarily relies on susceptibility screens performed in laboratories. This type of information is presented in this report. Problematic pests of cotton and soybeans in five Latin American countries currently are effectively controlled by Bt crops. Growers that plant conventional (non-Bt) cotton or soybeans have to spray synthetic insecticides against multiple pests that otherwise are controlled by these Bt crops. A similar situation has been observed in six Latin American countries where Bt maize is planted. No synthetic insecticide applications are used to control corn pests because they are controlled by Bt maize, with the exception of Spodoptera frugiperda. While this insect in some countries is still effectively controlled by Bt maize, in others resistance has evolved and necessitates supplemental insecticide applications and/or the use of Bt maize cultivars that express multiple Bt proteins. Partial control of S. frugiperda in certain countries is due to its natural tolerance to the Bt bacterium. Of the 31 pests targeted and controlled by Bt crops in Latin America, only S. frugiperda has shown tolerance to certain Bt proteins in growers' fields, the most reliable indication of the status of Bt-susceptibility in most of the American continent. Copyright © 2016 Elsevier Inc. All rights reserved.

Study on the relationship between the opening of environmental tax and the prevention and control of air pollution in China

NASA Astrophysics Data System (ADS)

Gao, Guilin; Wang, Tianyi

2018-03-01

This article systematically expounds the status quo and sources of air pollution, the experience of foreign environmental tax policy, the advantages and disadvantages of environmental taxes levied in our country through literature research, historical analysis and comparative analysis and put forward recommendations on tax policy of prevention and control of air pollution by combining with the specific national conditions in our country. As one of the basic means of national macro-control, the tax policy is the major countermeasure that cannot be ignored in the prevention and control of air pollution. Studying the tax policy of prevention and control of air pollution will help to effectively control air pollution, develop a green economy and recycle economy and achieve the goal of improving environmental quality.

Implementation of a Regional Training Program on African Swine Fever As Part of the Cooperative Biological Engagement Program across the Caucasus Region

PubMed Central

De Nardi, Marco; Léger, Anaïs; Stepanyan, Tatul; Khachatryan, Bagrat; Karibayev, Talgat; Sytnik, Igor; Tyulegenov, Samat; Akhmetova, Assel; Nychyk, Serhiy; Sytiuk, Mykola; Nevolko, Oleg; Datsenko, Roman; Chaligava, Tengiz; Avaliani, Lasha; Parkadze, Otar; Ninidze, Lena; Kartskhia, Natia; Napetvaridze, Tsira; Asanishvili, Zviad; Khelaia, Demna; Menteshashvili, Ioseb; Zadayan, Meruzhan; Niazyan, Lyudmila; Mykhaylovska, Nataliya; Brooks, Bradford Raymond; Zhumabayeva, Gulnara; Satabayeva, Saltanat; Metreveli, Magda; Gallagher, Theresa; Obiso, Richard

2017-01-01

A training and outreach program to increase public awareness of African swine fever (ASF) was implemented by Defense Threat Reduction Agency and the Ministries of Agriculture in Armenia, Georgia, Kazakhstan, and Ukraine. The implementing agency was the company SAFOSO (Switzerland). Integration of this regional effort was administered by subject matter experts for each country. The main teaching effort of this project was to develop a comprehensive regional public outreach campaign through a network of expertise and knowledge for the control and prevention of ASF in four neighboring countries that experience similar issues with this disease. Gaps in disease knowledge, legislation, and outbreak preparedness in each country were all addressed. Because ASF is a pathogen with bioterrorism potential and of great veterinary health importance that is responsible for major economic instability, the project team developed public outreach programs to train veterinarians in the partner countries to accurately and rapidly identify ASF activity and report it to international veterinary health agencies. The project implementers facilitated four regional meetings to develop this outreach program, which was later disseminated in each partner country. Partner country participants were trained as trainers to implement the outreach program in their respective countries. In this paper, we describe the development, execution, and evaluation of the ASF training and outreach program that reached more than 13,000 veterinarians, farmers, and hunters in the partner countries. Additionally, more than 120,000 booklets, flyers, leaflets, guidelines, and posters were distributed during the outreach campaign. Pre- and post-ASF knowledge exams were developed. The overall success of the project was demonstrated in that the principles of developing and conducting a public outreach program were established, and these foundational teachings can be applied within a single country or expanded regionally to disseminate disease information across borders; overall, this method can be modified to raise awareness about many other diseases. PMID:29124058

Are urban children really healthier? Evidence from 47 developing countries.

PubMed

Van de Poel, Ellen; O'Donnell, Owen; Van Doorslaer, Eddy

2007-11-01

On average, child health outcomes are better in urban than in rural areas of developing countries. Understanding the nature and the causes of this rural-urban disparity is essential in contemplating the health consequences of the rapid urbanization taking place throughout the developing world and in targeting resources appropriately to raise population health. Using micro-data on child health taken from the most recent Demographic and Health Surveys for 47 developing countries, the purpose of this paper is threefold. First, we document the magnitude of rural-urban disparities in child nutritional status and under-5 mortality across all 47 developing countries. Second, we adjust these disparities for differences in population characteristics across urban and rural settings. Third, we examine rural-urban differences in the degree of socioeconomic inequality in these health outcomes. The results demonstrate that there are considerable rural-urban differences in mean child health outcomes in the entire developing world. The rural-urban gap in stunting does not entirely mirror the gap in under-5 mortality. The most striking difference between the two is in the Latin American and Caribbean region, where the gap in growth stunting is more than 1.5 times higher than that in mortality. On average, the rural-urban risk ratios of stunting and under-5 mortality fall by, respectively, 53% and 59% after controlling for household wealth. Controlling thereafter for socio-demographic factors reduces the risk ratios by another 22% and 25%. We confirm earlier findings of higher socioeconomic inequality in stunting in urban areas and demonstrate that this also holds for under-5 mortality. In a considerable number of countries, the urban poor actually have higher rates of stunting and mortality than their rural counterparts. The findings imply that there is a need for programs that target the urban poor, and that this is becoming more necessary as the size of the urban population grows.

Technologies for utilizing natural resources create new job opportunities in the geosciences in developing countries

NASA Astrophysics Data System (ADS)

Aswathanarayana, U.

Water, soils, minerals, and biota constitute a community's most significant natural resources. Innovations in technology are generating new jobs in converting into a resource what was yesterday a non-resource; in developing process and control technologies to minimize wastes; and in waste recycling.“Resources are not, they become,” in the words of Zimmerman. In the case of the developing countries, the technologies of choice have not only to be ecologically sustainable and economically viable, but more importantly, employment generating. The new kinds of jobs—for example, in poverty alleviation projects via micro-enterprises based on value-added processing of natural resources—have a strong environmental relevance and tend to lie at the interface of several traditional scientific disciplines. Geoscience graduates in the developing countries are best placed to take advantage of these new job opportunities involving Earth materials, but only if they are exposed to broad-based geoscience instruction.

Research on the coordination framework for water resources utilization on the interests of mutual compensation in Lancang-Mekong River

NASA Astrophysics Data System (ADS)

Wang, Y.; Fang, D., VI; Xu, J.; Dong, Q.

2017-12-01

The Lancang-Mekong River is an important international river, cascaded hydropower stations development in which attracts the attention of downstream countries. In this paper, we proposed a coordination framework for water resources utilization on the interests of mutual compensation to relieve the conflict of upstream and downstream countries. Firstly, analyze the benefits and risks caused by the cascaded hydropower stations development and the evolution process of water resources use conflict between upstream and downstream countries. Secondly, evaluate the benefits and risks of flood control, water supply, navigation and power generation based on the energy theory of cascaded hydropower stations development in Lancang-Mekong River. Thirdly, multi-agent cooperation motivation and cooperation conditions between upstream and downstream countries in Lancang-Mekong River is given. Finally, the coordination framework for water resources utilization on the interests of mutual compensation in Lancang-Mekong River is presented. This coordination framework for water resources utilization can increase comprehensive benefits in Lancang-Mekong River.

Controlling and Autonomy-Supportive Parenting in the United States and China: Beyond Children's Reports.

PubMed

Cheung, Cecilia S; Pomerantz, Eva M; Wang, Meifang; Qu, Yang

2016-11-01

Research comparing the predictive power of parents' control and autonomy support in the United States and China has relied almost exclusively on children's reports. Such reports may lead to inaccurate conclusions if they do not reflect parents' practices to the same extent in the two countries. A total of 394 American and Chinese children (M age  = 13.19 years) and their mothers reported on mothers' controlling and autonomy-supportive parenting in the academic arena; trained observers coded such parenting in the laboratory. Children's reports were associated modestly with mothers' reports and weakly, if at all, with observers' reports in both the United States and China. Parenting predicted children's academic and emotional functioning similarly in the two countries, irrespective of reporter. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

[The strategy for establishment of comprehensive cervical cancer prevention and control in the world].

PubMed

Bao, H L; Fang, L W; Wang, L H

2017-01-06

Cervical cancer is one of the most common malignancies among women. Screening programs for cervical cancer have been implemented in many developed countries. Comprehensive systems for cervical cancer prevention and control have improved over the past 30 years, which has led to a significant decline in the morbidity and mortality of cervical cancer. Since 2009, the Chinese government has conducted the Cervical Cancer and Breast Cancer Screening Program for Rural Women on a national scale, which has substantially improved cervical cancer prevention and control. However, a comprehensive system for cervical cancer prevention has been not established in China. It is essential to investigate suitable strategies for cervical cancer prevention system in the country by referring to the experiences of developed nations in comparison with the situation in China, with respect to system operations, compatibility with the existing health care system, choice of suitable technologies, and information and evaluation platforms.

Centre-based day care for children younger than five years of age in low- and middle-income countries.

PubMed

Brown, Taylor W; van Urk, Felix C; Waller, Rebecca; Mayo-Wilson, Evan

2014-09-25

Because of poverty, children and families in low- and middle-income countries often face significant impediments to health and well-being. Centre-based day care services may influence the development of children and the economic situation of parents by providing good quality early childhood care and by freeing parents to participate in the labour force. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development, health and well-being of children and families in low- and middle-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, ERIC and 16 other sources, including several World Health Organization (WHO) regional databases. We also searched two trials registers, websites of government and non-government agencies and reference lists of relevant studies. We included randomised and quasi-randomised controlled trials and prospective non-randomised studies with contemporaneous control groups and assessments both before and after intervention. We considered non-randomised controlled trials, as centre-based care in low- and middle-income countries is unlikely to be studied using randomised controlled trials (Higgins 2011). We included the following outcomes: child intellectual development, child psychosocial development, maternal and family outcomes and incidence of infectious diseases. Two review authors independently assessed risk of bias and extracted data from the single included study. Only one trial, involving 256 children, met the inclusion criteria for this review. This study was assessed as having high risk of bias because of non-random allocation, incomplete outcome data and insufficient control of confounding factors. Results from this study suggest that centre-based day care may have a positive effect on child cognitive ability compared with no treatment (care at home) (assessed using a modified version of the British Ability Scale-II (BAS-II) (standardised mean difference (SMD) 0.74, 95% confidence interval (CI) 0.48 to 1.00, 256 participants, 1 study, very low-quality evidence). This study did not measure other variables relevant to this review. The single study included in this review provides limited evidence on the effects of centre-based day care for children younger than five years of age in low- and middle-income countries. This study was at high risk of bias and may have limited generalisability to other low- and middle-income countries. Many of the studies excluded from this review paired day care attendance with co-interventions that are unlikely to be provided in normal day care centres. Effectiveness studies on centre-based day care without these co-interventions are few, and the need for such studies is significant. In future studies, comparisons might include home visits or alternative day care arrangements.

Insight into Alternative Approaches for Control of Avian Influenza in Poultry, with Emphasis on Highly Pathogenic H5N1

PubMed Central

Abdelwhab, E. M.; Hafez, Hafez M.

2012-01-01

Highly pathogenic avian influenza virus (HPAIV) of subtype H5N1 causes a devastating disease in poultry but when it accidentally infects humans it can cause death. Therefore, decrease the incidence of H5N1 in humans needs to focus on prevention and control of poultry infections. Conventional control strategies in poultry based on surveillance, stamping out, movement restriction and enforcement of biosecurity measures did not prevent the virus spreading, particularly in developing countries. Several challenges limit efficiency of the vaccines to prevent outbreaks of HPAIV H5N1 in endemic countries. Alternative and complementary approaches to reduce the current burden of H5N1 epidemics in poultry should be encouraged. The use of antiviral chemotherapy and natural compounds, avian-cytokines, RNA interference, genetic breeding and/or development of transgenic poultry warrant further evaluation as integrated intervention strategies for control of HPAIV H5N1 in poultry. PMID:23202521

The JICA training course, community-based cancer prevention for the Asian Pacific countries, fiscal years 2004 and 2005 (epidemiological approach).

PubMed

Wakai, Kenji

2006-01-01

Communicable diseases are still major causes of deaths in developing countries. Cancer incidence, however, increased 19% between 1990 and 2000, mainly in this same developing world (Stewart and Kleihaus, 2003), and malignant neoplasms are now the second leading cause of mortality in these countries (WHO, 2003). Limitations of medical facilities and equipment mean that prevention is indispensable for cancer control (Mikheev et al., 1994). However, human resources concerning cancer prevention are limited, and encouragement of their development should be taken as a first priority. To assist in this aim, the present training course was designed by the Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Japan, and has been annually conducted since 1999, supported by the Japan International Cooperation Agency (JICA) (Takezaki, 2001; 2002; 2003; Wakai, 2004). The course targets doctors and public health workers who are responsible for community-based cancer prevention in developing countries to promote the introduction of comprehensive procedures, focusing mainly on primary prevention but also including screening for secondary prevention of cancer.

The JICA training course, community-based cancer prevention for the Asian and Pan-Pacific countries, fiscal year 2006 (epidemiological approach).

PubMed

Wakai, Kenji; Matsuo, Keitaro

2007-01-01

Communicable diseases are still major causes of deaths in developing countries. Cancer incidence, however, increased 19% between 1990 and 2000, mainly in this same developing world (Stewart and Kleihaus, 2003), and malignant neoplasms are now the second leading cause of mortality in these countries (WHO, 2003). Limitations of medical facilities and equipment mean that prevention is indispensable for cancer control (Mikheev et al., 1994). However, human resources concerning cancer prevention are also limited, and encouragement of their development should be taken as a first priority. To assist in this aim, the present training course was designed by the Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Japan, and has been annually conducted since 1999, supported by the Japan International Cooperation Agency (JICA) (Takezaki, 2001; 2002; 2003; Wakai, 2004; 2006). The course targets doctors and public health workers who are responsible for community-based cancer prevention in developing countries to promote the introduction of comprehensive procedures, focusing mainly on primary prevention but also including screening for secondary prevention of cancer.

Manual de Adiestramiento sobre Terapia de Rehidratacion Oral y Control de las Enfermedades Diarreicas (Oral Rehydration Therapy and the Control of Diarrheal Diseases). Training for Development. Peace Corps Information Collection & Exchange Training Manual No. T-53.

ERIC Educational Resources Information Center

Clark, Mari; And Others

This Spanish-language manual was developed to train Peace Corps volunteers and other community health workers in Spanish-speaking countries in oral rehydration therapy (ORT) and the control of diarrheal diseases. Using a competency-based format, the manual contains three training modules (organized in seven sessions) that focus on interrelated…

Duplex recombinase polymerase amplification assays incorporating competitive internal controls for bacterial meningitis detection.

PubMed

Higgins, Owen; Clancy, Eoin; Forrest, Matthew S; Piepenburg, Olaf; Cormican, Martin; Boo, Teck Wee; O'Sullivan, Nicola; McGuinness, Claire; Cafferty, Deirdre; Cunney, Robert; Smith, Terry J

2018-04-01

Recombinase polymerase amplification (RPA) is an isothermal nucleic acid amplification technology that provides rapid and robust infectious disease pathogen detection, ideal for point-of-care (POC) diagnostics in disease-prevalent low-resource countries. We have developed and evaluated three duplex RPA assays incorporating competitive internal controls for the detection of leading bacterial meningitis pathogens. Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae singleplex RPA assays were initially developed and evaluated, demonstrating 100% specificity with limits of detection of 4.1, 8.5 and 3.9 genome copies per reaction, respectively. Each assay was further developed into internally controlled duplex RPA assays via the incorporation of internal amplification control templates. Clinical performance of each internally controlled duplex RPA assay was evaluated by testing 64 archived PCR-positive clinical samples. Compared to real-time PCR, all duplex RPA assays demonstrated 100% diagnostic specificity, with diagnostic sensitivities of 100%, 86.3% and 100% for the S. pneumoniae, N. meningitidis and H. influenzae assays, respectively. This study details the first report of internally controlled duplex RPA assays for the detection of bacterial meningitis pathogens: S. pneumoniae, N. meningitidis and H. influenzae. We have successfully demonstrated the clinical diagnostic utility of each duplex RPA assay, introducing effective diagnostic technology for POC bacterial meningitis identification in disease-prevalent developing countries. Copyright © 2018 Elsevier Inc. All rights reserved.

North-South Partnership in Training and Education in Space Research and Application

NASA Astrophysics Data System (ADS)

Balogun, E.

Partnership between developed and developing countries in matters of space research and application must perforce be lopsided at the outset for a variety of reasons. In such developing countries, universities are weak, there are few centers of applied sciences, communities of scientists are sub-critical and isolated, institutional framework is inadequate, and because of shifting political climate, societies are not as well-ordered as in developed countries. Initially therefore, flow of ideas and facilities, both tangible and intangible, will be unidirectional. For this initial stage to be as short as possible, new approaches to hasten the process have to be developed. Classical approaches to collaborative effort by developed countries to assist these developing countries to the level at which meaningful partnership can evolve has to be reassessed. A few decades ago, one could speak of developing countries as a coherent whole, but now, the situation has changed. The collaborative effort between such countries as India, Korea, etc. and the developed world, which enabled those countries to take off technologically, cannot be adequately applied to the developing countries in Africa. New approaches have to be devised. New recipes have to be concocted. Even with countries in Africa, different approaches have to be taken. Each country in Africa faces unique circumstances, situations, and problems. While a country like Nigeria has a large trainable labour force and an enormous human capital which gives the country a comparative advantage, many countries have less than 10% of the young people between the ages of 1 11 years; 12-19 years; 20-24 years in- educational institutions. In establishing partnership between African countries and the developed countries, specific approaches need to be taken. For example, problems such as cultivating the right attitude in young people to the learning of science are common to both developed and developing countries. The problem could be tackled by capturing the interest of young people in science, by appealing to space science. This is an area of cooperation in which complementarities of experience, stemming from different cultural origins can yield positive results. Researches into the utilization of space-based observation to monitor and control environmental resources (forests, oceans, atmosphere etc.) and climate change, are other examples of areas in which North-South Space Research and Application partnership can be established and sustained. Another area of partnership is in the development of space-based experiments, especially in the area of Communication Satellites, Earth threatening Asteroids and Comets, Global Navigation Satellites Systems, and the promotion of public awareness in space science and technology applications. Such activities will encourage mutual exchange of ideas and intellectual input by both partners in the progress, as opposed to a unilateral transfer of ideas from one partner to the other. Collaborative projects between partners from the North and South should involve university systems, the polytechnics, elementary and secondary school systems, colleges of education, research centers and organizations, corporate enterprise training, the Internet, and all those institutions whose responsibilities are to manage education and training in the developing world. Partnership in space science and technology, if nurtured in these institutions, can in the long run become one of mutual interaction, and can be sustained for a very long time.

North-South Partnership in Training and Education in Space Research and Application

NASA Astrophysics Data System (ADS)

Balogun, E.

Partnership between developed and developing countries in matters of space research and application must perforce be lopsided at the outset for a variety of reasons. In such developing countries, universities are weak, there are few centers of applied sciences, communities of scientists are sub-critical and isolated, institutional framework is inadequate, and because of shifting political climate, societies are not as well-ordered as in developed countries. Initially therefore, flow of ideas and facilities, both tangible and intangible, will be unidirectional. For this initial stage to be as short as possible, new approaches to hasten the process have to be developed. Classical approaches to collaborative effort by developed countries to assist these developing countries to the level at which meaningful partnership can evolve has to be reassessed. A few decades ago, one could speak of developing countries as a coherent whole, but now, the situation has changed. The collaborative effort between such countries as India, Korea, etc. and the developed world, which enabled those countries to take off technologically, cannot be adequately applied to the developing countries in Africa. New approaches have to be devised. New recipes have to be concocted. Even with countries in Africa, different approaches have to be taken. Each country in Africa faces unique circumstances, situations, and problems. While a country like Nigeria has a large trainable labour force and an enormous human capital which gives the country a comparative advantage, many countries have less than 10% of the young people between the ages of 1 11 years; 12-19 years; 20-24 years in educational- institutions. In establishing partnership between African countries and the developed countries, specific approaches need to be taken. For example, problems such as cultivating the right attitude in young people to the learning of science are common to both developed and developing countries. The problem could be tackled by capturing the interest of young people in science, by appealing to space science. This is an area of cooperation in which complementarities of experience, stemming from different cultural origins can yield positive results. Researches into the utilization of space-based observation to monitor and control environmental resources (forests, oceans, atmosphere etc.) and climate change, are other examples of areas in which North-South Space Research and Application partnership can be established and sustained. Another area of partnership is in the development of space-based experiments, especially in the area of Communication Satellites, Earth threatening Asteroids and Co mets, Global Navigation Satellites Systems, and the promotion of public awareness in space science and technology applications. Such activities will encourage mutual exchange of ideas and intellectual input by both partners in the progress, as opposed to a unilateral transfer of ideas from one partner to the other. Collaborative projects between partners from the North and South should involve university systems, the polytechnics, elementary and secondary school systems, colleges of education, research centers and organizations, corporate enterprise training, the Internet, and all those institutions whose responsibilities are to manage education and training in the developing world. Partnership in space science and technology, if nurtured in these institutions, can in the long run become one of mutual interaction, and can be sustained for a very long time.

Analyzing whether countries are equally efficient at improving longevity for men and women.

PubMed

Barthold, Douglas; Nandi, Arijit; Mendoza Rodríguez, José M; Heymann, Jody

2014-11-01

We examined the efficiency of country-specific health care spending in improving life expectancies for men and women. We estimated efficiencies of health care spending for 27 Organisation for Economic Co-operation and Development (OECD) countries during the period 1991 to 2007 using multivariable regression models, including country fixed-effects and controlling for time-varying levels of national social expenditures, economic development, and health behaviors. Findings indicated robust differences in health-spending efficiency. A 1% annual increase in health expenditures was associated with percent changes in life expectancy ranging from 0.020 in the United States (95% confidence interval [CI] = 0.008, 0.032) to 0.121 in Germany (95% CI = 0.099, 0.143). Health-spending increases were associated with greater life expectancy improvements for men than for women in nearly every OECD country. This is the first study to our knowledge to estimate the effect of country-specific health expenditures on life expectancies of men and women. Future work understanding the determinants of these differences has the potential to improve the overall efficiency and equity of national health systems.

Development and implementation of Models of Care for musculoskeletal conditions in middle-income and low-income Asian countries.

PubMed

Lim, Keith K; Chan, Madelynn; Navarra, Sandra; Haq, Syed Atiqul; Lau, Chak Sing

2016-06-01

This chapter discusses the challenges faced in the development and implementation of musculoskeletal (MSK) Models of Care (MoCs) in middle-income and low-income countries in Asia and outlines the components of an effective MoC for MSK conditions. Case studies of four such countries (The Philippines, Malaysia, Bangladesh and Myanmar) are presented, and their unique implementation issues are discussed. The success experienced in one high-income country (Singapore) is also described as a comparison. The Community Oriented Program for Control of Rheumatic Diseases (COPCORD) project and the role of Asia Pacific League of Associations for Rheumatology (APLAR), a professional body supporting MoC initiatives in this region, are also discussed. The experience and lessons learned from these case studies can provide useful information to guide the implementation of future MSK MoC initiatives in other middle-income and low-income countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Method Development and Monitoring of Cyanotoxins in Water

EPA Science Inventory

This presentation describes method development of two ambient water LC/MS/MS methods for microcystins, cylindrospermopsin and anatoxin-a. Ruggedness of the methods will be demonstrated by evaluation of quality control samples derived from various water bodies across the country.

Historical review and insights on the livestock tick-borne disease research of a developing country: The Philippine scenario.

PubMed

Ybañez, Adrian P; Mingala, Claro N; Ybañez, Rochelle Haidee D

2018-04-01

Tick-borne diseases (TBDs) remain to be a global animal health threat. Developing countries like the Philippines is not exempt to this. Despite the potential impact TBDs can give to these countries, local government initiatives and researches remain to be limited. In the Philippines, most epidemiological studies were confined only to specific areas, and predominantly in the Northern Area. Due to its unique geography and limited studies, the current nationwide status of most TBDs could not be clearly established. This review mainly covered published studies and presented challenges in the conduct of TBD research in the Philippines, which may be similar to other Southeast Asian or developing countries. To date, reported livestock TBD pathogens in the Philippines include Anaplasma, Babesia, Theileria, and Mycoplasma spp. With the ubiquitous presence of the Rhipicephalus microplus ticks in the country, it is highly probable that other pathogens transmitted by these vectors could be present. Despite studies on different TBDs in the livestock sector, the Philippine government has not yet heightened its efforts to implement tick control measures as part of the routine animal health program for local farmers. Further studies might be needed to determine the nationwide prevalence of TBDs and the presence of other possible tick species and TBD pathogens. The Philippine scenario may present situations that are similar to other developing countries. Copyright © 2017 Elsevier B.V. All rights reserved.

Health aid and governance in developing countries.

PubMed

Fielding, David

2011-07-01

Despite anecdotal evidence that the quality of governance in recipient countries affects the allocation of international health aid, there is no quantitative evidence on the magnitude of this effect, or on which dimensions of governance influence donor decisions. We measure health-aid flows over 1995-2006 for 109 aid recipients, matching aid data with measures of different dimensions of governance and a range of country-specific economic and health characteristics. Everything else being equal, countries with more political rights receive significantly more aid, but so do countries with higher corruption levels. The dependence of aid on political rights, even when we control for other governance indicators, suggests that health aid is sometimes used as an incentive to reward political reforms. Copyright © 2010 John Wiley & Sons, Ltd.

Global contraceptive use improves health.

PubMed

Ross, J A

1988-01-01

Over 40% of all cohabiting women, in Asia and Latin America, are using contraceptives, most of them modern methods. In many countries, upper order births are disappearing, and rural birth rates in some regions have fallen nearly as much as urban ones. The average family size is diminishing sharply. It is close to 2 children in Thailand, and below 2 throughout urban China. 4/5 of the developing world's population live in only 17 countries, in which contraceptive use has risen from 41% to 52% of couples in 10 years. Moreover, family planning programs affect the overall health of the population: fewer births have meant fewer maternal deaths, and fewer orphans, fewer infant and child deaths, fewer high-risk births (especially at short intervals and upper parities), fewer children left unimmunized, and fewer unserved by the health services. The extent of this quiet social revolution has its limits. Mainly in the 50 struggling countries of sub-Saharan Africa, most of them with weak health ministries, as well as, among the largest 8 countries, Nigeria and Pakistan, which have changed little. But both are reactivating their family planning programs, and the concentration of 2/3 of the developing world's population in 8 large countries means that only 8 administrations can control the course of vital rates. The consequence of the great transformation induced by contraceptive use has begun to give developing world's women control over their own child bearing, adding freedom to their lives. Nevertheless, if the contraceptive revolution has enormously advanced the cause of international health, it still has a long way to go.

Fisheries and aquaculture industries involvement to control product health and quality safety to satisfy consumer-driven objectives on retail markets in Europe.

PubMed

Roth, Eva; Rosenthal, Harald

2006-01-01

Over the past years the export of agricultural and fishery products from developing countries has substantially increased to markets within the OECD. Retailers and importers are expanding their international operations to meet consumer demands for year-round delivery of products. Moreover, consumers have become increasingly concerned about the safety of food, including those derived from aquatic resources [FAO/NACA/WHO Joint Study Group, 1999. Report food safety issues associated with products from aquaculture. WHO Technical Report Series No 883: VII, pp. 1-55]. Governments and leading businesses are responding by imposing new safety regulations and standards to the international food system (e.g. HACCP, EUREP-GAP), product liability and labeling [Reilly, A., Howgate, P., Käferstein, F., 1997. Safety hazards and the application of HACCP in aquaculture. In: Proceedings of the Second International Conference on Fish Inspection and Quality Control: A Global Focus, Arlington, VA, 19-24 May 1996. Technomic Publishing, Lancaster, PA, pp. 353-373]. Initial concerns for imports of aquacultural products from developing to industrialized countries focussed on bacterial contamination [Buras, N. 1993. Microbial safety of produce from wastewater-fed aquaculture. In: Pullin, R.V.C., Rosenthal, H., MacLean, J.L.(Eds.), Proceedings of ICLARM Conferences, vol. 31, pp. 285-295]. Today, if trade opportunities are to be maintained, these countries must adapt to a full array of regulations and standards. This paper describes four scenarios in aquaculture and fishing product trade between developing countries and countries in the European Union.

Literacy, Income Generation, and Poverty Alleviation in Sindh Pakistan and Its Impact on Economic Development, Human Resource Development in Pakistan.

ERIC Educational Resources Information Center

Panhwar, Farzana

Rural poverty in Sindh, Pakistan, has been artificially created by low prices of wheat, fixed by the federal government's price control board. Agriculture and agro-based industries account for 80 percent of the country's labor force. Among the consequences of this price control are low margins of profit to the farming community; low capacity to…

US tobacco export to Third World: Third World War.

PubMed

Mackay, J

1992-01-01

Global tobacco-related mortality will rise from the current 2.5 million to over 10 million annually by 2050. Most of this increase will occur in developing countries, where legislative controls and other measures that succeed in limiting the use of tobacco in industrialized countries do not exist or are at best inadequate. Of particular concern is the penetration of developing countries by the transnational tobacco companies, with aggressive promotional campaigns that include specific targeting of women, few of whom currently smoke in developing countries. The transnational tobacco companies advertise and market in ways long banned in the United States, for example, selling cigarettes without health warnings, advertising on television, and selling cigarettes with higher tar content than the same cigarettes sold in the United States. Also, tobacco advertising revenue prevents the media from reporting on the hazards of tobacco, a particularly serious problem in developing countries, where awareness of the harmfulness of tobacco is low. The transnational tobacco companies interfere with the national public health laws of developing countries via political and commercial pressures to open markets and to promote foreign cigarettes. This has led to an increase in market share by foreign cigarettes, but evidence also points to market expansion, especially among young people. The entry of the transnationals leads to a collapse of national tobacco monopolies or to their changing from unsophisticated government departments that may still cooperate with health initiatives on tobacco to copying the aggressive marketing and promotional behavior of the transnationals.(ABSTRACT TRUNCATED AT 250 WORDS)

Financing healthcare in Gulf Cooperation Council countries: a focus on Saudi Arabia

PubMed Central

Alkhamis, Abdulwahab; Hassan, Amir; Cosgrove, Peter

2014-01-01

Background This paper presents an analysis of the main characteristics of the Gulf Cooperation Council’s (GCC) health financing systems and draws similarities and differences between GCC countries and other high-income and low-income countries, in order to provide recommendations for healthcare policy makers. The paper also illustrates some financial implications of the recent implementation of the Compulsory Employment-based Health Insurance (CEBHI) system in Saudi Arabia. Methods Employing a descriptive framework for the country-level analysis of healthcare financing arrangements, we compared expenditure data on healthcare from GCC and other developing and developed countries, mostly using secondary data from the World Health Organization health expenditure database. The analysis was supported by a review of related literature. Results There are three significant characteristics affecting healthcare financing in GCC countries: (i) large expatriate populations relative to the national population, which leads GCC countries to use different strategies to control expatriate healthcare expenditure; (ii) substantial government revenue, with correspondingly high government expenditure on healthcare services in GCC countries; and (iii) underdeveloped healthcare systems, with some GCC countries’ healthcare indicators falling below those of upper-middle-income countries. Conclusion Reforming the mode of health financing is vital to achieving equitable and efficient healthcare services. Such reform could assist GCC countries in improving their healthcare indicators and bring about a reduction in out-of-pocket payments for healthcare. PMID:23996348

Microcontroller-Based Experimental Setup and Experiments for SCADA Education

ERIC Educational Resources Information Center

Sahin, S.; Olmez, M.; Isler, Y.

2010-01-01

In the field of automation technology, research and development for industrial applications has increased rapidly in recent years. Therefore, industrial automation and control education is a very important element of the industrialization process in developing countries, such as Turkey, which needs to keep abreast for the latest developments in…

Pharmaceutical policies in European countries.

PubMed

Barros, Pedro Pita

2010-01-01

Pharmaceutical expenditures have an important role in Europe. The attempts to control expenditure have used a wide range of policy measures. We reviewed the main measures adopted by the European Union countries, especially in countries where governments are the largest third-party payers. To complement a literature review on the topic, data was gathered from national reviews of health systems and direct inquiries to several government bodies. Almost all countries regulate prices of pharmaceutical products. Popular policy measures include international referencing to set prices (using as benchmark countries that have set lower prices), internal reference pricing systems to promote price competition in domestic markets, and positive lists for reimbursement to promote consumption of generics (including in some cases substitution by pharmacists of drugs prescribed by physicians). Despite the wide range of policy measures, it is not possible to identify a "silver bullet" to control pharmaceutical expenditures. We also identified two main policy challenges: policy coordination among countries within the European Union to maintain incentives for R&D at the global level, and the development of new relationships with the pharmaceutical industry; namely, the so-called risk-sharing agreements between the pharmaceutical industry and governments/regulators (or large third-party payers).

Harmonisation of standards for permissible radionuclide activity concentrations in foodstuffs in the long term after the Chernobyl accident.

PubMed

Balonov, M; Kashparov, V; Nikolaenko, A; Berkovskyy, V; Fesenko, S

2018-06-01

The article critically examines the practice of post-Chernobyl standardisation of radionuclide concentrations (mainly 137 Cs and 90 Sr) in food products (FPs) in the USSR and the successor countries of Belarus, Russia and Ukraine. Recommendations are given on potential harmonisation of these standards of radionuclide concentrations in FPs among the three countries, taking into account substantial international experience. We propose to reduce the number of product groups for standardisation purposes from the current amount of several dozens to three to five groups to optimise radiation control and increase the transparency of the process. We recommend five product groups for the standardisation of 137 Cs and three groups for 90 Sr in food in radiocontaminated areas. The values of standards for individual product groups are recommended to be set proportionally to the measured specific activity in each of these groups, which will reduce unreasonable food rejection. The standards might be set for the entire country, and could be also used to control imports from other countries as well as exports to other countries. The developed recommendations were transferred in 2015-2016 to the regulatory authorities of the three countries.

The Role of Policy and Institutions on Health Spending.

PubMed

de la Maisonneuve, Christine; Moreno-Serra, Rodrigo; Murtin, Fabrice; Oliveira Martins, Joaquim

2017-07-01

This paper investigates the impact of policies and institutions on health expenditures for a large panel of Organisation for Economic Co-operation and Development countries for the period of 2000-2010. A set of 20 policy and institutional indicators developed by the Organisation for Economic Co-operation and Development are integrated into a theoretically motivated econometric framework, alongside control variables related to demographic (dependency ratio) and non-demographic (income, prices and technology) drivers of health expenditures per capita. Although a large share of cross-country differences in public health expenditures can be explained by demographic and economic factors (around 71%), cross-country variations in policies and institutions also have a significant influence, explaining most of the remaining difference in public health spending (23%). Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

My revolutionary adventures in the development of modern emergency medical systems in our country.

PubMed

Edlich, Richard F

2008-05-01

The purpose of this article is to describe my exciting adventures in the development of the emergency medical systems in our country. After my training in plastic surgery at the University of Virginia, I accepted the position of Acting Director of the Emergency Room at the University of Virginia Health Science Center. Working with gifted physicians, basic scientists, nurses, and students, we coordinated the development of an emergency medical system that has been replicated throughout our country. Our system included the following: State legislation for the sexual assault victim, public access by the 9-1-1 telephone number, training of rescue squads, emergency radio communication system, trauma centers, poison control centers, emergency medical plan for the President of the United States, national telecommunications system for the deaf, and the first air medical transportation system in Virginia.

The Design and Development of Educational Materials Using Microcomputer Technology in Distance Teaching Institutions: Some Issues for Consideration.

ERIC Educational Resources Information Center

Yates, Christopher

Perhaps the most significant development in microcomputer technology over the last two years has been the development of desktop publishing techniques. This technology promises to offer some significant advantages to institutions developing instructional materials in less developed countries, particularly in terms of control, cost effectiveness,…

"Quitting like a Turk:" How political priority developed for tobacco control in Turkey.

PubMed

Hoe, Connie; Rodriguez, Daniela C; Üzümcüoğlu, Yeşim; Hyder, Adnan A

2016-09-01

In recent years, tobacco control emerged as a political priority in Turkey and today the country is widely regarded as one of the global leaders in tackling tobacco use. Although political priority is considered a facilitating factor to the success of addressing public health issues, there is a paucity of research to help us understand how it is developed in middle-income countries. The primary aim of this study is to understand the process and determinants of how tobacco control became a political priority in Turkey using the Multiple Streams Framework. A mixed-methods case study approach was used whereby data were gathered from three different sources: in-depth interviews (N = 19), document reviews (N = 216), and online self-administered surveys (N = 61). Qualitative data were collected for the purpose of understanding the processes and determinants that led to political prioritization of tobacco control and were analyzed using deductive and inductive coding. Quantitative data were collected to examine the actors and were analyzed using descriptive statistics and network nominations. Data were triangulated. Findings revealed that tobacco control achieved political priority in Turkey as a result of the development and convergence of multiple streams, including a fourth, separate global stream. Findings also shed light on the importance of Turkey's foreign policy in the transformation of the political stream. The country's desire for European Union accession and global visibility helped generate a political environment that was receptive to global norms for tobacco control. A diverse but cohesive network of actors joined forces with global allies to capitalize on this opportunity. Results suggest (1) the importance of global-agenda setting activities on political priority development, (2) the utility of aligning public health and foreign policy goals and (3) the need to build a strong global incentive structure to help entice governments to take action on public health issues. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Impact of Dialogic Book-Sharing Training on Infant Language and Attention: A Randomized Controlled Trial in a Deprived South African Community

ERIC Educational Resources Information Center

Vally, Zahir; Murray, Lynne; Tomlinson, Mark; Cooper, Peter J.

2015-01-01

Background: Dialogic book-sharing is an interactive form of shared reading. It has been shown in high income countries (HICs) to be of significant benefit to child cognitive development. Evidence for such benefit in low and middle income countries (LMICs) is scarce, although a feasibility study of our own produced encouraging findings.…

Hygiene Hypothesis: Is the Evidence the Same All Over the World?

PubMed

Leong, Rupert W; Mitrev, Nikola; Ko, Yanna

2016-01-01

The hygiene hypothesis refers to where modern living conditions are responsible for the increasing incidences of immune-related diseases including the development of inflammatory bowel diseases (IBD). Improved hygiene may result in decreased enteric microbiota diversity and dysbiosis, which may be responsible for the development of IBD. The rising incidence of IBD is well documented in developing regions of the world, in accordance with the hygiene hypothesis. What is unknown, however, is whether the hygiene hypothesis is applicable all over the world. Hygiene cannot be easily measured and proxy markers need to be used. These include regional data such as a country's gross domestic product or an individual's affluence or exposure to infection risk factors. A comparative case-control study of Caucasian Australian IBD subjects versus migrants from the Middle East to Australia identified that environmental risk factors are different in the 2 populations. Among Australian Caucasians, hygiene-related environmental risk factors are no longer relevant in the development of IBD. Given the country's high affluence, there has been high hygienic standard for several generations. However, migrants from less affluent countries exposed to hygiene-related environmental factors are at increased risks of developing IBD, especially in the second generation migrants born in the affluent country. Divergent risk factors include the use of antibiotics in childhood increasing the risk of IBD in developed societies but being a risk factor for developing IBD in migrants. In India, risk factors associated with infections were found to be positively associated with the development of ulcerative colitis, rather than protective. The hygiene hypothesis is not applicable to all populations worldwide, being most relevant in societies undergoing increasing affluence or following migration from less to more affluent countries. This review examines data from around the world that link the hygiene hypothesis with the development of IBD and in particular the divergent results arising from data from affluent countries versus less-affluent countries. © 2016 S. Karger AG, Basel.

Costs of Addressing Heroin Addiction in Malaysia and 32 Comparable Countries Worldwide

PubMed Central

Ruger, Jennifer Prah; Chawarski, Marek; Mazlan, Mahmud; Luekens, Craig; Ng, Nora; Schottenfeld, Richard

2012-01-01

Objective Develop and apply new costing methodologies to estimate costs of opioid dependence treatment in countries worldwide. Data Sources/Study Setting Micro-costing methodology developed and data collected during randomized controlled trial (RCT) involving 126 patients (July 2003–May 2005) in Malaysia. Gross-costing methodology developed to estimate costs of treatment replication in 32 countries with data collected from publicly available sources. Study Design Fixed, variable, and societal cost components of Malaysian RCT micro-costed and analytical framework created and employed for gross-costing in 32 countries selected by three criteria relative to Malaysia: major heroin problem, geographic proximity, and comparable gross domestic product (GDP) per capita. Principal Findings Medication, and urine and blood testing accounted for the greatest percentage of total costs for both naltrexone (29–53 percent) and buprenorphine (33–72 percent) interventions. In 13 countries, buprenorphine treatment could be provided for under $2,000 per patient. For all countries except United Kingdom and Singapore, incremental costs per person were below $1,000 when comparing buprenorphine to naltrexone. An estimated 100 percent of opiate users in Cambodia and Lao People's Democratic Republic could be treated for $8 and $30 million, respectively. Conclusions Buprenorphine treatment can be provided at low cost in countries across the world. This study's new costing methodologies provide tools for health systems worldwide to determine the feasibility and cost of similar interventions. PMID:22091732

Association between body mass index and body fat in 9–11-year-old children from countries spanning a range of human development

PubMed Central

Katzmarzyk, P T; Barreira, T V; Broyles, S T; Chaput, J-P; Fogelholm, M; Hu, G; Kuriyan, R; Kurpad, A; Lambert, E V; Maher, C; Maia, J; Matsudo, V; Olds, T; Onywera, V; Sarmiento, O L; Standage, M; Tremblay, M S; Tudor-Locke, C; Zhao, P; Church, T S

2015-01-01

The purpose was to assess associations between body mass index (BMI) and body fat in a multinational sample of 9–11-year-old children. The sample included 7265 children from countries ranging in human development. Total body fat (TBF) and percentage body fat (PBF) were measured with a Tanita SC-240 scale and BMI z-scores (BMIz) and percentiles were computed using reference data from the World Health Organization and the U.S. Centers for Disease Control and Prevention, respectively. Mean PBF at BMIz values of −1, 0 and +1 were estimated using multilevel models. Correlations between BMI and TBF were >0.90 in all countries, and correlations between BMI and PBF ranged from 0.76 to 0.96. Boys from India had higher PBF than boys from several other countries at all levels of BMIz. Kenyan girls had lower levels of PBF than girls from several other countries at all levels of BMIz. Boys and girls from Colombia had higher values of PBF at BMIz=−1, whereas Colombian boys at BMIz 0 and +1 also had higher values of PBF than boys in other countries. Our results show a consistently high correlation between BMI and adiposity in children from countries representing a wide range of human development. PMID:27152184

Costs of addressing heroin addiction in Malaysia and 32 comparable countries worldwide.

PubMed

Ruger, Jennifer Prah; Chawarski, Marek; Mazlan, Mahmud; Luekens, Craig; Ng, Nora; Schottenfeld, Richard

2012-04-01

Develop and apply new costing methodologies to estimate costs of opioid dependence treatment in countries worldwide. Micro-costing methodology developed and data collected during randomized controlled trial (RCT) involving 126 patients (July 2003-May 2005) in Malaysia. Gross-costing methodology developed to estimate costs of treatment replication in 32 countries with data collected from publicly available sources. Fixed, variable, and societal cost components of Malaysian RCT micro-costed and analytical framework created and employed for gross-costing in 32 countries selected by three criteria relative to Malaysia: major heroin problem, geographic proximity, and comparable gross domestic product (GDP) per capita. Medication, and urine and blood testing accounted for the greatest percentage of total costs for both naltrexone (29-53 percent) and buprenorphine (33-72 percent) interventions. In 13 countries, buprenorphine treatment could be provided for under $2,000 per patient. For all countries except United Kingdom and Singapore, incremental costs per person were below $1,000 when comparing buprenorphine to naltrexone. An estimated 100 percent of opiate users in Cambodia and Lao People's Democratic Republic could be treated for $8 and $30 million, respectively. Buprenorphine treatment can be provided at low cost in countries across the world. This study's new costing methodologies provide tools for health systems worldwide to determine the feasibility and cost of similar interventions. © Health Research and Educational Trust.

India Co2 Emissions

NASA Astrophysics Data System (ADS)

Sharan, S.; Diffenbaugh, N. S.

2010-12-01

Is there a way to find a balance between improving living conditions for the people on the margins and also reducing emissions while limiting our negative impacts on the climate? This is a critical question today because there are many arguments between developed and developing countries about who is responsible for global warming. Developed countries believe that it is the poor countries because they are not educated enough to know about how they are affecting the climate. While the developing countries hold wealthy nations responsible because they are using the most resources. However it is important to acknowledge the fact that if there was no gap in between the developed and developing countries our emissions total would be much higher. This “gap” has been a natural controlling factor in climate change. This is why I wanted to see if I could plot what it would look like if a developing country such as India were to produce emissions that the US or Switzerland or Norway are producing as developed countries. India has a population total of 1.1 billion compared to the US with only 298 million, Switzerland with 7.5 million, and Norway with 4.6 million people. When the population is compared to the emissions output in metric tons, per capita, India produced the least emissions out of these countries, 1.4 tons per person while having the second largest population in the world, while the US produced 19 tons per capita, Switzerland produced 5.6 and Norway produced 8.7 tons per capita in 2006. The emissions rate is growing every year and increases widely and globally. If India was producing emissions that equal Norway, Switzerland and the US the total emissions it would be producing annually would be 9 billion for Norway, 6 billion for Switzerland and 20 billion emissions for the US, all in the year 2006 alone. This shows how the balance between countries with huge populations and very little emission output and average population and high emission out put has created a balance in between the “developed” and developing countries. If India was producing the same amounts of emissions per capita as the it would have a total of 20 billion metric tons of CO2 emissions annually.

Nutrition in pregnancy and early childhood and associations with obesity in developing countries.

PubMed

Yang, Zhenyu; Huffman, Sandra L

2013-01-01

Concerns about the increasing rates of obesity in developing countries have led many policy makers to question the impacts of maternal and early child nutrition on risk of later obesity. The purposes of the review are to summarise the studies on the associations between nutrition during pregnancy and infant feeding practices with later obesity from childhood through adulthood and to identify potential ways for preventing obesity in developing countries. As few studies were identified in developing countries, key studies in developed countries were included in the review. Poor prenatal dietary intakes of energy, protein and micronutrients were shown to be associated with increased risk of adult obesity in offspring. Female offspring seem to be more vulnerable than male offspring when their mothers receive insufficient energy during pregnancy. By influencing birthweight, optimal prenatal nutrition might reduce the risk of obesity in adults. While normal birthweights (2500-3999 g) were associated with higher body mass index (BMI) as adults, they generally were associated with higher fat-free mass and lower fat mass compared with low birthweights (<2500 g). Low birthweight was associated with higher risk of metabolic syndrome and central obesity in adults. Breastfeeding and timely introduction of complementary foods were shown to protect against obesity later in life in observational studies. High-protein intake during early childhood however was associated with higher body fat mass and obesity in adulthood. In developed countries, increased weight gain during the first 2 years of life was associated with a higher BMI in adulthood. However, recent studies in developing countries showed that higher BMI was more related to greater lean body mass than fat mass. It appears that increased length at 2 years of age was positively associated with height, weight and fat-free mass, and was only weakly associated with fat mass. The protective associations between breastfeeding and obesity may differ in developing countries compared to developed countries because many studies in developed countries used formula feeding as a control. Future research on the relationship between breastfeeding, timely introduction of complementary feeding or rapid weight gain and obesity are warranted in developing countries. The focus of interventions to reduce risk of obesity in later life in developing countries could include: improving maternal nutritional status during pregnancy to reduce low birthweight; enhancing breastfeeding (including durations of exclusive and total breastfeeding); timely introduction of high-quality complementary foods (containing micronutrients and essential fats) but not excessive in protein; further evidence is needed to understand the extent of weight gain and length gain during early childhood are related to body composition in later life. © 2012 Blackwell Publishing Ltd.

[Developing a harmonised system for the recognition of clinical trials for veterinary product registration].

PubMed

Maliandi, F S

2008-12-01

The increase of commerce between developing countries requires a harmonised system for accepting the results of clinical trials (CT) of veterinary products, similar to those that exist in developed countries. The objective of this paper is to propose a basis for the creation of a system that harmonises CTs for approving veterinary products (VP) for registration. Such a system would be a step towards unifying the CTs of different countries, while maintaining country-specific variations that are compatible with the scientific method, international standards, and the principles of objectivity, transparency and confidentiality. Basic requirements to be fulfilled by both private institutions and public offices are described, as are professional responsibilities and possible administrative procedures that could be adapted in each country. The conclusion reached is that a harmonised system is feasible, as has been demonstrated in numerous countries throughout the world. A harmonised system will result in a more efficient product approval process, a reduction in costs, greater transparency in controls, an improvement in the reliability of the health system, and a reduction in the time the process takes. It will also contribute to animal welfare by avoiding the need to repeat trials. The author acknowledges that there are cultural, technological and economic limitations and that these problems, and others, have yet to be overcome.

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

PubMed Central

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

2007-01-01

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

Security and privacy issues of personal health.

PubMed

Blobel, Bernd; Pharow, Peter

2007-01-01

While health systems in developed countries and increasingly also in developing countries are moving from organisation-centred to person-centred health service delivery, the supporting communication and information technology is faced with new risks regarding security and privacy of stakeholders involved. The comprehensively distributed environment puts special burden on guaranteeing communication security services, but even more on guaranteeing application security services dealing with privilege management, access control and audit regarding social implication and connected sensitivity of personal information recorded, processed, communicated and stored in an even internationally distributed environment.

Research Programs & Initiatives

Cancer.gov

CGH develops international initiatives and collaborates with other NCI divisions, NCI-designated Cancer Centers, and other countries to support cancer control planning, encourage capacity building, and support cancer research and research networks.

Global tobacco control and economic norms: an analysis of normative commitments in Kenya, Malawi and Zambia.

PubMed

Lencucha, Raphael; Reddy, Srikanth K; Labonte, Ronald; Drope, Jeffrey; Magati, Peter; Goma, Fastone; Zulu, Richard; Makoka, Donald

2018-04-01

Tobacco control norms have gained momentum over the past decade. To date 43 of 47 Sub-Saharan African countries are party to the Framework Convention on Tobacco Control (FCTC). The near universal adoption of the FCTC illustrates the increasing strength of these norms, although the level of commitment to implement the provisions varies widely. However, tobacco control is enmeshed in a web of international norms that has bearing on how governments implement and strengthen tobacco control measures. Given that economic arguments in favor of tobacco production remain a prominent barrier to tobacco control efforts, there is a continued need to examine how economic sectors frame and mobilize their policy commitments to tobacco production. This study explores the proposition that divergence of international norms fosters policy divergence within governments. This study was conducted in three African countries: Kenya, Malawi, and Zambia. These countries represent a continuum of tobacco control policy, whereby Kenya is one of the most advanced countries in Africa in this respect, whereas Malawi is one of the few countries that is not a party to the FCTC and has implemented few measures. We conducted 55 key informant interviews (Zambia = 23; Kenya = 17; Malawi = 15). Data analysis involved deductive coding of interview transcripts and notes to identify reference to international norms (i.e. commitments, agreements, institutions), coupled with an inductive analysis that sought to interpret the meaning participants ascribe to these norms. Our analysis suggests that commitments to tobacco control have yet to penetrate non-health sectors, who perceive tobacco control as largely in conflict with international economic norms. The reasons for this perceived conflict seems to include: (1) an entrenched and narrow conceptualization of economic development norms, (2) the power of economic interests to shape policy discourses, and (3) a structural divide between sectors in the form of bureaucratic silos.

[Challenge and strategy of prevention and control of important parasitic diseases under the Belt and Road Initiative].

PubMed

Chun-Li, Cao; Jia-Gang, Guo

2018-04-17

China was once a country with the heaviest burden of parasitic diseases. Under the leadership of the Communist Party and national authority, after more than 60 years' efforts of prevention and control, the remarkable results have been achieved in China. However, affected by the social and economic development and environmental changes, the prevention and control of parasitic diseases, especially imported parasitic diseases, are facing new challenges, and the parasitic diseases, such as malaria, schistosomiasis, leishmaniasis, filariasis and trypanosomiasis, appear increasingly. With the development of the Belt and Road Initiative, the transmission risks of these diseases are more increased. The purpose of this paper is to describe the experience and results of parasitic disease prevention and control in China, understand the present parasitic disease epidemic situation of the Belt and Road Initiative related countries, analyze the transmission risks of important parasitic diseases, and present some relevant suggestions, so as to provide the evidence for the health administrative department formulating the prevention and control strategies of such parasitic diseases timely and effectively.

Tuberculosis in Asia and the Pacific: The Role of Socioeconomic Status and Health System Development

PubMed Central

Wu, Jie; Dalal, Koustuv

2012-01-01

Objective: To identify the relationship between socioeconomic status, health system development and the incidence, prevalence and mortality of tuberculosis in Asia and the Pacific. Methods: Incidence, prevalence and mortality rates of tuberculosis and 20 variables of socioeconomic, health system and biological–behavioral issues were included in the study involving all 46 countries of the Asian Development Bank region (2007 data). Both univariate and multivariate linear regressions were used. Results: The worst three tuberculosis affected countries were Cambodia, India and Indonesia, while the least affected was Australia. Tuberculosis incidence, prevalence and mortality rate were higher in countries with lower human development index, corruption perception index, gross domestic product (GDP) per capita and countries with more people under minimum food supplements. Among the health system variables, total health expenditure per capita, governmental health expenditure per capita, hospital beds, and access to improved water and sanitation were strongly associated with tuberculosis. Conclusions: Socioeconomic determinants and health system development have significant effect on the control of tuberculosis in Asia and the Pacific region. The study has some policy implications by means of lowering the corruption and improving the sanitation. PMID:22355472

Health promotion in Kenya: a volunteer nurse's experience.

PubMed

Kater, Vered; Liebergall, Michal

2010-01-01

This article presents a case study describing how nurses can improve the health behaviors of people living in developing countries. Difficulties and potential solutions are presented. Health promotion allows people to exert control over their health to improve it. A primary difficulty of health promotion in developing countries is communication between care providers and patients. One solution is the utilization of an interpreter; however, in the present study, no professional interpreters were available, thereby complicating the comprehension of new health-related concepts. Another challenge is to understand the patients' perspectives as related to healthcare values. Additionally, as a result of a dearth of evidence-based research in developing countries, difficulties arise in implementing, assessing, and evaluating health promotion programs. Despite these obstacles, nurses continue to travel to developing countries to promote health. Recommendations include respect for a community's health values and incorporation of these values into healthcare planning. To be accepted as a teacher by the local population, the nurse must be able to set aside his/her personal beliefs relating to healthcare, well-being, and disease. Health promotion initiatives should include the means for implementation, thereby enabling the local population to develop skills that will allow them to carry out health promotion projects.

Factors influencing malaria control policy-making in Kenya, Uganda and Tanzania.

PubMed

Mutero, Clifford M; Kramer, Randall A; Paul, Christopher; Lesser, Adriane; Miranda, Marie Lynn; Mboera, Leonard E G; Kiptui, Rebecca; Kabatereine, Narcis; Ameneshewa, Birkinesh

2014-08-08

Policy decisions for malaria control are often difficult to make as decision-makers have to carefully consider an array of options and respond to the needs of a large number of stakeholders. This study assessed the factors and specific objectives that influence malaria control policy decisions, as a crucial first step towards developing an inclusive malaria decision analysis support tool (MDAST). Country-specific stakeholder engagement activities using structured questionnaires were carried out in Kenya, Uganda and Tanzania. The survey respondents were drawn from a non-random purposeful sample of stakeholders, targeting individuals in ministries and non-governmental organizations whose policy decisions and actions are likely to have an impact on the status of malaria. Summary statistics across the three countries are presented in aggregate. Important findings aggregated across countries included a belief that donor preferences and agendas were exerting too much influence on malaria policies in the countries. Respondents on average also thought that some relevant objectives such as engaging members of parliament by the agency responsible for malaria control in a particular country were not being given enough consideration in malaria decision-making. Factors found to influence decisions regarding specific malaria control strategies included donor agendas, costs, effectiveness of interventions, health and environmental impacts, compliance and/acceptance, financial sustainability, and vector resistance to insecticides. Malaria control decision-makers in Kenya, Uganda and Tanzania take into account health and environmental impacts as well as cost implications of different intervention strategies. Further engagement of government legislators and other policy makers is needed in order to increase funding from domestic sources, reduce donor dependence, sustain interventions and consolidate current gains in malaria.

The Will to Survive

ERIC Educational Resources Information Center

Katz, Robert

1975-01-01

Bangladesh could achieve self-sufficiency despite natural and man-made catastrophies. It contains rich alluvial soils and abundant groundwater. The country also possesses energy resources needed for development. By combining agrarian reform with population control and small industry development the Bangladesh government hopes to restructure its…

An overview of tobacco control and prevention policy status in Africa.

PubMed

Husain, Muhammad Jami; English, Lorna McLeod; Ramanandraibe, Nivo

2016-10-01

Tobacco smoking prevalence remains low in many African countries. However, growing economies and the increased presence of multinational tobacco companies in the African Region have the potential to contribute to increasing tobacco use rates in the future. This paper used data from the 2014 Global Progress Report on implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), as well as the 2015 WHO report on the global tobacco epidemic, to describe the status of tobacco control and prevention efforts in countries in the WHO African Region relative to the provisions of the WHO FCTC and MPOWER package. Among the 23 countries in the African Region analyzed, there are large variations in the overall WHO FCTC implementation rates, ranging from 9% in Sierra Leone to 78% in Kenya. The analysis of MPOWER implementation status indicates that opportunities exist for the African countries to enhance compliance with WHO recommended best practices for monitoring tobacco use, protecting people from tobacco smoke, offering help to quit tobacco use, warning about the dangers of tobacco, enforcing bans on tobacco advertising and promotion, and raising taxes on tobacco products. If tobacco control interventions are successfully implemented, African nations could avert a tobacco-related epidemic, including premature death, disability, and the associated economic, development, and societal costs. Published by Elsevier Inc.

Are TB control programmes in South Asia ignoring children with disease? A situational analysis.

PubMed

Shakoor, Sadia; Qamar, Farah Naz; Mir, Fatima; Zaidi, Anita; Hasan, Rumina

2015-02-01

Paediatric tuberculosis (TB) has long been an evasive entity for public health practitioners striving to control the disease. Owing to difficulty in diagnosis of paediatric TB, incidence estimates based on current case detection fall short of actual rates. The four high-burden countries in South Asia (SA-HBC)-Afghanistan, Pakistan, India and Bangladesh-alone account for >75% of missed TB cases worldwide. It follows that these countries are also responsible for a large although unmeasured proportion of missed paediatric cases. In view of current Millennium Development Goals recommending a scale-up of paediatric TB detection and management globally, there is a dire need to improve paediatric TB programmes in these high-burden countries. Inherent problems with diagnosis of paediatric TB are compounded by programmatic and social barriers in SA-HBC. We have reviewed the current situation of TB control programmes in SA-HBC countries based on published statistics and performed a strengths, weaknesses, opportunities and threats situational analysis with a view towards identifying critical issues operant in the region posing barriers to improving paediatric TB control. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

An overview of tobacco control and prevention policy status in Africa

PubMed Central

Husain, Muhammad Jami; English, Lorna McLeod; Ramanandraibe, Nivo

2017-01-01

Tobacco smoking prevalence remains low in many African countries. However, growing economies and the increased presence of multinational tobacco companies in the African Region have the potential to contribute to increasing tobacco use rates in the future. This paper used data from the 2014 Global Progress Report on implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), as well as the 2015 WHO report on the global tobacco epidemic, to describe the status of tobacco control and prevention efforts in countries in the WHO African Region relative to the provisions of the WHO FCTC and MPOWER package. Among the 23 countries in the African Region analyzed, there are large variations in the overall WHO FCTC implementation rates, ranging from 9% in Sierra Leone to 78% in Kenya. The analysis of MPOWER implementation status indicates that opportunities exist for the African countries to enhance compliance with WHO recommended best practices for monitoring tobacco use, protecting people from tobacco smoke, offering help to quit tobacco use, warning about the dangers of tobacco, enforcing bans on tobacco advertising and promotion, and raising taxes on tobacco products. If tobacco control interventions are successfully implemented, African nations could avert a tobacco-related epidemic, including premature death, disability, and the associated economic, development, and societal costs. PMID:26876626

Similarities and differences between stakeholders' opinions on using Health Technology Assessment (HTA) information across five European countries: results from the EQUIPT survey.

PubMed

Vokó, Zoltan; Cheung, Kei Long; Józwiak-Hagymásy, Judit; Wolfenstetter, Silke; Jones, Teresa; Muñoz, Celia; Evers, Silvia M A A; Hiligsmann, Mickaël; de Vries, Hein; Pokhrel, Subhash

2016-05-26

The European-study on Quantifying Utility of Investment in Protection from Tobacco (EQUIPT) project aimed to study transferability of economic evidence by co-creating the Tobacco Return On Investment (ROI) tool, previously developed in the United Kingdom, for four sample countries (Germany, Hungary, Spain and the Netherlands). The EQUIPT tool provides policymakers and stakeholders with customized information about the economic and wider returns on the investment in evidence-based tobacco control, including smoking cessation interventions. A Stakeholder Interview Survey was developed to engage with the stakeholders in early phases of the development and country adaptation of the ROI tool. The survey assessed stakeholders' information needs, awareness about underlying principles used in economic analyses, opinion about the importance, effectiveness and cost-effectiveness of tobacco control interventions, and willingness to use a Health Technology Assessment (HTA) tool such as the ROI tool. A cross sectional study using a mixed method approach was conducted among participating stakeholders in the sample countries and the United Kingdom. The individual questionnaire contained open-ended questions as well as single choice and 7- or 3-point Likert-scale questions. The results corresponding to the priority and needs assessment and to the awareness of stakeholders about underlying principles used in economic analysis are analysed by country and stakeholder categories. Stakeholders considered it important that the decisions on the investments in tobacco control interventions should be supported by scientific evidence, including prevalence of smoking, cost of smoking, quality of life, mortality due to smoking, and effectiveness, cost-effectiveness and budget impact of smoking cessation interventions. The proposed ROI tool was required to provide this granularity of information. The majority of the stakeholders were aware of the general principles of economic analyses used in decision making contexts but they did not appear to have in-depth knowledge about specific technical details. Generally, stakeholders' answers showed larger variability by country than by stakeholder category. Stakeholders across different European countries viewed the use of HTA evidence to be an important factor in their decision-making process. Further, they considered themselves to be capable of interpreting the results from a ROI tool and were highly motivated to use it.

Critical role of developing national strategic plans as a guide to strengthen laboratory health systems in resource-poor settings.

PubMed

Nkengasong, John N; Mesele, Tsehaynesh; Orloff, Sherry; Kebede, Yenew; Fonjungo, Peter N; Timperi, Ralph; Birx, Deborah

2009-06-01

Medical laboratory services are an essential, yet often neglected, component of health systems in developing countries. Their central role in public health, disease control and surveillance, and patient management is often poorly recognized by governments and donors. However, medical laboratory services in developing countries can be strengthened by leveraging funding from other sources of HIV/AIDS prevention, care, surveillance, and treatment programs. Strengthening these services will require coordinated efforts by national governments and partners and can be achieved by establishing and implementing national laboratory strategic plans and policies that integrate laboratory systems to combat major infectious diseases. These plans should take into account policy, legal, and regulatory frameworks; the administrative and technical management structure of the laboratories; human resources and retention strategies; laboratory quality management systems; monitoring and evaluation systems; procurement and maintenance of equipment; and laboratory infrastructure enhancement. Several countries have developed or are in the process of developing their laboratory plans, and others, such as Ethiopia, have implemented and evaluated their plan.

Does trade liberalization reduce child mortality in low- and middle-income countries? A synthetic control analysis of 36 policy experiments, 1963-2005.

PubMed

Barlow, Pepita

2018-05-01

Scholars have long argued that trade liberalization leads to lower rates of child mortality in developing countries. Yet current scholarship precludes definitive conclusions about the magnitude and direction of this relationship. Here I analyze the impact of trade liberalization on child mortality in 36 low- and middle-income countries, 1963-2005, using the synthetic control method. I test the hypothesis that trade liberalization leads to lower rates of child mortality, examine whether this association varies between countries and over time, and explore the potentially modifying role of democratic politics, historical context, and geographic location on the magnitude and direction of this relationship. My analysis shows that, on average, trade liberalization had no impact on child mortality in low- and middle-income countries between 1963 and 2005 (Average effect (AE): -0.15%; 95% CI: -2.04%-2.18%). Yet the scale, direction and statistical significance of this association varied markedly, ranging from a ∼20% reduction in child mortality in Uruguay to a ∼20% increase in the Philippines compared with synthetic controls. Trade liberalization was also followed by the largest declines in child mortality in democracies (AE 10-years post reform (AE 10 ): -3.28%), in Latin America (AE 10 : -4.15%) and in the 1970s (AE 10 : -6.85%). My findings show that trade liberalization can create an opportunity for reducing rates of child mortality, but its effects cannot be guaranteed. Inclusive and pro-growth contextual factors appear to influence whether trade liberalization actually yields beneficial consequences in developing societies. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Responses to antismoking radio and television advertisements among adult smokers and non-smokers across Africa: message-testing results from Senegal, Nigeria and Kenya.

PubMed

Perl, Rebecca; Murukutla, Nandita; Occleston, Jessica; Bayly, Megan; Lien, Mego; Wakefield, Melanie; Mullin, Sandra

2015-11-01

This study examined whether adaptation of existing antitobacco television and radio advertisements (ads) from high-income countries is a viable tobacco control strategy for Africa. 1078 male and female adult smokers and non-smokers, aged 18-40 years, from major and smaller urban locations in Kenya, Nigeria and Senegal, were recruited into groups using locally appropriate convenience sampling methods and stratified by smoking status, gender, age and socioeconomic status. Eligibility criteria included age, smoking status and literacy. Each participant rated five radio and five TV antismoking ads on five-point scales, which were later aggregated into measures of perceived effectiveness, potential behaviour change and antitobacco industry sentiment/support for government actions. For radio ads across all three countries, two health harms-focused ads-Coughing Child followed by Suffering-had the highest odds of a positive rating on the Perceived Effectiveness measure among smokers and non-smokers. For television ads, the strong graphic ad Baby Alive tended to be rated most positively across the majority of measures by all subgroups. This first systematic study of tobacco control advertisements in Africa is consistent with findings from other countries, suggesting that graphic health-harms ads developed and used in other countries could also be effective in African countries. This implies that adaptation would be a successful approach in Africa, where scarce resources for tobacco control communications can be focused on advertising dissemination, saving programmes from the cost, time and technical expertise required for development of new materials. 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/

Cancer mortality-to-incidence ratio as an indicator of cancer management outcomes in Organization for Economic Cooperation and Development countries.

PubMed

Choi, Eunji; Lee, Sangeun; Nhung, Bui Cam; Suh, Mina; Park, Boyoung; Jun, Jae Kwan; Choi, Kui Son

2017-01-01

Assessing long-term success and efficiency is an essential part of evaluating cancer control programs. The mortality-to-incidence ratio (MIR) can serve as an insightful indicator of cancer management outcomes for individual nations. By calculating MIRs for the top five cancers in Organization for Economic Cooperation and Development (OECD) countries, the current study attempted to characterize the outcomes of national cancer management policies according to the health system ranking of each country. The MIRs for the five most burdensome cancers globally (lung, colorectal, prostate, stomach, and breast) were calculated for all 34 OECD countries using 2012 GLOBOCAN incidence and mortality statistics. Health system rankings reported by the World Health Organization in 2000 were updated with relevant information when possible. A linear regression model was created, using MIRs as the dependent variable and health system rankings as the independent variable. The linear relationships between MIRs and health system rankings for the five cancers were significant, with coefficients of determination ranging from 49 to 75% when outliers were excluded. A clear outlier, Korea reported lower-than-predicted MIRs for stomach and colorectal cancer, reflecting its strong national cancer control policies, especially cancer screening. The MIR was found to be a practical measure for evaluating the long-term success of cancer surveillance and the efficacy of cancer control programs, especially cancer screening. Extending the use of MIRs to evaluate other cancers may also prove useful.

[The organisation and future development of Veterinary Services in Latin America].

PubMed

Gimeno, E

2003-08-01

Latin America undoubtedly has comparative advantages in the fields of animal production, animal health and the production of food of animal origin. However, countries in Latin America must build on these strengths if the continent is to become more competitive and be able to deal with the complexities of world markets. To do this, Veterinary Services must define their objectives and establish quality standards on which to base their work. For this to occur, the State must create well-defined regulations, establish systems of audit and find ways of working which allow for a high degree of coordination and collaboration between the public and private sectors. This should be done within a framework of a quality assurance system, which allows for responsible accreditation and independent audit and evaluation. The author discusses the approaches of the different countries in the region to animal health, zoonosis, food safety, veterinary drugs control, animal welfare and export-import control. All programmes relating to these issues must be based on technical information gained through epidemiological surveillance, the network of diagnostic laboratories, quarantine systems, risk analysis, identification and traceability of animals and animal products, registration and control of veterinary drugs, and food safety research. In some countries these systems are already being developed. Maintaining good international relations and cooperating with neighbouring countries is always a challenge for official Veterinary Services and international organisations such as the OIE (World organisation for animal health) have a key role to play in facilitating these relationships.

Evolution of the National Schistosomiasis Control Programmes in The People's Republic of China.

PubMed

Xu, J; Steinman, P; Maybe, D; Zhou, X-N; Lv, S; Li, S-Z; Peeling, R

2016-01-01

Schistosomiasis japonica is caused by the parasitic trematode Schistosoma japonicum. It is endemic in The People's Republic of China and has significant impact on human health and socioeconomic development in certain regions. Over the last six decades, the national control programmes evolved in remarkable ways and brought schistosomiasis japonica largely under control. We describe the history and evolution of schistosomiasis control in The People's Republic of China, with an emphasis on shifts in control strategies that evolved with new insights into the biology of the parasite and its intermediate hosts, and the epidemiology of the disease in the country. We also highlight the achievements in controlling the disease in different socioecological settings, and identify persisting challenges to fully eliminate schistosomiasis japonica from the country. To reach the goal of schistosomiasis elimination, further integration of interventions, multisector collaboration, sensitive and effective surveillance are needed to strengthen. Copyright © 2016 Elsevier Ltd. All rights reserved.

Women and smoking.

PubMed

Amos, A

1996-01-01

Smoking kills over half a million women each year and is the most important preventable cause of female premature death in several developed countries. However, in many countries, cigarette smoking still tends to be regarded as a mainly male problem. This paper explores the reasons why more attention needs to be paid to issues around smoking and women, even in countries which currently have low levels of female cigarette smoking. The article includes an overview of current patterns and trends of smoking among women, and the factors which influence smoking uptake and cessation in women compared to men. The experience of countries with the longest history of widespread female smoking is used to identify some of the key challenges facing developed and developing countries. Tobacco companies have identified women as a key target group, therefore particular attention is given to the ways in which they have attempted to reach women through advertising and other marketing strategies. It is concluded that in order to halt and ultimately reverse the tobacco epidemic among women, tobacco control policies need to encompass both gender-specific and gender-sensitive approaches. Examples are given of the types of action that are needed in relation to research, public policy and legislation, and education.

How did national life expectation related to school years in developing countries - an approach using panel data mining.

PubMed

Jian, Wen-Shan; Huang, Chen-Ling; Iqbal, Usman; Nguyen, Phung-Anh; Hsiao, George; Li, Hsien-Chang

2014-03-01

The purpose of the study was to probe into the changes in life expectancy associated with schooling years found by the Organization for Economic Co-operation and Development (OECD). The study was based on the OECD database from the period 2000 to 2006. The data of thirty countries were constructed to allow comparisons over time and across these countries. Panel data analysis was used to estimate the relationship of national education, as defined as school years, with life expectancy. The control factors considered were numbers of practicing physicians, practicing nurses, hospital beds, and GDP. We used fixed effects of both country and time through linear regression, the coefficient of school years in relation to life expectancy was statistically significant but negative. This finding is not in accord with the hypothesis that investing in human capital through education stimulates better health outcomes. Within developing countries, educational attainment is no longer keeping the same pace with life expectancy as before. Therefore, we suggest that an effective education policy should cover diverse topics, for example, balancing economic growth and mental hygiene, to improve national life expectancy. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Financing healthcare in Gulf Cooperation Council countries: a focus on Saudi Arabia.

PubMed

Alkhamis, Abdulwahab; Hassan, Amir; Cosgrove, Peter

2014-01-01

This paper presents an analysis of the main characteristics of the Gulf Cooperation Council's (GCC) health financing systems and draws similarities and differences between GCC countries and other high-income and low-income countries, in order to provide recommendations for healthcare policy makers. The paper also illustrates some financial implications of the recent implementation of the Compulsory Employment-based Health Insurance (CEBHI) system in Saudi Arabia. Employing a descriptive framework for the country-level analysis of healthcare financing arrangements, we compared expenditure data on healthcare from GCC and other developing and developed countries, mostly using secondary data from the World Health Organization health expenditure database. The analysis was supported by a review of related literature. There are three significant characteristics affecting healthcare financing in GCC countries: (i) large expatriate populations relative to the national population, which leads GCC countries to use different strategies to control expatriate healthcare expenditure; (ii) substantial government revenue, with correspondingly high government expenditure on healthcare services in GCC countries; and (iii) underdeveloped healthcare systems, with some GCC countries' healthcare indicators falling below those of upper-middle-income countries. Reforming the mode of health financing is vital to achieving equitable and efficient healthcare services. Such reform could assist GCC countries in improving their healthcare indicators and bring about a reduction in out-of-pocket payments for healthcare. © 2013 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.

Asthma prevalence and severity in low-resource communities.

PubMed

Cruz, Álvaro A; Stelmach, Rafael; Ponte, Eduardo V

2017-06-01

The prevalence of asthma was thought to be low in most low-income countries, but several reports have indicated this is not always true. This is a narrative review of recent publications on the burden of asthma in low and middle-income countries (LMIC) and underprivileged communities from developed countries. Several studies have reported a low prevalence of asthma is LMIC, but indicate it is increasing. In the last few years, however, many surveys demonstrated this may not always be true. An analysis of the International Study for Asthma and Allergy in Childhood phase III database indicated although the prevalence of asthma among children and adolescents is higher in the developed countries, symptoms of asthma are often more severe in less affluent nations. The rate of uncontrolled asthma is also higher among underprivileged communities of developed countries. Secondary analysis of data generated by the WHO's world health survey performed among adults of 70 countries indicate symptoms of asthma are less frequent in middle-income countries and more frequent in the extremes, low income and high income. This sort of U shaped distribution suggests the disease (or syndrome) comprise more than one major phenotype related to diverse underlying mechanisms. In fact, recent reports show symptoms of asthma among the poor are associated with unhygienic living conditions, which may reduce the risk of atopy but increase the risk of nonatopic wheezing. Urbanization and exposure to air pollution also seem to contribute to an increasing prevalence severity of asthma in LMIC. Access to proper diagnosis and treatment with controller medications for asthma, specially with inhaled corticosteroids is feasible and cost-effective, reduce symptoms, health resource utilization, improves quality of life, and reduce mortality in low-resource settings. Prevalence of asthma was thought to be low in low-income countries, but several reports have indicated this is not always true. Under diagnosis, under treatment, exposure to air pollution, and unhygienic living conditions may contribute to a higher frequency and severity of symptoms of asthma among the poor. Proper diagnosis and treatment with controller medications for asthma is feasible and cost-effective in low-resource settings.

Reported awareness of tobacco advertising and promotion in China compared to Thailand, Australia and the USA.

PubMed

Li, L; Yong, H-H; Borland, R; Fong, G T; Thompson, M E; Jiang, Y; Yang, Y; Sirirassamee, B; Hastings, G; Harris, F

2009-06-01

China currently does not have comprehensive laws or regulations on tobacco advertising and promotion, although it ratified the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in October 2005 and promised to ban all tobacco advertising by January 2011. Much effort is needed to monitor the current situation of tobacco advertising and promotion in China. This study aims to examine levels of awareness of tobacco advertising and promotion among smokers in China as compared to other countries with different levels of restrictions. One developing country (Thailand) and two developed countries (Australia and the USA) were selected for comparison. All four countries are part of the International Tobacco Control (ITC) Policy Evaluation Survey project. Between 2005 and 2006, parallel ITC surveys were conducted among adult smokers (at least smoked weekly) in China (n = 4763), Thailand (n = 2000), Australia (n = 1767) and the USA (n = 1780). Unprompted and prompted recall of noticing tobacco advertising and promotion were measured. Chinese respondents reported noticing tobacco advertisements in a range of channels and venues, with highest exposure levels on television (34.5%), billboards (33.4%) and in stores (29.2%). A quarter of respondents noticed tobacco sponsorships, and a high level of awareness of promotion was reported. Cross-country comparison reveals that overall reported awareness was significantly higher in China than in Thailand (particularly) and Australia, but lower than in the USA. There is a big gap between China and the better-performing countries such as Thailand and Australia regarding tobacco promotion restrictions. China needs to do more, including enhanced policy and more robust enforcement.

Knowledge gaps that hamper prevention and control of Mycobacterium avium subspecies paratuberculosis infection.

PubMed

Barkema, H W; Orsel, K; Nielsen, S S; Koets, A P; Rutten, V P M G; Bannantine, J P; Keefe, G P; Kelton, D F; Wells, S J; Whittington, R J; Mackintosh, C G; Manning, E J; Weber, M F; Heuer, C; Forde, T L; Ritter, C; Roche, S; Corbett, C S; Wolf, R; Griebel, P J; Kastelic, J P; De Buck, J

2018-05-01

In the last decades, many regional and country-wide control programmes for Johne's disease (JD) were developed due to associated economic losses, or because of a possible association with Crohn's disease. These control programmes were often not successful, partly because management protocols were not followed, including the introduction of infected replacement cattle, because tests to identify infected animals were unreliable, and uptake by farmers was not high enough because of a perceived low return on investment. In the absence of a cure or effective commercial vaccines, control of JD is currently primarily based on herd management strategies to avoid infection of cattle and restrict within-farm and farm-to-farm transmission. Although JD control programmes have been implemented in most developed countries, lessons learned from JD prevention and control programmes are underreported. Also, JD control programmes are typically evaluated in a limited number of herds and the duration of the study is less than 5 year, making it difficult to adequately assess the efficacy of control programmes. In this manuscript, we identify the most important gaps in knowledge hampering JD prevention and control programmes, including vaccination and diagnostics. Secondly, we discuss directions that research should take to address those knowledge gaps. © 2017 Blackwell Verlag GmbH.

Internet-based interventions for the prevention and treatment of depression in people living in developing countries: A systematic review.

PubMed

Martínez, Pablo; Rojas, Graciela; Martínez, Vania; Lara, María Asunción; Pérez, J Carola

2018-07-01

Internet-based interventions for depression may be a valuable resource to reduce the treatment gap for those living in developing countries. However, evidence comes mainly from developed countries. This systematic review summarized the evidence on preventive or therapeutic Internet-based interventions for depression for people who reside in developing countries. CINAHL, EMBASE, PubMed, SciELO Citation Indexes, the Journal of Medical Internet Research, and the Telemedicine and e-Health journal, were searched up to June 2017, to identify feasibility or effectiveness studies of preventive or therapeutic Internet-based interventions for depression, with or without human support. Studies included subjects residing in developing countries, and were published in English or Spanish. Study protocols were included. Risk of bias and/or quality of the reporting of the studies included was assessed. Five feasibility studies, aimed at the prevention of depression, and a study protocol were included in this systematic review. Reports came mostly from the Americas (n = 4). Internet-based interventions aimed at the prevention of depression presented low levels of human support, were useful and acceptable to their users, and require further design refinements to improve their use and retention. No gray literature was searched or included in this systematic review. Searches were limited to English and Spanish languages. Internet-based interventions aimed at the prevention of depression in people who reside in developing countries are in an early phase of development, limiting the generalizability of the results. Future studies must employ persuasive designs to improve user retention, incorporating larger samples and a control group to conclusively determine feasibility. Copyright © 2018 Elsevier B.V. All rights reserved.

Challenges in the management of rheumatoid arthritis in developing countries.

PubMed

Mody, Girish M; Cardiel, Mario H

2008-08-01

Rheumatoid arthritis (RA) is a systemic autoimmune disease which is characterized by chronic inflammation of the joints. Patients experience chronic pain and suffering, and increasing disability; without treatment, life expectancy is reduced. It is imperative to identify patients early so that control of inflammation can prevent joint destruction and disability. Although great advances have been made in the developed nations, early diagnosis remains a great challenge for developing countries during the Bone and Joint Decade (2000-2010) and beyond. Developing countries face important and competitive social, economic, health- and poverty-related issues, and this frequently results in chronic diseases such as RA being forgotten in health priorities when urgent health needs are considered in an environment with poor education and scarce resources. Epidemiological studies in developing countries show a lower but still important prevalence in different regions when compared to that in Caucasians. It seems that the severity of RA varies among different ethnic groups, and probably starts at a younger age in developing countries. Practising rheumatologists in these regions need to take into account several important problems that include suboptimal undergraduate education, inadequate diagnosis, late referrals, lack of human and technical resources, poor access to rheumatologists, and some deficiencies in drug availability. Infections are very important in RA, and special care is needed in developing countries as some endemic infections include tuberculosis, human immunodeficiency virus (HIV), hepatitis B, and hepatitis C. These infections should be carefully taken into account when medications are prescribed and monitored. This chapter presents published information covering the main challenges faced in these environments, and suggests strategies to overcome these important problems in RA management.

The optimal duration of exclusive breastfeeding: a systematic review.

PubMed

Kramer, Michael S; Kakuma, Ritsuko

2004-01-01

Although the health benefits of breastfeeding are acknowledged widely, opinions and recommendations are divided on the optimal duration of exclusive breastfeeding. We systematically reviewed available evidence concerning the effects on child health, growth, and development and on maternal health of exclusive breastfeeding for 6 months vs. exclusive breastfeeding for 3-4 months followed by mixed breastfeeding (introduction of complementary liquid or solid foods with continued breastfeeding) to 6 months. Two independent literature searches were conducted, together comprising the following databases: MEDLINE (as of 1966), Index Medicus (prior to 1966), CINAHL, HealthSTAR, BIOSIS, CAB Abstracts, EMBASE-Medicine, EMBASE-Psychology, Econlit, Index Medicus for the WHO Eastern Mediterranean Region, African Index Medicus, Lilacs (Latin American and Carribean literature), EBM Reviews-Best Evidence, the Cochrane Database of Systematic Reviews, and the Cochrane Controlled Trials Register. No language restrictions were imposed. The two searches yielded a total of 2,668 unique citations. Contacts with experts in the field yielded additional published and unpublished studies. Studies were stratified according to study design (controlled trials vs. observational studies) and provenance (developing vs. developed countries). The main outcome measures were weight and length gain, weight-for-age and length-for-age z-scores, head circumference, iron status, gastrointestinal and respiratory infectious morbidity, atopic eczema, asthma, neuromotor development, duration of lactational amenorrhea, and maternal postpartum weight loss. Twenty independent studies meeting the selection criteria were identified by the literature search: 9 from developing countries (2 of which were controlled trials in Honduras) and 11 from developed countries (all observational studies). Neither the trials nor the observational studies suggest that infants who continue to be exclusively breastfed for 6 months show deficits in weight or length gain, although larger sample sizes would be required to rule out modest increases in the risk of undernutrition. The data are conflicting with respect to iron status but suggest that, at least in developing-country settings, where iron stores of newborn infants may be suboptimal, exclusive breastfeeding without iron supplementation through 6 months of age may compromise hematologic status. Based primarily on an observational analysis of a large randomized trial in Belarus, infants who continue exclusive breastfeeding for 6 months or more appear to have a significantly reduced risk of one or more episodes of gastrointestinal tract infection. No significant reduction in risk of atopic eczema, asthma, or other atopic outcomes has been demonstrated in studies from Finland, Australia, and Belarus. Data from the two Honduran trials suggest that exclusive breastfeeding through 6 months of age is associated with delayed resumption of menses and more rapid postpartum weight loss in the mother. Infants who are breastfed exclusively for 6 months experience less morbidity from gastrointestinal tract infection than infants who were mixed breastfed as of 3 or 4 months of age. No deficits have been demonstrated in growth among infants from either developing or developed countries who are exclusively breastfed for 6 months or longer. Moreover, the mothers of such infants have more prolonged lactational amenorrhea and faster postpartum weight loss. Based on the results of this review, the World Health Assembly adopted a resolution to recommend exclusive breastfeeding for 6 months to its member countries. Large randomized trials are recommended in both developed and developing countries to ensure that exclusive breastfeeding for 6 months does not increase the risk of undernutrition (growth faltering), to confirm the health benefits reported thus far, and to investigate other potential effects on health and development, especially over the long term.

Future expectations for Japanese pharmacists as compared to the rest of the world.

PubMed

Inoue, Yutaka; Morita, Yuki; Takikawa, Mayu; Takao, Koichi; Kanamoto, Ikuo; Sugibayashi, Kenji

2015-01-01

It is important to share information about other countries' pharmacists to optimize cross-border medical cooperation. This paper examines the dispensing systems and the work done by pharmacists in the United Kingdom, Germany, France, Thailand, and Malaysia so as to compare these countries' medical practices and develop a cohesive vision for the future of Japanese pharmacists. All five of the countries have dispensing assistants. Pharmacists in Japan have duties of inventory control, drug dispensing, and providing medication advice. In contrast, assistants working in other countries are responsible for some aspects of dispensing and inventory control, allowing the pharmacists to spend their time and competency in instructing patients on how to take their medication. Because of this, pharmacists were actively involved with health promotion intervention in the United Kingdom, Germany, and France. It is hoped that work done by Japanese pharmacists would transition from primarily dispensing drugs to patient care, advice, and counseling to enrich overall health promotion and health/nutrition counseling. Copyright © 2015 Elsevier Inc. All rights reserved.

Contributions of the US Centers for Disease Control and Prevention in Implementing the Global Health Security Agenda in 17 Partner Countries

PubMed Central

Mahar, Michael; Moriarty, Leah F.; Bartee, Maureen; Hirai, Mitsuaki; Li, Wenshu; Gerber, A. Russell; Tappero, Jordan W.; Bunnell, Rebecca

2017-01-01

The Global Health Security Agenda (GHSA), a partnership of nations, international organizations, and civil society, was launched in 2014 with a mission to build countries’ capacities to respond to infectious disease threats and to foster global compliance with the International Health Regulations (IHR 2005). The US Centers for Disease Control and Prevention (CDC) assists partner nations to improve IHR 2005 capacities and achieve GHSA targets. To assess progress through these CDC-supported efforts, we analyzed country activity reports dating from April 2015 through March 2017. Our analysis shows that CDC helped 17 Phase I countries achieve 675 major GHSA accomplishments, particularly in the cross-cutting areas of public health surveillance, laboratory systems, workforce development, and emergency response management. CDC’s engagement has been critical to these accomplishments, but sustained support is needed until countries attain IHR 2005 capacities, thereby fostering national and regional health protection and ensuring a world safer and more secure from global health threats. PMID:29155676

Contraceptive prevalence, reproductive health and our common future. The C. Donald Christian Memorial Lecture.

PubMed

Diczfalusy, E

1993-05-01

Worldwide, female sterilization is the most common contraceptive method, followed by IUDs and oral contraceptives. As unwanted pregnancy for women in developing countries can mean life or death, which may explain why modern contraceptive methods with low failure rates (e.g., sterilization, IUDs. and hormonal methods) predominate in developing countries. Conventional methods with relatively high failure rates (e.g., natural family planning, barrier methods, and withdrawal) predominate in developed countries. Developing-country governments first supported family planning programs for demographic reasons. They now embrace them because they save the lives of women and children. The four fundamental pillars of reproductive health policy are family planning, maternal care, infant and child care, and control of sexually transmitted diseases (STDs). Indicators of reproductive health include, rates of maternal mortality and morbidity; induced abortion; infertility; perinatal, infant, and child mortality; and STDs (including AIDS). Governments in the poorest countries invest only US$5 per capita for health, compared to US$400 per capita for developed countries. If the poorest countries increased that $5 figure by just $2 per capita, they could immunize all children, eradicate polio, and provide the drugs to cure the most common diseases. Further, if humans were to use resources more reasonably, we could greatly decrease the number of people living in poverty. Three UN population projections show that the population will continue to grow well within the next century. With strong commitment from governments and individuals, we can increase contraceptive use and reduce total fertility rates. Barriers to achieving those goals are few funds allocated to family planning methods and services; politicians; religious and community leaders; culture; low women's status; limited accessibility to information, methods, and quality services; and limited contraceptive choice.

A New Dual-purpose Quality Control Dosimetry Protocol for Diagnostic Reference-level Determination in Computed Tomography.

PubMed

Sohrabi, Mehdi; Parsi, Masoumeh; Sina, Sedigheh

2018-05-17

A diagnostic reference level is an advisory dose level set by a regulatory authority in a country as an efficient criterion for protection of patients from unwanted medical exposure. In computed tomography, the direct dose measurement and data collection methods are commonly applied for determination of diagnostic reference levels. Recently, a new quality-control-based dose survey method was proposed by the authors to simplify the diagnostic reference-level determination using a retrospective quality control database usually available at a regulatory authority in a country. In line with such a development, a prospective dual-purpose quality control dosimetry protocol is proposed for determination of diagnostic reference levels in a country, which can be simply applied by quality control service providers. This new proposed method was applied to five computed tomography scanners in Shiraz, Iran, and diagnostic reference levels for head, abdomen/pelvis, sinus, chest, and lumbar spine examinations were determined. The results were compared to those obtained by the data collection and quality-control-based dose survey methods, carried out in parallel in this study, and were found to agree well within approximately 6%. This is highly acceptable for quality-control-based methods according to International Atomic Energy Agency tolerance levels (±20%).

Concern about passive smoking and tobacco control policies in European countries: An ecological study

PubMed Central

2012-01-01

Background Because of the magnitude of the global tobacco epidemic, the World Health Organisation developed the Framework Convention on Tobacco Control (FCTC), an international legally binding treaty to control tobacco use. Adoption and implementation of specific tobacco control measures within FCTC is an outcome of a political process, where social norms and public opinion play important roles. The objective of our study was to examine how a country’s level of tobacco control is associated with smoking prevalence, two markers of denormalisation of smoking (social disapproval of smoking and concern about passive smoking), and societal support for tobacco control. Methods An ecological study was conducted, using data from two sources. The first source was the Tobacco Control Scale (TCS) from 2011, which quantifies the implementation of tobacco control policies in European Union (EU) countries. Data on smoking prevalence, societal disapproval of smoking, concern about passive smoking, and societal support for policy measures were taken from the Eurobarometer survey of 2009. Data from Eurobarometer surveys were aggregated to country level. Data from the 27 European Union member states were used. Results Smoking prevalence rates in 2009 were negatively associated with a country’s TCS 2011 score, although not statistically significant (r = −.25; p = .21). Experience of societal disapproval was positively associated with higher TCS scores, though not significantly (r = .14; p = .48). The same was true for societal support for tobacco control (r = .27; p = .18). The TCS score in 2011 was significantly correlated with concern about passive smoking (r = .42; p =.03). Support for tobacco control measures was also strongly correlated with concern about passive smoking (r = .52, p = .006). Conclusions Smokers in countries with a higher TCS score were more concerned about whether their smoke harms others. Further, support for tobacco control measures is higher in countries that have more of these concerned smokers. Concerns about passive smoking seem central in the implementation of tobacco control measures, stressing the importance of continuing to educate the public about the harm from passive smoking. PMID:23067145

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

PubMed

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

2014-02-01

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

Development of an exposure measurement database on five lung carcinogens (ExpoSYN) for quantitative retrospective occupational exposure assessment.

PubMed

Peters, Susan; Vermeulen, Roel; Olsson, Ann; Van Gelder, Rainer; Kendzia, Benjamin; Vincent, Raymond; Savary, Barbara; Williams, Nick; Woldbæk, Torill; Lavoué, Jérôme; Cavallo, Domenico; Cattaneo, Andrea; Mirabelli, Dario; Plato, Nils; Dahmann, Dirk; Fevotte, Joelle; Pesch, Beate; Brüning, Thomas; Straif, Kurt; Kromhout, Hans

2012-01-01

SYNERGY is a large pooled analysis of case-control studies on the joint effects of occupational carcinogens and smoking in the development of lung cancer. A quantitative job-exposure matrix (JEM) will be developed to assign exposures to five major lung carcinogens [asbestos, chromium, nickel, polycyclic aromatic hydrocarbons (PAH), and respirable crystalline silica (RCS)]. We assembled an exposure database, called ExpoSYN, to enable such a quantitative exposure assessment. Existing exposure databases were identified and European and Canadian research institutes were approached to identify pertinent exposure measurement data. Results of individual air measurements were entered anonymized according to a standardized protocol. The ExpoSYN database currently includes 356 551 measurements from 19 countries. In total, 140 666 personal and 215 885 stationary data points were available. Measurements were distributed over the five agents as follows: RCS (42%), asbestos (20%), chromium (16%), nickel (15%), and PAH (7%). The measurement data cover the time period from 1951 to present. However, only a small portion of measurements (1.4%) were performed prior to 1975. The major contributing countries for personal measurements were Germany (32%), UK (22%), France (14%), and Norway and Canada (both 11%). ExpoSYN is a unique occupational exposure database with measurements from 18 European countries and Canada covering a time period of >50 years. This database will be used to develop a country-, job-, and time period-specific quantitative JEM. This JEM will enable data-driven quantitative exposure assessment in a multinational pooled analysis of community-based lung cancer case-control studies.

Social Responsibility in Tobacco Production? Tobacco Companies Use of Green Supply Chains to Obscure the Real Costs of Tobacco Farming

PubMed Central

Otañez, Marty

2011-01-01

Background Tobacco companies have come under increased criticism because of environmental and labor practices related to growing tobacco in developing countries. Methods Analysis of tobacco industry documents, industry web sites and interviews with tobacco farmers in Tanzania and tobacco farm workers, farm authorities, trade unionists, government officials and corporate executives from global tobacco leaf companies in Malawi. Results British American Tobacco and Philip Morris created supply chains in the 1990s to improve production efficiency, control, access to markets, and profits. In the 2000s, the companies used their supply chains in an attempt to legitimize their portrayals of tobacco farming as socially and environmentally friendly, rather than take meaningful steps to eliminate child labor and reduce deforestation in developing countries. The tobacco companies used nominal self-evaluation (not truly independent evaluators) and public relations to create the impression of social responsibility. The companies benefit from $1.2 billion in unpaid labor costs due to child labor and more than $64 million annually in costs that would have been made to avoid tobacco related deforestation in the top twelve tobacco growing developing countries, far exceeding the money they spend nominally working to change these practices. Conclusions The tobacco industry uses green supply chains to make tobacco farming in developing countries appear sustainable while continuing to purchase leaf produced with child labor and high rates of deforestation. Strategies to counter green supply chain schemes include securing implementing protocols for the WHO Framework Convention on Tobacco Control to regulate the companies’ practices at the farm level. PMID:21504915

Social responsibility in tobacco production? Tobacco companies' use of green supply chains to obscure the real costs of tobacco farming.

PubMed

Otañez, Marty; Glantz, Stanton A

2011-11-01

Tobacco companies have come under increased criticism because of environmental and labour practices related to growing tobacco in developing countries. Analysis of tobacco industry documents, industry websites and interviews with tobacco farmers in Tanzania and tobacco farm workers, farm authorities, trade unionists, government officials and corporate executives from global tobacco leaf companies in Malawi. British American Tobacco and Philip Morris created supply chains in the 1990 s to improve production efficiency, control, access to markets and profits. In the 2000s, the companies used their supply chains in an attempt to legitimise their portrayals of tobacco farming as socially and environmentally friendly, rather than take meaningful steps to eliminate child labour and reduce deforestation in developing countries. The tobacco companies used nominal self-evaluation (not truly independent evaluators) and public relations to create the impression of social responsibility. The companies benefit from $1.2 billion in unpaid labour costs because of child labour and more than $64 million annually in costs that would have been made to avoid tobacco-related deforestation in the top 12 tobacco growing developing countries, far exceeding the money they spend nominally working to change these practices. The tobacco industry uses green supply chains to make tobacco farming in developing countries appear sustainable while continuing to purchase leaf produced with child labour and high rates of deforestation. Strategies to counter green supply chain schemes include securing implementing protocols for the WHO Framework Convention on Tobacco Control to regulate the companies' practices at the farm level.

European Perceptions of Plan Colombia: A Virtual Contribution to a Virtual War and Peace Plan?

DTIC Science & Technology

2001-05-01

government for more effective control of the paramilitary forces may help. A greater surge of European activism backed by development assistance funds and...economic, security, and political spillover effects for neighboring countries. Finally and logically, the author reflects the European concern that...economic, security, and political spillover effects for neighboring countries. Finally and logically, Roy reflects the European concern that whatever

Tobacco excise and declining tobacco consumption: the case of Papua New Guinea.

PubMed Central

Chapman, S; Richardson, J

1990-01-01

Excise elasticities of demand for non-cigarette tobacco and cigarettes were calculated for Papua New Guinea for the 14 years 1973-86. Respectively, these were -0.50 and -0.71. This means that 10 percent increases in cigarette and non-cigarette tobacco excise are associated with an estimated 7.1 percent fall in demand for cigarettes and a 5 percent decrease in the demand for tobacco. As tax (excise) elasticities would normally be significantly smaller than price elasticities, these results imply that the consumption of cigarettes and tobacco in Papua New Guinea are more responsive to prices than in the United States and other Western countries. The level of excise is therefore an important and practical instrument for the control of consumption. These elasticities appear to be the first reported for a developing country. It is suggested that if they are indicative of consumer behavior in lower income countries then increasing tobacco and cigarette excise should be considered as an important strategy for the control of smoking in these countries which, because of their large populations, are huge markets for tobacco products and thus major targets for tobacco control measures. PMID:2327528

Rabies in South Asia: fighting for elimination.

PubMed

Chowdhury, Fazle-Rabbi; Basher, Ariful; Amin, Mohammad R; Hassan, Nazia; Patwary, Mohammad I

2015-01-01

South Asia is regarded as the hot spot for the tourist and travelers. Unfortunately, three big countries (India, Pakistan and Bangladesh) of this region belong to top five rabies endemic countries of the world. Around 55,000 people die of rabies every year globally and 45% of them belong to South and South East Asia. Countries are now working on the elimination of rabies by the year 2020. Elimination of animal rabies is the pivotal of controlling human rabies. Dog (primary source) registration, population control and mass vaccination are the different ways of eliminating animal rabies. Pre (for risk groups including travelers) and post-exposure vaccine is the core for controlling human rabies. Post-exposure vaccine consists of nerve tissue vaccine and tissue culture vaccine. Due to low antigenicity and post-vaccine neurological complications all countries of South Asia except Pakistan have phased out the production and use of nerve tissue vaccine. To reduce the cost intramuscular regimen is now largely replaced by intradermal regimen and equine rabies immunoglobulin will probably replace human immunoglobulin in future for category III animal bite. 'SAARC' took initiatives for rabies elimination through 'SAARC development fund' which would hopefully play a vital role in regional collaboration to make the region rabies free.

Findings of the International Nosocomial Infection Control Consortium (INICC), Part I: Effectiveness of a multidimensional infection control approach on catheter-associated urinary tract infection rates in pediatric intensive care units of 6 developing countries.

PubMed

Rosenthal, Victor D; Ramachandran, Bala; Dueñas, Lourdes; Alvarez-Moreno, Carlos; Navoa-Ng, J A; Armas-Ruiz, Alberto; Ersoz, Gulden; Matta-Cortés, Lorena; Pawar, Mandakini; Nevzat-Yalcin, Ata; Rodríguez-Ferrer, Marena; Bran de Casares, Ana Concepción; Linares, Claudia; Villanueva, Victoria D; Campuzano, Roberto; Kaya, Ali; Rendon-Campo, Luis Fernando; Gupta, Amit; Turhan, Ozge; Barahona-Guzmán, Nayide; de Jesús-Machuca, Lilian; Tolentino, María Corazon V; Mena-Brito, Jorge; Kuyucu, Necdet; Astudillo, Yamileth; Saini, Narinder; Gunay, Nurgul; Sarmiento-Villa, Guillermo; Gumus, Eylul; Lagares-Guzmán, Alfredo; Dursun, Oguz

2012-07-01

A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates. Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey. PICU inpatients. We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented. During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UC-days in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21-1.0]), indicating a rate reduction of 57%. Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries.

Linking Global Youth Tobacco Survey (GYTS) data to the WHO framework convention on tobacco control: the case for India.

PubMed

Sinha, Dhirendra Narain; Reddy, K Srinath; Rahman, Khalilur; Warren, Charles W; Jones, Nathan R; Asma, Samira

2006-01-01

India ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) on February 27, 2005. The WHO FCTC is the world's first public health treaty that aims to promote and protect public health and reduce the devastating health and economic impacts of tobacco. Post ratification, each member state as part of general obligation has agreed to develop, implement, periodically update and review comprehensive multisectoral national tobacco control strategies, plans and programmes in accordance with this Convention and the protocols to which it is a Party. The Global Youth Tobacco Survey (GYTS) was developed to track tobacco use among young people across countries and the GYTS surveillance system intends to enhance the capacity of countries to design, implement, and evaluate tobacco control and prevention programs. The South-East Asia Region of WHO has developed the "Regional Strategy for Utilization of the GYTS" to meet this need for countries in the Region. In 2003, India has passed its national tobacco control legislation (India Tobacco Control Act [ITCA]), which includes provisions designed to reduce tobacco consumption and protect citizens from exposure to second hand smoke. Data in the GYTS (India) report can be used as a baseline measure for future evaluation of the tobacco control programs implemented by the Ministry of Health and Family Welfare, Government of India. India has to upscale some provisions of its National Law to accommodate all of the requirements of FCTC. Using determinants measured by GYTS in India, the government can monitor the impact of enforcing various provisions of the ITCA and the progress made in achieving the goals of the WHO FCTC and the Regional Strategies. Effective enforcement of the provisions of ITCA will show in the receding numbers of tobacco use prevalence figures and reduction in the expenditures associated with tobacco use in India.

The effect of social franchising on access to and quality of health services in low- and middle-income countries.

PubMed

Koehlmoos, Tracey Perez; Gazi, Rukhsana; Hossain, S Shahed; Zaman, K

2009-01-21

Social franchising has developed as a possible means of improving provision of health services through engaging the non-state sector in low- and middle-income countries. To examine the evidence that social franchising has on access to and quality of health services in low- and middle-income countries. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (up to October 2007), Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 3), MEDLINE, Ovid (1950 to September Week 3 2007), EMBASE, Ovid (1980 to 2007 Week 38), CINAHL, Ovid (1982 to September Week 3 2007), EconLit, WebSPIRS (1969 to Sept 2007), LILACS, Science Citation Index Expanded and Social Sciences Citation Index (1975 to March 2008), Sociological Abstracts, CSA Illumnia (1952 September 2007), WHOLIS (1948 November 2007). Randomized controlled trials, non-randomized controlled trials, controlled before and after studies and interrupted time series comparing social franchising models with other models of health service delivery, other social franchising models or absence of health services. Two review authors independently applied the criteria for inclusion and exclusion of studies to scan titles and abstracts. The same two review authors independently screened full reports of selected citations . At each stage, results were compared and discrepancies settled through discussion. No studies were found which were eligible for inclusion in this review. There is a need to develop rigorous studies to evaluate the effects of social franchising on access to and quality of health services in low- and middle-income countries. Such studies should be informed by the wider literature to identify models of social franchising that have a sound theoretical basis and empirical research addressing their reach, acceptability, feasibility, maintenance and measurability.

International trade agreements: a threat to tobacco control policy

PubMed Central

Shaffer, E; Brenner, J; Houston, T

2005-01-01

International covenants establish a role for governments in ensuring the conditions for human health and wellbeing, which has been recognised as a central human right. International trade agreements, conversely, prioritise the rights of corporations over health and human rights. International trade agreements are threatening existing tobacco control policies and restrict the possibility of implementing new controls. This situation is unrecognised by many tobacco control advocates in signatory nations, especially those in developing countries. Recent agreements on eliminating various trade restrictions, including those on tobacco, have expanded far beyond simply international movement of goods to include internal tobacco distribution regulations and intellectual property rules regulating advertising and labelling. Our analysis shows that to the extent trade agreements protect the tobacco industry, in itself a deadly enterprise, they erode human rights principles and contribute to ill health. The tobacco industry has used trade policy to undermine effective barriers to tobacco importation. Trade negotiations provide an unwarranted opportunity for the tobacco industry to assert its interests without public scrutiny. Trade agreements provide the industry with additional tools to obstruct control policies in both developed and developing countries and at every level. The health community should become involved in reversing these trends, and help promote additional measures to protect public health. PMID:16046697

International trade agreements: a threat to tobacco control policy.

PubMed

Shaffer, E R; Brenner, J E; Houston, T P

2005-08-01

International covenants establish a role for governments in ensuring the conditions for human health and wellbeing, which has been recognised as a central human right. International trade agreements, conversely, prioritize the rights of corporations over health and human rights. International trade agreements are threatening existing tobacco control policies and restrict the possibility of implementing new controls. This situation is unrecognised by many tobacco control advocates in signatory nations, especially those in developing countries. Recent agreements on eliminating various trade restrictions, including those on tobacco, have expanded far beyond simply international movement of goods to include internal tobacco distribution regulations and intellectual property rules regulating advertising and labelling. Our analysis shows that to the extent trade agreements protect the tobacco industry, in itself a deadly enterprise, they erode human rights principles and contribute to ill health. The tobacco industry has used trade policy to undermine effective barriers to tobacco importation. Trade negotiations provide an unwarranted opportunity for the tobacco industry to assert its interests without public scrutiny. Trade agreements provide the industry with additional tools to obstruct control policies in both developed and developing countries and at every level. The health community should become involved in reversing these trends, and help promote additional measures to protect public health.

Review: Evaluation of Foot-and-Mouth Disease Control Using Fault Tree Analysis.

PubMed

Isoda, N; Kadohira, M; Sekiguchi, S; Schuppers, M; Stärk, K D C

2015-06-01

An outbreak of foot-and-mouth disease (FMD) causes huge economic losses and animal welfare problems. Although much can be learnt from past FMD outbreaks, several countries are not satisfied with their degree of contingency planning and aiming at more assurance that their control measures will be effective. The purpose of the present article was to develop a generic fault tree framework for the control of an FMD outbreak as a basis for systematic improvement and refinement of control activities and general preparedness. Fault trees are typically used in engineering to document pathways that can lead to an undesired event, that is, ineffective FMD control. The fault tree method allows risk managers to identify immature parts of the control system and to analyse the events or steps that will most probably delay rapid and effective disease control during a real outbreak. The present developed fault tree is generic and can be tailored to fit the specific needs of countries. For instance, the specific fault tree for the 2001 FMD outbreak in the UK was refined based on control weaknesses discussed in peer-reviewed articles. Furthermore, the specific fault tree based on the 2001 outbreak was applied to the subsequent FMD outbreak in 2007 to assess the refinement of control measures following the earlier, major outbreak. The FMD fault tree can assist risk managers to develop more refined and adequate control activities against FMD outbreaks and to find optimum strategies for rapid control. Further application using the current tree will be one of the basic measures for FMD control worldwide. © 2013 Blackwell Verlag GmbH.

Measles control in Australia - threats, opportunities and future needs.

PubMed

MacIntyre, C Raina; Kpozehouen, Elizabeth; Kunasekaran, Mohana; Harriman, Kathleen; Conaty, Stephen; Rosewell, Alexander; Druce, Julian; Martin, Nicolee; Heywood, Anita E; Gidding, Heather F; Wood, James; Nicholl, Sonya

2018-06-19

Control of measles was the focus of a national workshop held in 2015 in Sydney, Australia, bringing together stakeholders in disease control and immunisation to discuss maintaining Australia's measles elimination status in the context of regional and global measles control. The global epidemiology of measles was reviewed, including outbreaks in countries that have achieved elimination, such as the Disneyland outbreak in the United States and large outbreaks in Sydney, Australia. Transmission of measles between Australia and New Zealand occurs, but has not been a focus of control measures. Risk groups, the genetic and seroepidemiology of measles as well as surveillance, modelling and waning vaccine-induced immunity were reviewed. Gaps in policy, research and practice for maintaining measles elimination status in Australia were identified and recommendations were developed. Elimination of measles globally is challenging because of the infectiousness of measles and the need for 2-dose vaccine coverage rates in excess of 95% in all countries to achieve it. Until this occurs, international travel will continue to permit measles importation from endemic countries to countries that have achieved elimination. When measles cases are imported, failure to diagnose and isolate cases places the health system at risk of measles outbreaks. Vaccine funding models can result in gaps in vaccine coverage for adults and migrants. Australia introduced a whole-of-life immunisation register in 2016 and catch-up vaccination for at-risk communities, which will improve measles control. Research on diagnosis, immunology, case management and modelling of vaccination strategies are important to ensure continued control of measles. Copyright © 2018.

Women and tobacco: a call for including gender in tobacco control research, policy and practice.

PubMed

Amos, Amanda; Greaves, Lorraine; Nichter, Mimi; Bloch, Michele

2012-03-01

Female smoking is predicted to double between 2005 and 2025. There have been numerous calls for action on women's tobacco use over the past two decades. In the present work, evidence about female tobacco use, progress, challenges and ways forward for developing gendered tobacco control is reviewed. Literature on girls, women and tobacco was reviewed to identify trends and determinants of tobacco use and exposure, the application of gender analysis, tobacco marketing, the impact of tobacco control on girls and women and ways to address these issues particularly in low-income and middle-income countries. Global female tobacco use is increasingly complex, involving diverse products and factors including tobacco marketing, globalisation and changes in women's status. In high-income countries female smoking is declining but is increasingly concentrated among disadvantaged women. In low-income and middle-income countries the pattern is more complex; in several regions the gap between girls' and boys' smoking is narrow. Gendered analyses and approaches to tobacco control are uncommon, especially in low-income and middle-income countries. Tobacco control has remained largely gender blind, with little recognition of the importance of understanding the context and challenges of girl's and women's smoking and secondhand smoke exposure. There has been little integration of gender considerations in research, policy and programmes. The present work makes a case for gender and diversity analyses in tobacco control to reflect and identify intersecting factors affecting women's tobacco use. This will help animate the WHO Framework Convention on Tobacco Control's concern for gender specificity and women's leadership, and reduce the impact of tobacco on women.

Smoking estimates from around the world: data from the first 17 participating countries in the World Mental Health Survey Consortium

PubMed Central

Storr, Carla L; Cheng, Hui; Alonso, Jordi; Angermeyer, Matthias; Bruffaerts, Ronny; de Girolamo, Giovanni; de Graaf, Ron; Gureje, Oye; Karam, Elie G; Kostyuchenko, Stanislav; Lee, Sing; Lepine, Jean-Pierre; Mora, Maria Elena Medina; Myer, Landon; Neumark, Yehuda; Posada-Villa, Jose; Watanabe, Makoto; Wells, J Elisabeth; Kessler, Ronald C; Anthony, James C

2014-01-01

Objective To contribute new multinational findings on basic descriptive features of smoking and cessation, based upon standardised community surveys of adults residing in seven low-income and middle-income countries and 10 higher-income countries from all regions of the world. Methods Data were collected using standardised interviews and community probability sample survey methods conducted as part of the WHO World Mental Health Surveys Initiative. Demographic and socioeconomic correlates of smoking are studied using cross-tabulation and logistic regression approaches. Within-country sample weights were applied with variance estimation appropriate for complex sample survey designs. Results Estimated prevalence of smoking experience (history of ever smoking) and current smoking varied across the countries under study. In all but four countries, one out of every four adults currently smoked. In higher-income countries, estimated proportions of former smokers (those who had quit) were roughly double the corresponding estimates for most low-income and middle-income countries. Characteristics of smokers varied within individual countries, and in relation to the World Bank's low-medium-high gradient of economic development. In stark contrast to a sturdy male-female difference in the uptake of smoking seen in each country, there is no consistent sex-associated pattern in the odds of remaining a smoker (versus quitting). Conclusion The World Mental Health Surveys estimates complement existing global tobacco monitoring efforts. The observed global diversity of associations with smoking and smoking cessation underscore reasons for implementation of the Framework Convention on Tobacco Control provisions and prompt local adaptation of prevention and control interventions. PMID:19965796

Health care financing and utilization of maternal health services in developing countries.

PubMed

Kruk, Margaret E; Galea, Sandro; Prescott, Marta; Freedman, Lynn P

2007-09-01

The Millennium Development Goals call for a 75% reduction in maternal mortality between 1990 and 2015. Skilled birth attendance and emergency obstetric care, including Caesarean section, are two of the most important interventions to reduce maternal mortality. Although international pressure is rising to increase donor assistance for essential health services in developing countries, we know less about whether government or the private sector is more effective at financing these essential services in developing countries. We conducted a cross-national analysis to determine the association between government versus private financing of health services and utilization of antenatal care, skilled birth attendants and Caesarean section in 42 low-income and lower-middle-income countries. We controlled for possible confounding effects of total per capita health spending and female literacy. In multivariable analysis, adjusting for confounders, government health expenditure as a percentage of total health expenditure is significantly associated with utilization of skilled birth attendants (P = 0.05) and Caesarean section (P = 0.01) but not antenatal care. Total health expenditure is also significantly associated with utilization of skilled birth attendants (P < 0.01) and Caesarean section (P < 0.01). Greater government participation in health financing and higher levels of health spending are associated with increased utilization of two maternal health services: skilled birth attendants and Caesarean section. While government financing is associated with better access to some essential maternal health services, greater absolute levels of health spending will be required if developing countries are to achieve the Millennium Development Goal on maternal mortality.

Examining the policies and guidelines around the use of masks and respirators by healthcare workers in China, Pakistan and Vietnam

PubMed Central

MacIntyre, C Raina; Zheng, Yang; Wang, Quanyi; Toor, Zafar Iqbal; Dung, Tham Chi; Hien, Nguyen Tran; Seale, Holly

2014-01-01

Background: There is an ongoing debate regarding the type of respiratory protection that should be recommended for use for healthcare workers. Materials and methods: A cross-sectional survey was conducted in three countries: China, Pakistan and Vietnam. Results: In China and Pakistan, the infection control guidelines were developed to be in line with the recommendations from the World Health Organization (WHO) and the Centers for Disease Control and Prevention, while in the Vietnamese guidelines the recommendations correspond with the WHO suggestions only. The guidelines from all three countries document the need for training and fit testing; however there is no system to monitor the training and fit testing programs. Across the three countries, there was some inconsistency with regard to the types of products (i.e. masks vs. respirators) recommended for influenza, severe acute respiratory syndrome (SARS) and tuberculosis. Conclusions: Available evidence should be examined and a comprehensive policy should be developed on the use of masks and respirators. The policy should address critical areas such as regulation, training, fit testing and reuse. PMID:28989404

Examining the policies and guidelines around the use of masks and respirators by healthcare workers in China, Pakistan and Vietnam.

PubMed

Chughtai, Abrar Ahmad; MacIntyre, C Raina; Zheng, Yang; Wang, Quanyi; Toor, Zafar Iqbal; Dung, Tham Chi; Hien, Nguyen Tran; Seale, Holly

2015-03-01

There is an ongoing debate regarding the type of respiratory protection that should be recommended for use for healthcare workers. A cross-sectional survey was conducted in three countries: China, Pakistan and Vietnam. In China and Pakistan, the infection control guidelines were developed to be in line with the recommendations from the World Health Organization (WHO) and the Centers for Disease Control and Prevention, while in the Vietnamese guidelines the recommendations correspond with the WHO suggestions only. The guidelines from all three countries document the need for training and fit testing; however there is no system to monitor the training and fit testing programs. Across the three countries, there was some inconsistency with regard to the types of products (i.e. masks vs. respirators) recommended for influenza, severe acute respiratory syndrome (SARS) and tuberculosis. Available evidence should be examined and a comprehensive policy should be developed on the use of masks and respirators. The policy should address critical areas such as regulation, training, fit testing and reuse.

Interventions to prevent HIV/AIDS among adolescents in less developed countries: are they effective?

PubMed

Magnussen, Lesley; Ehiri, John E; Ejere, Henry O D; Jolly, Pauline E

2004-01-01

The objective of this study was to summarize and critically assess the effects of interventions to prevent HIV/AIDS among adolescents in less developed countries. Reports of studies that evaluated interventions for preventing HIV/AIDS/STDs among persons aged 11-25 years were obtained from online computer databases, by searching conference proceedings and relevant journals, and by following up references cited in published reports. Studies were included if they investigated any educational, behavioral, psychosocial or other intervention that aimed to prevent or reduce HIV/AIDS/STD among persons aged 11-25 years in a less developed country. Only studies that included a control group, and which involved pre- and post-intervention assessments were included. Outcome measures included: (i) changes in safe sex practices (abstinence, condom use, limitation of sexual partners, avoidance of casual sex), (ii) knowledge about HIV/AIDS transmission and prevention methods, (iii) perception of HIV/AIDS/STD risks, (iv) self-efficacy with regard to condom negotiation and refusal of sex, (v) uptake of voluntary counseling and testing (VCT), and (vi) reduction in incidence of HIV/AIDS/STDs. Studies were assessed in terms of intervention format (e.g., education, role-play, video), duration, and setting (school or community). Reported improvements in outcome measures in intervention versus control groups were assessed. Sixteen studies met the inclusion criteria. Thirteen of these were conducted in Africa and three in Latin America. Twelve of the sixteen studies were school-based, and four were community-based. The interventions reviewed were not resoundingly successful in achieving their goals of increasing knowledge of HIV/AIDS, altering attitudes, improving negotiation and communication skills, or in influencing positive behavior evidenced through consistent condom use, abstinence, or reducing the number of partners. Considering the importance of HIV/AIDS prevention among adolescents, design of evaluation studies of programs in less developed countries need to be improved. The use of randomized controlled trials or other rigorous approaches for evaluating population-based behavioral interventions (e.g., Solomon Four design) is recommended.

Cancer research performance in the European Union: a study of published output from 2000 to 2008.

PubMed

Micheli, Andrea; Di Salvo, Francesca; Lombardo, Claudio; Ugolini, Donatella; Baili, Paolo; A Pierotti, Marco

2011-01-01

Although several studies have assessed cancer research performance in individual European countries, comparisons of European Union (EU27) performance with countries of similar population size are not available. We compared cancer research performance in 2000-2008 between EU27 and 11 countries with over 100 million inhabitants. Performance should not have been affected by the 2007-2009 recession. We examined 143 journals considered oncology journals by Journal Citation Reports, accessing them via Scopus. Publications were attributed to countries using a published counting procedure. For number of publications, the USA held a clear lead in 2006-2008 (yearly averages: 10,293 USA vs 9,962 EU27), whereas the EU27 held the lead previously. EU27 was also second to the USA for total impact factor. China markedly improved its cancer publications record over the period. Compared to the USA, EU27 and Japan, the other countries (all developing) had a poor publications record. Comparative cancer research spending data are not available. However from 2002 to 2007, gross domestic expenditure on research and development (UNESCO data) increased by 34% in North America, 161% in China and only 28% in EU27. Thus the European Union is lagging behind North America and may well be eclipsed by China in research and development spending in the near future. We suggest that these new findings should be considered by policymakers in Europe and other countries when developing policies for cancer control.

Political and economic characteristics as moderators of the relationship between health services and infant mortality in less-developed countries.

PubMed

Chuang, Kun-Yang; Sung, Pei-Wei; Chang, Chia-Jung; Chuang, Ying-Chih

2013-12-01

Few studies have addressed how political and economic contexts shape the effects of health services and environment, such that a politically and economically unstable society, despite having sufficient health professionals and facilities, finds it difficult to transfer health resources into actual population health performance. We examined whether political and economic characteristics moderate the effects of health services on infant mortality rates (IMR) in less-developed countries. This study used a longitudinal ecological study design and focused on 46 less-developed countries during the 30-year period from 1980 to 2009. Data were derived from World Development Indicators, the United Nations Commodity Trade Statistics Database and the Polity IV project. Lagged dependent variable panel regression models were used to increase the causal inferences. Random intercept models were used to accommodate the possible problem of a serial correlation of errors because of the repeated measurements. After controlling for baseline IMR and other socioeconomic variables, our study showed that democracy had a direct effect on IMR, and a moderating effect on the relationship between health services and IMR. The effects of health services on IMR were stronger for countries with a lower level of democracy than for countries with a higher level of democracy in the 10-year models. Compared with other trade-rated characteristics, democracy is a more robust predictor of long-term IMR in less-developed countries. Our study provides additional evidence that democracy has direct effects on IMR and further showed that democracy can modify the effects of health services on IMR.

The Presidential Initiative on Shared Early Warning

NASA Astrophysics Data System (ADS)

Pettis, Roy

2000-04-01

In September 1998, President Clinton and President Yeltsin issued a statement that our two countries would develop a system to share data from our respective early warning systems. The purpose of the initiative is to further reduce the risk of ballistic missile launches occurring in response to a misunderstanding about the data from such systems. The proposal includes a permanent center for sharing such data, located in Moscow, separate from but communicating with the strategic command-and-control centers of each country. It also includes development of a system of pre-launch notifications, which is expected to eventually provide notification of a broad class of launches, on a voluntary basis, including launches by all the countries that engage in missile and space activities. The status, progress, and prognosis for the work will be discussed. The presentation will address the experience gained from the operation of the Center for Y2K Strategic Stability in Colorado Springs (12/99 - 01/00), which tested many of our ideas for a joint center sharing both pre- launch and sensor data on worldwide launches. In addition, the potential of the initiative -- the first arms control effort involving active and continuing U.S.-Russian joint operations -- to provide a model for future arms control opportunities will be discussed.

Community Psychology in Search of a New Focus.

ERIC Educational Resources Information Center

Vassaf, Gunduz Y. H.

1983-01-01

In the West, the community movement emphasizes grass roots control. In developing countries, however, community movements often reinforce the centralizing tendencies of the emerging nation-states. These third world movements must become independent of plans imposed by national governments, and instead, develop networks of ties with other…

Family support for reducing morbidity and mortality in people with HIV/AIDS.

PubMed

Mohanan, Padma; Kamath, Asha

2009-07-08

Care and support play a critical role in assisting people who are HIV-positive to understand the need for prevention and to enable them to protect others. As the HIV/AIDS pandemic progresses and HIV-seropositive individuals contend with devastating illness, it seemed timely to inquire if they receive support from family members. It also was important to develop a normative idea of how much family support exists and from whom it emanates. To assess the effect of family support on morbidity, mortality, quality of life, and economics in families with at least one HIV-infected member, in developing countries. The following databases were searched:The Cochrane Central Register for Controlled Trials (CENTRAL), the Cochrane Database of Systematic Reviews, MEDLINE, AIDSLINE, CINAHL, Dissertation Abstracts International (DAI), EMBASE, BIOSIS, SCISEARCH, the Cochrane HIV/AIDS group specialized register, INDMED, Proquest, and various South Asian abstracting databases, will be included in the database list. The publication sites of the World Health Organization, the US Centers for Disease Control and Prevention, and other international research and non-governmental organizations. An extensive search strategy string was developed in consultation with the trial search coordinator of the HIV/AIDS Review Group. Numerous relevant keywords were included in the string to get an exhaustive electronic literature search. The search was not restricted by language. Articles from other languages were translated into English with the help of experts. A hand search was carried out in many journals and abstracts of the conference proceedings of national and international conferences related to AIDS (e.g. the International Conference on HIV/AIDS and STI in Africa [ICASA]). Efforts also were made to contact experts to identify unpublished research and trials still underway. Intervention studies. Randomized control trials (RCTs) and quasi-RCTs involving HIV-infected individuals with family support in developing countries. We independently screened the results of the search to select potentially relevant studies and to retrieve the full articles. We independently applied the inclusion criteria to the potentially relevant studies. No studies were identified that fulfilled the selection criteria. We were unable to find any trials of family support in reducing the morbidity and mortality in HIV-infected persons in developing countries. There is insufficient evidence to bring out the effect of family support in reducing the morbidity and mortality of HIV-infected persons in developing countries. This review has highlighted the dearth of high-quality quantitative research about family support. There is a clear need for rigorous studies of the clinical effects of family support on people with HIV in developing countries.

Cancer surveillance in northern Africa, and central and western Asia: challenges and strategies in support of developing cancer registries.

PubMed

Znaor, Ariana; Eser, Sultan; Anton-Culver, Hoda; Fadhil, Ibtihal; Ryzhov, Anton; Silverman, Barbara G; Bendahou, Karima; Demetriou, Anna; Nimri, Omar; Yakut, Cankut; Bray, Freddie

2018-02-01

The Global Initiative for Cancer Registry Development partnership, led by the International Agency for Research on Cancer (IARC), was established in response to an overwhelming need for high-quality cancer incidence data from low-income and middle-income countries. The IARC Regional Hub for cancer registration in North Africa, Central and West Asia was founded in 2013 to support capacity building for cancer registration in each of the countries in this region. In this Series paper, we advocate the necessity for tailored approaches to cancer registration given the rapidly changing cancer landscape for this region, and the challenges faced at a national level in developing data systems to help support this process given present disparities in resources and health infrastructure. In addition, we provide an overview of the status of cancer surveillance and activities country-by-country, documenting tailored approaches that are informing local cancer-control policy, and potentially curbing the growing cancer burden across the region. Copyright © 2018 Elsevier Ltd. All rights reserved.

Epidemiology, Incidence and Mortality of Breast Cancer in Asia.

PubMed

Ghoncheh, Mahshid; Momenimovahed, Zohre; Salehiniya, Hamid

2016-01-01

Breast cancer is the most common malignancy in women around the world. Information on the incidence and mortality of breast cancer is essential for planning health measures. This study aimed to investigate the incidence and mortality of breast cancer in the world using age-specific incidence and mortality rates for the year 2012 acquired from the global cancer project (GLOBOCAN 2012) as well as data about incidence and mortality of the cancer based on national reports. It was estimated that 1,671,149 new cases of breast cancer were identified and 521,907 cases of deaths due to breast cancer occurred in the world in 2012. According to GLOBOCAN, it is the most common cancer in women, accounting for 25.1% of all cancers. Breast cancer incidence in developed countries is higher, while relative mortality is greatest in less developed countries. Education of women is suggested in all countries for early detection and treatment. Plans for the control and prevention of this cancer must be a high priority for health policy makers; also, it is necessary to increase awareness of risk factors and early detection in less developed countries.

Multi-Stakeholder Taskforces in Bangladesh — A Distinctive Approach to Build Sustainable Tobacco Control Implementation

PubMed Central

Jackson-Morris, Angela M.; Chowdhury, Ishrat; Warner, Valerie; Bleymann, Kayleigh

2015-01-01

The MPOWER policy package enables countries to implement effective, evidence-based strategies to address the threat posed to their population by tobacco. All countries have challenges to overcome when implementing tobacco control policy. Some are generic such as tobacco industry efforts to undermine and circumvent legislation; others are specific to national or local context. Various factors influence how successfully challenges are addressed, including the legal-political framework for enforcement, public and administrative attitudes towards the law, and whether policy implementation measures are undertaken. This paper examines District Tobacco Control Taskforces, a flexible policy mechanism developed in Bangladesh to support the implementation of the Smoking and Tobacco Products Usage (Control) Act 2005 and its 2013 Amendment. At the time of this study published research and/or data was not available and understanding about these structures, their role, contribution, limitations and potential, was limited. We consider Taskforce characteristics and suggest that the “package” comprises a distinctive tobacco control implementation model. Qualitative data is presented from interviews with key informants in ten districts with activated taskforces (n = 70) to provide insight from the perspectives of taskforce members and non-members. In all ten districts taskforces were seen as a crucial tool for tobacco control implementation. Where taskforces were perceived to be functioning well, current positive impacts were perceived, including reduced smoking in public places and tobacco advertising, and increased public awareness and political profile. In districts with less well established taskforces, interviewees believed in their taskforce’s ‘potential’ to deliver similar benefits once their functioning was improved. Recommendations to improve functioning and enhance impact were made. The distinctive taskforce concept and lessons from their development may provide other countries with a flexible local implementation model for tobacco control. PMID:25575369

Multi-stakeholder taskforces in Bangladesh--a distinctive approach to build sustainable tobacco control implementation.

PubMed

Jackson-Morris, Angela M; Chowdhury, Ishrat; Warner, Valerie; Bleymann, Kayleigh

2015-01-07

The MPOWER policy package enables countries to implement effective, evidence-based strategies to address the threat posed to their population by tobacco. All countries have challenges to overcome when implementing tobacco control policy. Some are generic such as tobacco industry efforts to undermine and circumvent legislation; others are specific to national or local context. Various factors influence how successfully challenges are addressed, including the legal-political framework for enforcement, public and administrative attitudes towards the law, and whether policy implementation measures are undertaken. This paper examines District Tobacco Control Taskforces, a flexible policy mechanism developed in Bangladesh to support the implementation of the Smoking and Tobacco Products Usage (Control) Act 2005 and its 2013 Amendment. At the time of this study published research and/or data was not available and understanding about these structures, their role, contribution, limitations and potential, was limited. We consider Taskforce characteristics and suggest that the "package" comprises a distinctive tobacco control implementation model. Qualitative data is presented from interviews with key informants in ten districts with activated taskforces (n = 70) to provide insight from the perspectives of taskforce members and non-members. In all ten districts taskforces were seen as a crucial tool for tobacco control implementation. Where taskforces were perceived to be functioning well, current positive impacts were perceived, including reduced smoking in public places and tobacco advertising, and increased public awareness and political profile. In districts with less well established taskforces, interviewees believed in their taskforce's 'potential' to deliver similar benefits once their functioning was improved. Recommendations to improve functioning and enhance impact were made. The distinctive taskforce concept and lessons from their development may provide other countries with a flexible local implementation model for tobacco control.

The Role of Research in International Tobacco Control

PubMed Central

Warner, Kenneth E.

2005-01-01

The future of the tobacco-produced disease epidemic rests in low- and middle-income countries, where cigarette sales are growing—the result of rising incomes, trade liberalization, liberalization of the treatment of women, and the introduction of Western-style advertising. Research on disease causation, epidemiology, and educational and policy interventions has contributed significantly to reducing smoking rates in developed countries. A similar contribution is needed in less affluent nations, but severe challenges are involved in implementing a robust research program in such countries. In an attempt to understand these challenges and begin to conceptualize an approach to overcoming them, I examine the need for and methods to achieve a program of meaningful research on tobacco and health, as well as health policy, in the developing world. PMID:15914819

A Chronology of Global Assistance Funding for NCD.

PubMed

Nugent, Rachel

2016-12-01

Funding from the global community for noncommunicable disease (NCD) prevention and control in developing countries is miniscule-dwarfed by donor support for communicable diseases, maternal and child health, and other traditional health concerns in low-income countries. Yet, NCD now constitute the bulk of illness and deaths in low-income countries with, to date, only a small uptick in donor funding evident as a response. This paper describes recent magnitude and trends in the development of assistance for NCD; identifies the main sources among the 3 groupings of multilateral, bilateral, and private philanthropic funders; and discusses issues in tracking NCD donor funding, and challenges to mobilizing donor funding for NCD. Finally, it concludes with a more (slightly) optimistic outlook. Copyright © 2016 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

A duration analysis of the role of cigarette prices on smoking initiation and cessation in developing countries.

PubMed

Kostova, Deliana; Chaloupka, Frank J; Shang, Ce

2015-04-01

This study evaluates the impact of cigarette prices on smoking initiation and cessation among adults in two pooled samples of 6 low- to lower-middle income countries (LMICs) and 8 upper-middle income countries (UMICs). We find that, while higher prices reduce smoking across the board, this reduction occurs through different behavioral mechanisms in lower versus higher income countries. Specifically, cigarette prices reduce smoking rates by deterring initiation in LMICs while in UMICs they act primarily by promoting cessation. Because current smoking rates are relatively lower in LMICs and relatively higher in UMICs, this differential mechanism underscores the adaptability of tobacco prices as a tool for regulating tobacco use across countries at different levels of development; it shows that prices can be used to sustain the relatively low rates of smoking in LMICs by preventing entry of new smokers, and can reduce the relatively high rates of smoking in UMICs by encouraging exit of existing smokers. Using split-population duration models and controlling for fixed and time-varying unobserved country characteristics, we estimate that the price elasticity of initiation in LMICs is -0.74 and the price elasticity of cessation in UMICs is 0.51.

Analyzing Whether Countries Are Equally Efficient at Improving Longevity for Men and Women

PubMed Central

Nandi, Arijit; Mendoza Rodríguez, José M.; Heymann, Jody

2014-01-01

Objectives. We examined the efficiency of country-specific health care spending in improving life expectancies for men and women. Methods. We estimated efficiencies of health care spending for 27 Organisation for Economic Co-operation and Development (OECD) countries during the period 1991 to 2007 using multivariable regression models, including country fixed-effects and controlling for time-varying levels of national social expenditures, economic development, and health behaviors. Results. Findings indicated robust differences in health-spending efficiency. A 1% annual increase in health expenditures was associated with percent changes in life expectancy ranging from 0.020 in the United States (95% confidence interval [CI] = 0.008, 0.032) to 0.121 in Germany (95% CI = 0.099, 0.143). Health-spending increases were associated with greater life expectancy improvements for men than for women in nearly every OECD country. Conclusions. This is the first study to our knowledge to estimate the effect of country-specific health expenditures on life expectancies of men and women. Future work understanding the determinants of these differences has the potential to improve the overall efficiency and equity of national health systems. PMID:24328639

Technology transfer of oil-in-water emulsion adjuvant manufacturing for pandemic influenza vaccine production in Romania.

PubMed

Fox, Christopher B; Huynh, Chuong; O'Hara, Michael K; Onu, Adrian

2013-03-15

Many developing countries lack or have inadequate pandemic influenza vaccine manufacturing capacity. In the 2009 H1N1 pandemic, this led to delayed and inadequate vaccine coverage in the developing world. Thus, bolstering developing country influenza vaccine manufacturing capacity is urgently needed. The Cantacuzino Institute in Bucharest, Romania has been producing seasonal influenza vaccine since the 1970s, and has the capacity to produce ∼5 million doses of monovalent vaccine in the event of an influenza pandemic. Inclusion of an adjuvant in the vaccine could enable antigen dose sparing, expanding vaccine coverage and potentially allowing universal vaccination of the Romanian population and possibly neighboring countries. However, adjuvant formulation and manufacturing know-how are difficult to access. This manuscript describes the successful transfer of oil-in-water emulsion adjuvant manufacturing and quality control technologies from the Infectious Disease Research Institute in Seattle, USA to the Cantacuzino Institute. By describing the challenges and accomplishments of the project, it is hoped that the knowledge and experience gained will benefit other institutes involved in similar technology transfer projects designed to facilitate increased vaccine manufacturing capacity in developing countries. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

Marara, Madeleine; Okello, Nick; Kuhanwa, Zainab

This paper reviews and compares the condition of the environmental impact assessment (EIA) system in three countries in the East Africa region: Kenya, Rwanda and Tanzania. The criteria used for the evaluation and the comparison of each system are based on the elements of the legal, administrative and procedural frameworks, as well as the context in which they operate. These criteria are adapted from the evaluation and quality control criteria derived from a number of literature sources. The study reveals that the EIA systems of Kenya and Tanzania are at a similar stage in their development. The two countries, themore » first to introduce the EIA concept into their jurisdiction in this part of Africa, therefore have more experience than Rwanda in the practice of environmental impact assessment, where the legislation and process requires more time to mature both from the governmental and societal perspective. The analysis of the administrative and procedural frameworks highlights the weakness in the autonomy of the competent authority, in all three countries. Finally a major finding of this study is that the contextual set up i.e. the socio-economic and political situation plays an important role in the performance of an EIA system. The context in developing countries is very different from developed countries where the EIA concept originates. Interpreting EIA conditions in countries like Kenya, Rwanda and Tanzania requires that the analysis for determining the effectiveness of their systems should be undertaken within a relevant framework, taking into account the specific requirements of those countries.« less

Malaria vector control: from past to future.

PubMed

Raghavendra, Kamaraju; Barik, Tapan K; Reddy, B P Niranjan; Sharma, Poonam; Dash, Aditya P

2011-04-01

Malaria is one of the most common vector-borne diseases widespread in the tropical and subtropical regions. Despite considerable success of malaria control programs in the past, malaria still continues as a major public health problem in several countries. Vector control is an essential part for reducing malaria transmission and became less effective in recent years, due to many technical and administrative reasons, including poor or no adoption of alternative tools. Of the different strategies available for vector control, the most successful are indoor residual spraying and insecticide-treated nets (ITNs), including long-lasting ITNs and materials. Earlier DDT spray has shown spectacular success in decimating disease vectors but resulted in development of insecticide resistance, and to control the resistant mosquitoes, organophosphates, carbamates, and synthetic pyrethroids were introduced in indoor residual spraying with needed success but subsequently resulted in the development of widespread multiple insecticide resistance in vectors. Vector control in many countries still use insecticides in the absence of viable alternatives. Few developments for vector control, using ovitraps, space spray, biological control agents, etc., were encouraging when used in limited scale. Likewise, recent introduction of safer vector control agents, such as insect growth regulators, biocontrol agents, and natural plant products have yet to gain the needed scale of utility for vector control. Bacterial pesticides are promising and are effective in many countries. Environmental management has shown sufficient promise for vector control and disease management but still needs advocacy for inter-sectoral coordination and sometimes are very work-intensive. The more recent genetic manipulation and sterile insect techniques are under development and consideration for use in routine vector control and for these, standardized procedures and methods are available but need thorough understanding of biology, ethical considerations, and sufficiently trained manpower for implementation being technically intensive methods. All the methods mentioned in the review that are being implemented or proposed for implementation needs effective inter-sectoral coordination and community participation. The latest strategy is evolution-proof insecticides that include fungal biopesticides, Wolbachia, and Denso virus that essentially manipulate the life cycle of the mosquitoes were found effective but needs more research. However, for effective vector control, integrated vector management methods, involving use of combination of effective tools, is needed and is also suggested by Global Malaria Control Strategy. This review article raises issues associated with the present-day vector control strategies and state opportunities with a focus on ongoing research and recent advances to enable to sustain the gains achieved so far.

Rheumatic heart disease across the Western Pacific: not just a Pacific Island problem.

PubMed

Abouzeid, Marian; Katzenellenbogen, Judith; Wyber, Rosemary; Watkins, David; Johnson, Timothy David; Carapetis, Jonathan

2017-01-01

Some of the highest recorded rheumatic heart disease (RHD) prevalence and mortality rates are from the World Health Organization's Western Pacific Region (WPR). RHD burden has been well documented in much of the WPR subregion of Oceania, but less is known about RHD outside the Pacific Islands and Australasia. We aimed to review RHD burden in WPR outside Oceania to identify countries with high RHD burden and those with contemporary data gaps. We searched the peer-reviewed literature for English-language primary studies published between 1980 and April 2017 that reported RHD prevalence or mortality in the 13 WPR countries/areas outside Oceania, and Taiwan. We also searched for official government reports and health indicator documents. Results were synthesised narratively and reported stratified by 2015 Human Development Index (HDI) level. 30 peer-reviewed publications fulfilling inclusion criteria were identified, representing nine countries/areas. RHD prevalence and mortality have fallen in association with economic development, particularly in very high HDI countries. In several countries that have undergone recent economic development, RHD persists particularly among older populations. In poorer WPR countries there is a persistent RHD burden, including in young populations. Some countries had no available data. Although RHD burden has declined in many high-resource settings across the WPR, in several poorer countries, the impact of RHD appears to continue. Elsewhere, insufficient contemporary data make it difficult to gauge the current status of RHD burden and control. Concerted efforts are needed to fill information gaps and implement action to address this avoidable disease.

Developing an expanded vector control toolbox for malaria elimination

PubMed Central

Tatarsky, Allison; Diabate, Abdoulaye; Chaccour, Carlos J; Marshall, John M; Okumu, Fredros O; Brunner, Shannon; Newby, Gretchen; Williams, Yasmin A; Malone, David; Tusting, Lucy S; Gosling, Roland D

2017-01-01

Vector control using long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) accounts for most of the malaria burden reductions achieved recently in low and middle-income countries (LMICs). LLINs and IRS are highly effective, but are insufficient to eliminate malaria transmission in many settings because of operational constraints, growing resistance to available insecticides and mosquitoes that behaviourally avoid contact with these interventions. However, a number of substantive opportunities now exist for rapidly developing and implementing more diverse, effective and sustainable malaria vector control strategies for LMICs. For example, mosquito control in high-income countries is predominantly achieved with a combination of mosquito-proofed housing and environmental management, supplemented with large-scale insecticide applications to larval habitats and outdoor spaces that kill off vector populations en masse, but all these interventions remain underused in LMICs. Programmatic development and evaluation of decentralised, locally managed systems for delivering these proactive mosquito population abatement practices in LMICs could therefore enable broader scale-up. Furthermore, a diverse range of emerging or repurposed technologies are becoming available for targeting mosquitoes when they enter houses, feed outdoors, attack livestock, feed on sugar or aggregate into mating swarms. Global policy must now be realigned to mobilise the political and financial support necessary to exploit these opportunities over the decade ahead, so that national malaria control and elimination programmes can access a much broader, more effective set of vector control interventions. PMID:28589022

Health Systems' Responsiveness and Its Characteristics: A Cross-Country Comparative Analysis

PubMed Central

Robone, Silvana; Rice, Nigel; Smith, Peter C

2011-01-01

Objectives Responsiveness has been identified as one of the intrinsic goals of health care systems. Little is known, however, about its determinants. Our objective is to investigate the potential country-level drivers of health system responsiveness. Data Source Data on responsiveness are taken from the World Health Survey. Information on country-level characteristics is obtained from a variety of sources including the United Nations Development Program (UNDP). Study Design A two-step procedure. First, using survey data we derive a country-level measure of system responsiveness purged of differences in individual reporting behavior. Secondly, we run cross-sectional country-level regressions of responsiveness on potential drivers. Principal Findings Health care expenditures per capita are positively associated with responsiveness, after controlling for the influence of potential confounding factors. Aspects of responsiveness are also associated with public sector spending (negatively) and educational development (positively). Conclusions From a policy perspective, improvements in responsiveness may require higher spending levels. The expansion of nonpublic sector provision, perhaps in the form of increased patient choice, may also serve to improve responsiveness. However, these inferences are tentative and require further study. PMID:21762144

[The pharmaceutical industry and the sustainability of healthcare systems in developed countries and in Latin America].

PubMed

Iñesta, Antonio; Oteo, Luis Angel

2011-06-01

The global economic crisis and its impact on public finances in most developed countries are giving rise to cost-containment policies in healthcare systems. Prevailing legislation on medication requires the safety, quality, and efficacy of these products. A few countries include efficiency criteria, primarily for new medication that they wish to include in public financing. The appropriate use of generic and "biosimilar medication" is very important for maintaining the financial equilibrium of the Health Services. The problem in Latin America is that not all multisource products are bioequivalent and not all countries have the resources to conduct bioequivalence studies in vivo. The European Medicines Agency in 2005 adopted guidelines on "biosimilar medicines" and thirteen of them were subsequently approved for general release. Benchmarking of this model by other countries would be important. The influence of the pharmaceutical industry on political and administrative areas is enormous and control is necessary. The pharmaceutical companies claim that they act with corporate social responsibility, therefore, they must ensure this responsibility toward society.

Dengue Contingency Planning: From Research to Policy and Practice

PubMed Central

Runge-Ranzinger, Silvia; Kroeger, Axel; Olliaro, Piero; McCall, Philip J.; Sánchez Tejeda, Gustavo; Lloyd, Linda S.; Hakim, Lokman; Bowman, Leigh R.; Horstick, Olaf; Coelho, Giovanini

2016-01-01

Background Dengue is an increasingly incident disease across many parts of the world. In response, an evidence-based handbook to translate research into policy and practice was developed. This handbook facilitates contingency planning as well as the development and use of early warning and response systems for dengue fever epidemics, by identifying decision-making processes that contribute to the success or failure of dengue surveillance, as well as triggers that initiate effective responses to incipient outbreaks. Methodology/Principal findings Available evidence was evaluated using a step-wise process that included systematic literature reviews, policymaker and stakeholder interviews, a study to assess dengue contingency planning and outbreak management in 10 countries, and a retrospective logistic regression analysis to identify alarm signals for an outbreak warning system using datasets from five dengue endemic countries. Best practices for managing a dengue outbreak are provided for key elements of a dengue contingency plan including timely contingency planning, the importance of a detailed, context-specific dengue contingency plan that clearly distinguishes between routine and outbreak interventions, surveillance systems for outbreak preparedness, outbreak definitions, alert algorithms, managerial capacity, vector control capacity, and clinical management of large caseloads. Additionally, a computer-assisted early warning system, which enables countries to identify and respond to context-specific variables that predict forthcoming dengue outbreaks, has been developed. Conclusions/Significance Most countries do not have comprehensive, detailed contingency plans for dengue outbreaks. Countries tend to rely on intensified vector control as their outbreak response, with minimal focus on integrated management of clinical care, epidemiological, laboratory and vector surveillance, and risk communication. The Technical Handbook for Surveillance, Dengue Outbreak Prediction/ Detection and Outbreak Response seeks to provide countries with evidence-based best practices to justify the declaration of an outbreak and the mobilization of the resources required to implement an effective dengue contingency plan. PMID:27653786

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

Implications for Arms Control in Technology Transfer to Less Developed Countries (LDC’s) Volume IV. Essays on the Role of Coproduction and Dual-Use Technology in the Development of LDC Arms Industries

DTIC Science & Technology

1980-09-01

engaged in a coproduction venture with Contraves of Switzerland in which Bharat Electronics produces the fire control radars for the LP-70 AA system...produced and marketed by Contraves . Finally, it is expected that land warfare cap- abilities of LDCs will profit from the advantages of the RPV in

A developer solution for tank processing of x-ray film under ambient, tropical conditions.

PubMed

Wayrynen, R E; McKinney, W E

1976-05-01

A modification of a proprietary 90-sec. x-ray-film developer which permits its use as a hand-tank developer at ambient temperatures between 21.6 degrees-30.6 degrees C (80 degrees-100 degrees F) is described. This processing technique is useful in tropical countries where the control of developer temperature is particularly difficult.

Gender gap matters in maternal mortality in low and lower-middle-income countries: A study of the global Gender Gap Index.

PubMed

Choe, Seung-Ah; Cho, Sung-Il; Kim, Hongsoo

2017-09-01

Reducing maternal mortality has been a crucial part of the global development agenda. According to modernisation theory, the effect of gender equality on maternal health may differ depending on a country's economic development status. We explored the correlation between the Global Gender Gap Index (GGI) provided by the World Economic Forum and the maternal mortality ratio (MMR) obtained from the World Development Indicators database of the World Bank. The relationships between each score in the GGI, including its four sub-indices (measuring gender gaps in economic participation, educational attainment, health and survival, and political empowerment), and the MMR were analysed. When the countries were stratified by gross national income per capita, the low and lower-middle-income countries had lower scores in the GGI, and lower scores in the economic participation, educational attainment, and political empowerment sub-indices than the high-income group. Among the four sub-indices, the educational attainment sub-index showed a significant inverse correlation with the MMR in low and lower-middle-income countries when controlling for the proportion of skilled birth attendance and public share of health expenditure. This finding suggests that strategic efforts to reduce the gender gap in educational attainment could lead to improvements in maternal health in low and lower-middle-income countries.

Utilization of pyrosequencing to monitor the microbiome dynamics of probiotic treated poultry (Gallus gallus domesticus) during downstream poultry processing

USDA-ARS?s Scientific Manuscript database

Antibiotic growth promoters that have been historically employed to control pathogens and increase the rate of animal development for human consumption are currently banned in many countries. Probiotics have been proposed as an alternative to control pathogenic bacteria. Traditional culture method...

New Communications Technology and Distance Education: Implications for Commonwealth Countries of the South. Papers on Information Technology No. 239.

ERIC Educational Resources Information Center

Bates, A. W.

This review of the technical possibilities of audio, television, computing, and combination media addresses the main factors influencing decisions about each technology's suitability for distance teaching, including access, costs, symbolic representation, student control, teacher control, existing structures, learning skills to be developed, and…

Laboratory preparedness in EU/EEA countries for detection of novel avian influenza A(H7N9) virus, May 2013

PubMed Central

Broberg, E; Pereyaslov, D; Struelens, M; Palm, D; Meijer, A; Ellis, J; Zambon, M; McCauley, J; Daniels, R

2015-01-01

Following human infections with novel avian influenza A(H7N9) viruses in China, the European Centre for Disease Prevention and Control, the World Health Organization (WHO) Regional Office for Europe and the European Reference Laboratory Network for Human Influenza (ERLI-Net) rapidly posted relevant information, including real-time RT-PCR protocols. An influenza RNA sequence-based computational assessment of detection capabilities for this virus was conducted in 32 national influenza reference laboratories in 29 countries, mostly WHO National Influenza Centres participating in the WHO Global Influenza Surveillance and Response System (GISRS). Twenty-seven countries considered their generic influenza A virus detection assay to be appropriate for the novel A(H7N9) viruses. Twenty-two countries reported having containment facilities suitable for its isolation and propagation. Laboratories in 27 countries had applied specific H7 real-time RT-PCR assays and 20 countries had N9 assays in place. Positive control virus RNA was provided by the WHO Collaborating Centre in London to 34 laboratories in 22 countries to allow evaluation of their assays. Performance of the generic influenza A virus detection and H7 and N9 subtyping assays was good in 24 laboratories in 19 countries. The survey showed that ERLI-Net laboratories had rapidly developed and verified good capability to detect the novel A(H7N9) influenza viruses. PMID:24507469

[Current status and issues of anti-smoking measures in the workplace in Japan].

PubMed

Abe, Mayumi Saito

2014-02-01

Compared with developed foreign countries, anti-smoking measures in Japan is lagging behind. As a country that has signed the Framework Convention on Tobacco Control (FCTC), it should be run the appropriate tobacco control. For example, in many stores of the service industry that smoking is allowed, employees are working while being exposed to second-hand smoke. Even in workplace air polluted environment, employees will not be able to leave there. Such a harsh environment to ignore health and safety, it must be eliminated as soon as possible. In order to protect the health of workers, the workplace should be smoke free.

Sterilization for family planning in a Third World country.

PubMed

Reichert, J A; Nagel, L W; Solberg, N S

1997-07-01

Outpatient laparoscopy procedures have made sterilization possible for millions of women in developing countries. This report describes the experience of a team of doctors, nurses, and support staff that performed 107 laparoscopic tubal sterilizations during on eight-day sojourn in a remote north-central area of Nicaragua. Minimal analgesia (oral ibuprofen) and anesthesia (1% lidocaine) were used since most of the patients walked to and from the hospital-some up to 15 miles. Because the Nicaraguan government's support for birth-control programs is unreliable and because illegal abortion is the leading cause of maternal mortality in Nicaragua, this safe, minimally invasive surgical method is the favored means of birth control.

Modernization (Selected Articles),

DTIC Science & Technology

1986-09-18

newly developed science such as control theory, artificial intelligence, model identification, computer and microelectronics technology, graphic...five "top guns" from around the country specializing in intellignece , mechanics, software and hardware as our technical advisors. In addition

Net profit flow per country from 1980 to 2009: The long-term effects of foreign direct investment.

PubMed

Akkermans, Dirk H M

2017-01-01

The paper aims at describing and explaining net profit flows per country for the period 1980-2009. Net profit flows result from Foreign Direct Investment (FDI) stock and profit repatriation: inward stock creating a profit outflow and outward FDI stock a profit inflow. Profit flows, especially 'normal' ones are not commonly researched. According to world-system theory, countries are part of a system characterised by a core, semi-periphery and periphery, as shown by network analyses of trade relations. Network analyses based on ownership relations of TransNational Corporations (TNCs) show that the top 50 firms that control about 40% of the world economy are almost exclusively located in core countries. So, we may expect a hierarchy in net profit flows with core countries on top and the periphery at the bottom. FDI outflows from the core countries especially rose in the 1990s, so we may expect that the difference has grown in time. A dataset on 'net profit flow' per country is developed. There are diverging developments in net profit flows since the 1980s, as expected: ever more positive for core countries, negative and ever lower for semi-peripheral and peripheral countries, in particular from the 1990s onwards. A fixed effects quantile regression using publicly available data confirms the prediction that peripheral countries share a unique characteristic: their outward investments do not have a positive influence on net profit flow as is the case with semi-peripheral and core countries. The most probable explanation is that peripheral outward investments are indirectly owned by firms located in core and semi-peripheral countries, so all peripheral profit inflows end up in those countries.

Net profit flow per country from 1980 to 2009: The long-term effects of foreign direct investment

PubMed Central

2017-01-01

Aim of the paper The paper aims at describing and explaining net profit flows per country for the period 1980–2009. Net profit flows result from Foreign Direct Investment (FDI) stock and profit repatriation: inward stock creating a profit outflow and outward FDI stock a profit inflow. Profit flows, especially ‘normal’ ones are not commonly researched. Theoretical background According to world-system theory, countries are part of a system characterised by a core, semi-periphery and periphery, as shown by network analyses of trade relations. Network analyses based on ownership relations of TransNational Corporations (TNCs) show that the top 50 firms that control about 40% of the world economy are almost exclusively located in core countries. So, we may expect a hierarchy in net profit flows with core countries on top and the periphery at the bottom. FDI outflows from the core countries especially rose in the 1990s, so we may expect that the difference has grown in time. Data and results A dataset on 'net profit flow' per country is developed. There are diverging developments in net profit flows since the 1980s, as expected: ever more positive for core countries, negative and ever lower for semi-peripheral and peripheral countries, in particular from the 1990s onwards. A fixed effects quantile regression using publicly available data confirms the prediction that peripheral countries share a unique characteristic: their outward investments do not have a positive influence on net profit flow as is the case with semi-peripheral and core countries. The most probable explanation is that peripheral outward investments are indirectly owned by firms located in core and semi-peripheral countries, so all peripheral profit inflows end up in those countries. PMID:28654644

Comprehensive strategies for the prevention and control of diabetes and cardiovascular diseases in Africa: future directions.

PubMed

Muna, Walinjom F T

2013-01-01

The countries of the Sub Saharan African region have insufficient resources and healthcare systems that are poorly adapted to cope with the longstanding burden associated with communicable diseases and the ongoing HIV/AIDS pandemic. In addition, the rising burden of non-communicable diseases, including diabetes, cardiovascular diseases, and their risk factors, poses additional challenges. These countries need to urgently develop strategies to address these challenges of disease prevention and control. These strategies will require a new vision and more relevant and 'suitable' vocabulary in dealing with healthcare design, planning and implementation (using a cross-sectorial approach). Lessons learnt from the past (e.g. primary health care) in sub-Saharan Africa and other regions of the world may equally prove useful in developing strategies for the prevention and control of non-communicable diseases. Any potential strategy must emphasize the crucial role of economic, social, and environmental health determinants as well as the use of appropriate health technology. © 2013.

Malaria Control and Elimination,1 Venezuela, 1800s–1970s

PubMed Central

Villegas, Leopoldo; Udhayakumar, Venkatachalam

2014-01-01

Venezuela had the highest number of human malaria cases in Latin American before 1936. During 1891–1920, malaria was endemic to >600,000 km2 of this country; malaria death rates led to major population decreases during 1891–1920. No pathogen, including the influenza virus that caused the 1918 pandemic, caused more deaths than malaria during 1905–1945. Early reports of malaria eradication in Venezuela helped spark the world’s interest in global eradication. We describe early approaches to malaria epidemiology in Venezuela and how this country developed an efficient control program and an approach to eradication. Arnoldo Gabaldón was a key policy maker during this development process. He directed malaria control in Venezuela from the late 1930s to the end of the 1970s and contributed to malaria program planning of the World Health Organization. We discuss how his efforts helped reduce the incidence of malaria in Venezuela and how his approach diverged from World Health Organization guidelines.

Malaria control and elimination, Venezuela, 1800s –1970s.

PubMed

Griffing, Sean M; Villegas, Leopoldo; Udhayakumar, Venkatachalam

2014-10-01

Venezuela had the highest number of human malaria cases in Latin American before 1936. During 1891–1920,malaria was endemic to >600,000 km2 of this country; malaria death rates led to major population decreases during 1891–1920. No pathogen, including the influenza virus that caused the 1918 pandemic, caused more deaths than malaria during 1905–1945. Early reports of malaria eradication in Venezuela helped spark the world's interest in global eradication. We describe early approaches to malaria epidemiology in Venezuela and how this country developed an efficient control program and an approach to eradication.Arnoldo Gabaldón was a key policy maker during this development process. He directed malaria control in Venezuela from the late 1930s to the end of the 1970s and contributed to malaria program planning of the World Health Organization.We discuss how his efforts helped reduce the incidence of malaria in Venezuela and how his approach diverged from World Health Organization guidelines.

Soil erosion in developing countries: A politicoeconomic explanation

NASA Astrophysics Data System (ADS)

Thapa, Gopal B.; Weber, Karl E.

1991-07-01

Soil erosion is accelerating in developing countries of Asia, Africa, and Latin America. It has threatened the livelihood of millions of peasants, for agriculture is their economic mainstay. A probe into the forces causing erosion reveals that the elite’s resolve to accumulate ever more wealth and to maintain, consolidate, or expand their sociopolitical power and the necessity of the poor to fulfill their requirements of food, fuelwood, and fodder are the two major factors accelerating soil erosion. Unless the vast masses of poor people are integrated into the national mainstream through the implementation of equitable and redistributive development policies, it is impossible to control the accelerating rate of soil erosion and thus to achieve the objective of sustainable development.

Estimating the population-level impact of vaccines using synthetic controls.

PubMed

Bruhn, Christian A W; Hetterich, Stephen; Schuck-Paim, Cynthia; Kürüm, Esra; Taylor, Robert J; Lustig, Roger; Shapiro, Eugene D; Warren, Joshua L; Simonsen, Lone; Weinberger, Daniel M

2017-02-14

When a new vaccine is introduced, it is critical to monitor trends in disease rates to ensure that the vaccine is effective and to quantify its impact. However, estimates from observational studies can be confounded by unrelated changes in healthcare utilization, changes in the underlying health of the population, or changes in reporting. Other diseases are often used to detect and adjust for these changes, but choosing an appropriate control disease a priori is a major challenge. The "synthetic controls" (causal impact) method, which was originally developed for website analytics and social sciences, provides an appealing solution. With this approach, potential comparison time series are combined into a composite and are used to generate a counterfactual estimate, which can be compared with the time series of interest after the intervention. We sought to estimate changes in hospitalizations for all-cause pneumonia associated with the introduction of pneumococcal conjugate vaccines (PCVs) in five countries in the Americas. Using synthetic controls, we found a substantial decline in hospitalizations for all-cause pneumonia in infants in all five countries (average of 20%), whereas estimates for young and middle-aged adults varied by country and were potentially influenced by the 2009 influenza pandemic. In contrast to previous reports, we did not detect a decline in all-cause pneumonia in older adults in any country. Synthetic controls promise to increase the accuracy of studies of vaccine impact and to increase comparability of results between populations compared with alternative approaches.

Essential fats: how do they affect growth and development of infants and young children in developing countries? A literature review.

PubMed

Huffman, Sandra L; Harika, Rajwinder K; Eilander, Ans; Osendarp, Saskia J M

2011-10-01

Omega-3 and omega-6 fatty acids, particularly docosahexaenoic acid (DHA), are known to play an essential role in the development of the brain and retina. Intakes in pregnancy and early life affect growth and cognitive performance later in childhood. However, total fat intake, alpha-linolenic acid (ALA) and DHA intakes are often low among pregnant and lactating women, infants and young children in developing countries. As breast milk is one of the best sources of ALA and DHA, breastfed infants are less likely to be at risk of insufficient intakes than those not breastfed. Enhancing intake of ALA through plant food products (soy beans and oil, canola oil, and foods containing these products such as lipid-based nutrient supplements) has been shown to be feasible. However, because of the low conversion rates of ALA to DHA, it may be more efficient to increase DHA status through increasing fish consumption or DHA fortification, but these approaches may be more costly. In addition, breastfeeding up to 2 years and beyond is recommended to ensure an adequate essential fat intake in early life. Data from developing countries have shown that a higher omega-3 fatty acid intake or supplementation during pregnancy may result in small improvements in birthweight, length and gestational age based on two randomized controlled trials and one cross-sectional study. More rigorous randomized controlled trials are needed to confirm this effect. Limited data from developing countries suggest that ALA or DHA supplementation during lactation and in infants may be beneficial for growth and development of young children 6-24 months of age in these settings. These benefits are more pronounced in undernourished children. However, there is no evidence for improvements in growth following omega-3 fatty acid supplementation in children >2 years of age. © 2011 Blackwell Publishing Ltd.

Method Development and Monitoring of Cyanotoxins in Water ...

EPA Pesticide Factsheets

This presentation describes method development of two ambient water LC/MS/MS methods for microcystins, cylindrospermopsin and anatoxin-a. Ruggedness of the methods will be demonstrated by evaluation of quality control samples derived from various water bodies across the country. Presentation at the Central Regional meeting of the American Chemical Society ambient water methods development for cyanotoxins

Lessons learned during the development and transfer of technology related to a new Hib conjugate vaccine to emerging vaccine manufacturers.

PubMed

Hamidi, A; Boog, C; Jadhav, S; Kreeftenberg, H

2014-07-16

The incidence of Haemophilus Influenzae type b (Hib) disease in developed countries has decreased since the introduction of Hib conjugate vaccines in their National Immunization Programs (NIP). In countries where Hib vaccination is not applied routinely, due to limited availability and high cost of the vaccines, invasive Hib disease is still a cause of mortality. Through the development of a production process for a Hib conjugate vaccine and related quality control tests and the transfer of this technology to emerging vaccine manufacturers in developing countries, a substantial contribution was made to the availability and affordability of Hib conjugate vaccines in these countries. Technology transfer is considered to be one of the fastest ways to get access to the technology needed for the production of vaccines. The first Hib conjugate vaccine based on the transferred technology was licensed in 2007, since then more Hib vaccines based on this technology were licensed. This paper describes the successful development and transfer of Hib conjugate vaccine technology to vaccine manufacturers in India, China and Indonesia. By describing the lessons learned in this process, it is hoped that other technology transfer projects can benefit from the knowledge and experience gained. Copyright © 2014 Elsevier Ltd. All rights reserved.

Essays on the IT Industry in Korea and Taiwan

ERIC Educational Resources Information Center

Lee, Wen-Chieh

2012-01-01

This dissertation consists of three studies on the development of information technology (IT) industry in Korea and Taiwan. Using industry-level data from those countries, I would like to investigate why similar economies would take different paths toward developing their industries. The first chapter, "Span of Control and Production…

Asia's Four Little Tigers: A Comparison of the Role of Education in Their Development.

ERIC Educational Resources Information Center

Morris, Paul

1996-01-01

In four rapidly developing east Asian nations, educational similarities include strong national curricula and highly competitive selective systems. However, the countries differ in educational funding sources; access to education, particularly tertiary education; extent of state control; relative emphasis on general and technical education; nature…

Health workforce imbalances in times of globalization: brain drain or professional mobility?

PubMed

Marchal, Bruno; Kegels, Guy

2003-01-01

The health workforce is of strategic importance to the performance of national health systems as well as of international disease control initiatives. The brain drain from rural to urban areas, and from developing to industrialized countries is a long-standing phenomenon in the health professions but has in recent years taken extreme proportions, particularly in Africa. Adopting the wider perspective of health workforce balances, this paper presents an analysis of the underlying mechanisms of health professional migration and possible strategies to reduce its negative impact on health services. The opening up of international borders for goods and labour, a key strategy in the current liberal global economy, is accompanied by a linguistic shift from 'human capital flight' and 'brain drain' to 'professional mobility' or 'brain circulation'. In reality, this mobility is very asymmetrical, to the detriment of less developed countries, which lose not only much-needed human resources, but also considerable investments in education and fiscal income. It is argued that low professional satisfaction and the decreasing social valuation of the health professionals are important determinants of the decreasing attraction of the health professions, which underlies both the push from the exporting countries, as well as the pull from the recipient countries. Solutions should therefore be based on this wider perspective, interrelating health workforce imbalances between, but also within developing and developed countries.

Environmental Pollution: An Under-recognized Threat to Children’s Health, Especially in Low- and Middle-Income Countries

PubMed Central

Suk, William A.; Ahanchian, Hamid; Asante, Kwadwo Ansong; Carpenter, David O.; Diaz-Barriga, Fernando; Ha, Eun-Hee; Huo, Xia; King, Malcolm; Ruchirawat, Mathuros; da Silva, Emerson R.; Sly, Leith; Sly, Peter D.; Stein, Renato T.; van den Berg, Martin; Zar, Heather; Landrigan, Philip J.

2016-01-01

Summary Exposures to environmental pollutants during windows of developmental vulnerability in early life can cause disease and death in infancy and childhood as well as chronic, non-communicable diseases that may manifest at any point across the life span. Patterns of pollution and pollution-related disease change as countries move through economic development. Environmental pollution is now recognized as a major cause of morbidity and mortality in low- and middle-income countries (LMICs). According to the World Health Organization, pollution is responsible for 8.9 million deaths around the world each year; of these, 94% (8.4 million) are in LMICs. Toxic chemical pollution is growing into a major threat to children’s health in LMICs. The disease and disability caused by environmental pollution have great economic costs, and these costs can undercut trajectories of national development. To combat pollution, improved programs of public health and environmental protection are needed in countries at every level of development. Pollution control strategies and technologies that have been developed in high-income countries must now be transferred to LMICs to assist these emerging economies to avoid the mistakes of the past. A new international clearinghouse is needed to define and track the health effects of pollution, quantify the economic costs of these effects, and direct much needed attention to environmental pollution as a risk factor for disease. PMID:26930243

Environmental Pollution: An Under-recognized Threat to Children's Health, Especially in Low- and Middle-Income Countries.

PubMed

Suk, William A; Ahanchian, Hamid; Asante, Kwadwo Ansong; Carpenter, David O; Diaz-Barriga, Fernando; Ha, Eun-Hee; Huo, Xia; King, Malcolm; Ruchirawat, Mathuros; da Silva, Emerson R; Sly, Leith; Sly, Peter D; Stein, Renato T; van den Berg, Martin; Zar, Heather; Landrigan, Philip J

2016-03-01

Exposures to environmental pollutants during windows of developmental vulnerability in early life can cause disease and death in infancy and childhood as well as chronic, non-communicable diseases that may manifest at any point across the life span. Patterns of pollution and pollution-related disease change as countries move through economic development. Environmental pollution is now recognized as a major cause of morbidity and mortality in low- and middle-income countries (LMICs). According to the World Health Organization, pollution is responsible for 8.9 million deaths around the world each year; of these, 94% (8.4 million) are in LMICs. Toxic chemical pollution is growing into a major threat to children's health in LMICs. The disease and disability caused by environmental pollution have great economic costs, and these costs can undercut trajectories of national development. To combat pollution, improved programs of public health and environmental protection are needed in countries at every level of development. Pollution control strategies and technologies that have been developed in high-income countries must now be transferred to LMICs to assist these emerging economies to avoid the mistakes of the past. A new international clearinghouse is needed to define and track the health effects of pollution, quantify the economic costs of these effects, and direct much needed attention to environmental pollution as a risk factor for disease.

The impact of conditional cash transfers on child health in low- and middle-income countries: a systematic review.

PubMed

Owusu-Addo, Ebenezer; Cross, Ruth

2014-08-01

The review aimed to assess the effectiveness of conditional cash transfers (CCTs) in improving child health in low- and middle-income countries. Seven electronic databases were searched for papers: MEDLINE, EMBASE, PubMed, PsychINFO, BIOSIS Previews, Academic Search Complete, and CSA Sociological Abstracts. The included studies comprised of randomised controlled trials and controlled before-and-after studies evaluating the impact of CCTs on child health. Due to the substantial heterogeneity of the studies, a narrative synthesis was conducted on the extracted data. Sixteen studies predominantly from Latin American countries met the inclusion criteria. The outcomes reported by the studies in relation to CCTs' effectiveness in improving child health were reduction in morbidity risk, improvement in nutritional outcomes, health services utilisation, and immunisation coverage. The review suggests that to a large extent, CCTs are effective in improving child health by addressing child health determinants such as access to health care, child and maternal nutrition, morbidity risk, immunisation coverage, and household poverty in developing countries particularly middle-income countries. Of importance to both policy and practice, it appears that CCTs require effective functioning of health care systems to effectively promote child health.

Cardiovascular risk factor burden in Africa and the Middle East across country income categories: a post hoc analysis of the cross-sectional Africa Middle East Cardiovascular Epidemiological (ACE) study.

PubMed

Raal, Frederick J; Alsheikh-Ali, Alawi A; Omar, Mohamed I; Rashed, Wafa; Hamoui, Omar; Kane, Abdoul; Alami, Mohamed; Abreu, Paula; Mashhoud, Walid M

2018-01-01

A significant number of cardiovascular disease (CVD)-related deaths occur in developing countries. An increasing prevalence of CVD is associated with a change in the macro-economy of these countries. In this post hoc analysis, CVD risk factor (CVDRF) prevalence is evaluated across countries based on national income in the Africa and Middle East Region (AfME). Data from the Africa Middle East Cardiovascular Epidemiological (ACE) study were used; a cross-sectional study in 14 AfME countries (94 clinics) from July 2011-April 2012, which evaluated CVDRF prevalence in stable adult outpatients. World Bank definitions were used to classify countries as low-income (LI), lower-middle-income (LMI), upper-middle-income (UMI) or high-income (HI) countries. Four thousand three hundred seventy-eight subjects were recruited where 260 (6%), 1324 (30%), 1509 (35%) and 1285 (29%) were from LI, LMI, UMI, and HI countries, respectively. Of all the CVDRFs evaluated, almost two-thirds of the study population across the national income groups had abdominal obesity and dyslipidemia. Countries in the HI category were associated with a higher prevalence of diabetes (32%), obesity (44%) and smoking (16%). UMI and HI countries were associated with higher clustering of CVDRFs where at least one-third of subjects having four or more CVDRFs. Lower income countries had lower blood pressure control rates and lower percentages of outpatients achieving LDL-cholesterol targets. The burden of CVDRFs in stable outpatients is high across the national income categories in the AfME region, with HI countries showing a higher prevalence of CVDRFs. The high burden in lower income countries is associated with sub-optimal control of dyslipidemia and hypertension. Lowering the CVDRF burden would need specific public health actions in line with positive changes in the macro-economy of these countries. The ACE trial is registered under NCT01243138.

SEATCA Tobacco Industry Interference Index: a tool for measuring implementation of WHO Framework Convention on Tobacco Control Article 5.3

PubMed Central

Assunta, Mary; Dorotheo, E Ulysses

2016-01-01

Objective To measure the implementation of WHO Framework Convention on Tobacco Control (FCTC) Article 5.3 at country level using a new Tobacco Industry Interference Index and to report initial results using this index in seven Southeast Asian countries. Methods Score sheet based on WHO FCTC Article 5.3 Guidelines sent to correspondents in seven Southeast Asian countries, using a scoring system designed with the help of tobacco control experts and validated through focused group discussions. Results The seven countries ranked from the lowest level of interference to the highest are Brunei, Thailand, Lao PDR, Cambodia, Philippines, Malaysia and Indonesia. Countries that face high levels of unnecessary interaction with the tobacco industry also face high levels of tobacco industry influence in policy development. Most governments do not allow any tobacco industry representatives on their delegation to sessions of the Conference of the Parties or its subsidiary bodies nor accept their sponsorship for delegates, but most governments still accept or endorse offers of assistance from the tobacco industry in implementing tobacco control policies. Most governments also receive tobacco industry contributions (monetary or in kind) or endorse industry corporate social responsibility activities. Governments do not have a procedure for disclosing interactions with the tobacco industry, but Lao PDR, Philippines and Thailand have instituted measures to prevent or reduce industry interference. Conclusions This Tobacco Industry Interference Index, based on the WHO FCTC Article 5.3 Guidelines, is a useful advocacy tool for identifying both progress and gaps in national efforts at implementing WHO FCTC Article 5.3. PMID:25908597

How do output growth-rate distributions look like? Some cross-country, time-series evidence

NASA Astrophysics Data System (ADS)

Fagiolo, G.; Napoletano, M.; Roventini, A.

2007-05-01

This paper investigates the statistical properties of within-country gross domestic product (GDP) and industrial production (IP) growth-rate distributions. Many empirical contributions have recently pointed out that cross-section growth rates of firms, industries and countries all follow Laplace distributions. In this work, we test whether also within-country, time-series GDP and IP growth rates can be approximated by tent-shaped distributions. We fit output growth rates with the exponential-power (Subbotin) family of densities, which includes as particular cases both Gaussian and Laplace distributions. We find that, for a large number of OECD (Organization for Economic Cooperation and Development) countries including the US, both GDP and IP growth rates are Laplace distributed. Moreover, we show that fat-tailed distributions robustly emerge even after controlling for outliers, autocorrelation and heteroscedasticity.

"Fighting a hurricane": tobacco industry efforts to counter the perceived threat of Islam.

PubMed

Petticrew, Mark; Lee, Kelley; Ali, Haider; Nakkash, Rima

2015-06-01

Islamic countries are of key importance to transnational tobacco companies as growing markets with increasing smoking rates. We analyzed internal tobacco industry documents to assess the industry's response to rising concerns about tobacco use within Islamic countries. The tobacco industry perceived Islam as a significant threat to its expansion into these emerging markets. To counter these concerns, the industry framed antismoking views in Islamic countries as fundamentalist and fanatical and attempted to recruit Islamic consultants to portray smoking as acceptable. Tobacco industry lawyers also helped develop theological arguments in favor of smoking. These findings are valuable to researchers and policymakers seeking to implement culturally appropriate measures in Islamic countries under the World Health Organization Framework Convention on Tobacco Control.

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.

A training programme to build cancer research capacity in low- and middle-income countries: findings from Guatemala.

PubMed

Arnold, Lauren D; Barnoya, Joaquin; Gharzouzi, Eduardo N; Benson, Peter; Colditz, Graham A

2014-04-01

Guatemala is experiencing an increasing burden of cancer but lacks capacity for cancer prevention, control and research. In partnership with a medical school in the United States of America, a multidisciplinary Cancer Control Research Training Institute was developed at the Instituto de Cancerología (INCAN) in Guatemala City. This institute provided a year-long training programme for clinicians that focused on research methods in population health and sociocultural anthropology. The programme included didactic experiences in Guatemala and the United States as well as applied training in which participants developed research protocols responsive to Guatemala's cancer needs. Although INCAN is the point of referral and service for Guatemala's cancer patients, the institute's administration is also interested in increasing cancer research - with a focus on population health. INCAN is thus a resource for capacity building within the context of cancer prevention and control. Trainees increased their self-efficacy for the design and conduct of research. Value-added benefits included establishment of an annual cancer seminar and workshops in cancer pathology and qualitative analysis. INCAN has recently incorporated some of the programme's components into its residency training and established a research department. A training programme for clinicians can build cancer research capacity in low- and middle-income countries. Training in population-based research methods will enable countries such as Guatemala to gather country-specific data. Once collected, such data can be used to assess the burden of cancer-related disease, guide policy for reducing it and identify priority areas for cancer prevention and treatment.

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

Physician perspectives on the burden and management of asthma in six countries: The Global Asthma Physician Survey (GAPS).

PubMed

Chapman, Kenneth R; Hinds, David; Piazza, Peter; Raherison, Chantal; Gibbs, Michael; Greulich, Timm; Gaalswyk, Kenneth; Lin, Jiangtao; Adachi, Mitsuru; Davis, Kourtney J

2017-11-23

Despite recognition of asthma as a growing global issue and development of global guidelines, asthma treatment practices vary between countries. Several studies have reported patients' perspectives on asthma control. This study presents physicians' perspectives and strategies for asthma management. Physicians seeing ≥4 adult patients with asthma per month in Australia, Canada, China, France, Germany, and Japan were surveyed (N=1809; ≈300 per country). A standardised questionnaire was developed for this study and administered by telephone, online or face-to-face. Statistics were weighted to account for the sampling scheme. Physicians estimated that 71% of their adult patients received maintenance medication, with adherence monitored by 76-97% of physicians. Perceived major barriers to patient adherence included: patients taking treatment as needed; acceptance of symptoms; and patients not perceiving treatment benefits. Written action plans (37%) and technology (15%) were seldom employed by physicians to aid patients' asthma management. Physicians rarely (10%) used validated patient-reported questionnaires to monitor asthma control, instead monitoring selected symptoms, exacerbations, and/or lung function measurements. Awareness of single maintenance and reliever therapy (SMART/MART) varied among countries (56-100%); although most physicians (72%) had prescribed SMART/MART, the majority (91%) co-prescribed a short-acting bronchodilator at least some of the time. These results show that physicians generally do not employ standardised tools to monitor asthma control or to manage its treatment and that despite high awareness of SMART/MART, the strategy appears to be commonly misapplied. Better education for patients and physicians is required to improve asthma management and resulting patient outcomes.

Reported awareness of tobacco advertising and promotion in China compared to Thailand, Australia and the USA

PubMed Central

Li, L; Yong, H-H; Borland, R; Fong, G T; Thompson, M E; Jiang, Y; Yang, Y; Sirirassamee, B; Hastings, G; Harris, F

2009-01-01

Background: China currently does not have comprehensive laws or regulations on tobacco advertising and promotion, although it ratified the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in October 2005 and promised to ban all tobacco advertising by January 2011. Much effort is needed to monitor the current situation of tobacco advertising and promotion in China. Objective: This study aims to examine levels of awareness of tobacco advertising and promotion among smokers in China as compared to other countries with different levels of restrictions. Methods: One developing country (Thailand) and two developed countries (Australia and the USA) were selected for comparison. All four countries are part of the International Tobacco Control (ITC) Policy Evaluation Survey project. Between 2005 and 2006, parallel ITC surveys were conducted among adult smokers (at least smoked weekly) in China (n = 4763), Thailand (n = 2000), Australia (n = 1767) and the USA (n = 1780). Unprompted and prompted recall of noticing tobacco advertising and promotion were measured. Results: Chinese respondents reported noticing tobacco advertisements in a range of channels and venues, with highest exposure levels on television (34.5%), billboards (33.4%) and in stores (29.2%). A quarter of respondents noticed tobacco sponsorships, and a high level of awareness of promotion was reported. Cross-country comparison reveals that overall reported awareness was significantly higher in China than in Thailand (particularly) and Australia, but lower than in the USA. Conclusions: There is a big gap between China and the better-performing countries such as Thailand and Australia regarding tobacco promotion restrictions. China needs to do more, including enhanced policy and more robust enforcement. PMID:19332425

School closures during the 2009 influenza pandemic: national and local experiences

PubMed Central

2014-01-01

Background School closure is a non-pharmaceutical intervention that was considered in many national pandemic plans developed prior to the start of the influenza A(H1N1)pdm09 pandemic, and received considerable attention during the event. Here, we retrospectively review and compare national and local experiences with school closures in several countries during the A(H1N1)pdm09 pandemic. Our intention is not to make a systematic review of country experiences; rather, it is to present the diversity of school closure experiences and provide examples from national and local perspectives. Methods Data were gathered during and following a meeting, organized by the European Centres for Disease Control, on school closures held in October 2010 in Stockholm, Sweden. A standard data collection form was developed and sent to all participants. The twelve participating countries and administrative regions (Bulgaria, China, France, Hong Kong Special Administrative Region (SAR), Italy, Japan, New Zealand, Serbia, South Africa, Thailand, United Kingdom, and United States) provided data. Results Our review highlights the very diverse national and local experiences on school closures during the A(H1N1)pdm09 pandemic. The processes including who was in charge of making recommendations and who was in charge of making the decision to close, the school-based control strategies, the extent of school closures, the public health tradition of responses and expectations on school closure varied greatly between countries. Our review also discusses the many challenges associated with the implementation of this intervention and makes recommendations for further practical work in this area. Conclusions The single most important factor to explain differences observed between countries may have been the different public health practises and public expectations concerning school closures and influenza in the selected countries. PMID:24739814

How relevant is environmental quality to per capita health expenditures? Empirical evidence from panel of developing countries.

PubMed

Yahaya, Adamu; Nor, Norashidah Mohamed; Habibullah, Muzafar Shah; Ghani, Judhiana Abd; Noor, Zaleha Mohd

2016-01-01

Developing countries have witnessed economic growth as their GDP keeps increasing steadily over the years. The growth led to higher energy consumption which eventually leads to increase in air pollutions that pose a danger to human health. People's healthcare demand, in turn, increase due to the changes in the socioeconomic life and improvement in the health technology. This study is an attempt to investigate the impact of environmental quality on per capital health expenditure in 125 developing countries within a panel cointegration framework from 1995 to 2012. We found out that a long-run relationship exists between per capita health expenditure and all explanatory variables as they were panel cointegrated. The explanatory variables were found to be statistically significant in explaining the per capita health expenditure. The result further revealed that CO2 has the highest explanatory power on the per capita health expenditure. The impact of the explanatory power of the variables is greater in the long-run compared to the short-run. Based on this result, we conclude that environmental quality is a powerful determinant of health expenditure in developing countries. Therefore, developing countries should as a matter of health care policy give provision of healthy air a priority via effective policy implementation on environmental management and control measures to lessen the pressure on health care expenditure. Moreover more environmental proxies with alternative methods should be considered in the future research.

Effect of Video-Assisted Teaching Module (VATM) on Knowledge of ASHAs regarding RNTCP in Kuchinda Block of Sambalpur (Odisha).

PubMed

Pradhan, Malati; Dash, Bijayalakshmi

2015-05-01

Infectious disease is a major public health issue for both developed and developing countries. Among infectious diseases, tuberculosis (TB) is most prevalent in the develop- ing countries. India is the highest TB burden country in the world and accounts for nearly one fifth (20%) of global burden of tuberculosis. A pre-experimental design where pre- and post-test without control group with experimental approach was undertaken in Kuchinda block of Sambalpur district (Odisha) with the objectives to assess effectiveness of Video-assisted Teaching Module (VATM) on knowledge of Accredited Social Health Activists (ASHAs) regarding Revised National Tuberculosis Control Programme (RNTCP) Data were collected from 52 ASHAs, selected by systematic random sampling technique through structured questionnaire. The overall mean score in pre-test was 23.31±3.07 which is 58.27 percent of maximum score and good knowledge whereas it was 34.35±3.56 while post-test it was 85.87 percent of maximum score during post-test showing a difference of 27.6 percent effectiveness. Highly significant (p<0.01) differ- ence was found between pre- and post-test knowledge score and no significant (>0.05) association was found between post-test knowledge score when compared to all the demographic variables of ASHAs.

Role of Private Enterprise in Cancer Control in Low to Middle Income Countries

PubMed Central

Mahoney, Martin; Okoye, Ifeoma; Ejiogu, Kenneth; George, Saby; Dy, Grace; Jimoh, Mutiu; Salako, Omolola; Ilegbune, Oge; Chugani, Bindiya; Ezeome, Emmanuel; Popoola, Abiodun O.; Michalek, Arthur M.

2016-01-01

Background. About 65% of cancer deaths globally occur in low to middle income countries (LMICs) where prioritization and allocation of resources to cancer care are often quite poor. In the absence of governmental focus on this problem, public-private partnerships may be an avenue to provide effective cancer control. Methods. This manuscript highlights the establishment of a nongovernmental organization (NGO) to stimulate the development of partnerships between oncology professionals, private enterprise, and academic institutions, both locally and internationally. Examples of capacity building, grant support, establishment of collaborative networks, and the development of a facility to provide clinical care are highlighted. Results. Collaborations were established between oncology professionals at academic institutions in the US and Nigeria. Cancer control workshops were conducted in Nigeria with grant support from the Union for International Cancer Control (UICC). A monthly tumor board conference was established at LASUTH in Lagos, and further capacity building is underway with grant support from the United States NCI. An outpatient, privately funded oncology clinic in Lagos has been launched. Conclusion. In LMICs, effective partnership between public and private institutions can lead to tangible strides in cancer control. The use of creative healthcare financing models can also support positive change. PMID:28070189

The impact of tobacco control research on policy: 20 years of progress.

PubMed

Warner, Kenneth E; Tam, Jamie

2012-03-01

To assess progress in tobacco control policy research and the relevance of research to policy making. Over 100 experts were surveyed about their opinions on the body of research existing in 1992 and 2011 concerning 11 areas of tobacco control policy, the state of policy implementation in both years, the extent to which research has affected policy adoption and how experience with policy has influenced research. Case studies of how research and policy implementation have interacted were developed. The body of research was not judged 'substantial' in any of the policy areas in 1992. In 2011, 6 of the 11 areas were evaluated as substantial. None ranked as substantial regarding policy implementation in 1992, but by 2011 half were so ranked for developed countries; in low-income and middle-income countries policy implementation moved from very low to moderate. Respondents judged the role of research in actual policy making as 'substantial' regarding clean indoor air, taxation and cessation treatment policy. Case studies illustrate how research can directly affect policy (taxation), how policy and research can have iterative effects (clean indoor air), and how research and policy interact in the case of novel policies (graphic cigarette pack warnings). The role of research in the formulation of the Framework Convention on Tobacco Control is also examined. Policy research goals established in 1992 have been largely realised. For select tobacco control policies, research has made truly important contributions to saving lives. Evidence-based policy adoption will continue to be essential to minimising the toll of tobacco, especially in the world's poorer countries.

The SARE tool for rabies control: Current experience in Ethiopia.

PubMed

Coetzer, A; Kidane, A H; Bekele, M; Hundera, A D; Pieracci, E G; Shiferaw, M L; Wallace, R; Nel, L H

2016-11-01

The Stepwise Approach towards Rabies Elimination (SARE) tool was developed through a joint effort of the Food and Agriculture Organization (FAO) of the United Nations and the Global Alliance for Rabies Control (GARC), to provide a standard mechanism for countries to assess their rabies situation and measure progress in eliminating the disease. Because the African continent has the highest per capita death rate from rabies, and Ethiopia is estimated to have the second largest number of rabies deaths of all African countries, Ethiopia undertook a self-assessment by means of the Stepwise Approach towards Rabies Elimination (SARE) tool. In February 2016, the Ethiopian government hosted an intersectoral consultative meeting in an effort to assess the progress that has been made towards the control and elimination of canine rabies. The SARE assessment identified a number of critical gaps, including poor inter-sectoral collaboration and limited availability and access to dog vaccine, while the existence of a surveillance system for rabies and legislation for outbreak declaration and response were among the strengths identified. The SARE tool enabled key criteria to be prioritized, thereby accelerating the National Strategy and ensuring that Ethiopia will progress rapidly in line with the goals set by the global community for the elimination of human rabies deaths by 2030. Although the analysis showed that Ethiopia is still in the early stages of rabies control (Stage 0.5/5), the country shows great promise in terms of developing a SARE-guided National Rabies Prevention and Control Strategy. Copyright © 2016 Elsevier B.V. All rights reserved.

Turning the tide: national policy approaches to increasing physical activity in seven European countries.

PubMed

Bull, Fiona; Milton, Karen; Kahlmeier, Sonja; Arlotti, Alberto; Juričan, Andrea Backović; Belander, Olov; Martin, Brian; Martin-Diener, Eva; Marques, Ana; Mota, Jorge; Vasankari, Tommi; Vlasveld, Anita

2015-06-01

Physical inactivity is one of the four leading behavioural risk factors for non-communicable disease (NCD). Like tobacco control, increasing levels of health-enhancing physical activity (HEPA) will require a national policy framework providing direction and a clear set of actions. Despite frequent calls, there has been insufficient progress on policy development in the majority of countries around the world. This study sought and summarised national HEPA policy in seven European countries (Finland, Italy, the Netherlands, Norway, Portugal, Slovenia and Switzerland). Data collection used a policy audit tool (PAT), a 27-item instrument structured into four sections. All countries reported some legislation or policy across the sectors of education, sport and health. Only some countries reported supportive policy in the transport and environment sectors. Five countries reported a stand-alone HEPA policy and six countries reported national recommendations. HEPA prevalence targets varied in magnitude and specificity and the presence of other relevant goals from different sectors highlighted the opportunity for joint action. Evaluation and the use of scientific evidence were endorsed but described as weak in practice. Only two countries reported a national multisector coordinating committee and most countries reported challenges with partnerships on different levels of policy implementation. Bringing together the key components for success within a national HEPA policy framework is not simple. This in-depth policy audit and country comparison highlighted similarities and differences and revealed new opportunities for consideration by other countries. These examples can inform countries within and beyond Europe and guide the development of national HEPA policy within the NCD prevention agenda. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Validating the performance of vehicle classification stations : executive summary report.

DOT National Transportation Integrated Search

2012-05-01

Vehicle classification data are used in many transportation applications, including: pavement design, : environmental impact studies, traffic control, and traffic safety. Typical of most developed countries, every : state in the US maintains a networ...

A proposal for cervical screening information systems in developing countries.

PubMed

Marrett, Loraine D; Robles, Sylvia; Ashbury, Fredrick D; Green, Bo; Goel, Vivek; Luciani, Silvana

2002-11-20

The effective and efficient delivery of cervical screening programs requires information for planning, management, delivery and evaluation. Specially designed systems are generally required to meet these needs. In many developing countries, lack of information systems constitutes an important barrier to development of comprehensive screening programs and the effective control of cervical cancer. Our report outlines a framework for creating such systems in developing countries and describes a conceptual model for a cervical screening information system. The proposed system is modular, recognizing that there will be considerable between-region heterogeneity in current status and priorities. The proposed system is centered on modules that would allow for the assembly and computerization of data on Pap tests, since these represent the main screening modality at the present time. Additional modules would process data and create and maintain a screening database (e.g., standardize, edit, link and update modules) and allow for the integration of other types of data, such as cervical histopathology results. An open systems development model is proposed, since it is most compatible with the goals of local stakeholder involvement and capacity-building. Copyright 2002 Wiley-Liss, Inc.

Global Status of DDT and Its Alternatives for Use in Vector Control to Prevent Disease

PubMed Central

van den Berg, Henk

2009-01-01

Objective I review the status of dichlorodiphenyltrichloroethane (DDT), used for disease vector control, along with current evidence on its benefits and risks in relation to the available alternatives. Data sources and extraction Contemporary data on DDT use were largely obtained from questionnaires and reports. I also conducted a Scopus search to retrieve published articles. Data synthesis DDT has been recommended as part of the arsenal of insecticides available for indoor residual spraying until suitable alternatives are available. Approximately 14 countries use DDT for disease control, and several countries are preparing to reintroduce DDT. The effectiveness of DDT depends on local settings and merits close consideration in relation to the alternatives. Concerns about the continued use of DDT are fueled by recent reports of high levels of human exposure associated with indoor spraying amid accumulating evidence on chronic health effects. There are signs that more malaria vectors are becoming resistant to the toxic action of DDT, and that resistance is spreading to new countries. A comprehensive cost assessment of DDT versus its alternatives that takes side effects into account is missing. Effective chemical methods are available as immediate alternatives to DDT, but the choice of insecticide class is limited, and in certain areas the development of resistance is undermining the efficacy of insecticidal tools. New insecticides are not expected in the short term. Nonchemical methods are potentially important, but their effectiveness at program level needs urgent study. Conclusions To reduce reliance on DDT, support is needed for integrated and multipartner strategies of vector control and for the continued development of new technologies. Integrated vector management provides a framework for developing and implementing effective technologies and strategies as sustainable alternatives to reliance on DDT. PMID:20049114

Malaria and tuberculosis: our concerns.

PubMed

Shiva, M

1997-01-01

In 1978 the concept of primary health care was adopted by 116 countries at Alma Ata, yet the negative impact of structural readjustment programs in Africa and South America could be felt due to the cuts in expenditures on health, education, and social matters. The result is a resurgence of communicable diseases such as malaria and tuberculosis. Another factor in this resurgence is extreme poverty. In 1994 over 1000 people died in Rajasthan, India, of a malaria epidemic, and during the same time in Delhi over 300 deaths were attributed to hemorrhagic dengue fever. Malariogenic and tuberculous conditions continue to flourish owing to distorted development patterns and commercialization of medical care as public health and community health services are being replaced by profit-oriented curative care, 80% of which is in private hands. This has resulted in spiraling medical care costs and rural indebtedness. Socioeconomic deprivation in developing countries threatens TB control. Factors contributing to the spread of TB were established in 1899 and are still valid in India and other developing countries: TB contamination of air, inadequate food, overcrowded dwelling, and low state of physical health. Even in developed countries TB is on the rise: there were 172 cases in 1991 in England vs. 305 cases in 1993, half of them among immigrants. The increase occurred in the poorest 30% of the population. The World Bank is providing loans for a revised TB and malaria strategy, and the Disability Adjusted Life Year has been used to identify the greatest burden of diseases. On the other hand, the Indian National Health Policy has not been revised since 1983. Priority must be given to those living in extreme poverty to curb the resurgence of once controlled diseases.

Effectiveness of the tailored EBP training program for Filipino physiotherapists: a randomised controlled trial.

PubMed

Dizon, Janine Margarita; Grimmer-Somers, Karen; Kumar, Saravana

2011-04-13

Evidence implementation continues to challenge health professionals most especially those from developing countries. Filipino physiotherapists represent a group of health professionals in a developing country who by tradition and historical practice, take direction from a doctor, on treatment options. Lack of autonomy in decision-making challenges their capacity to deliver evidence-based care. However, this scenario should not limit them from updating and up-skilling themselves on evidence- based practice (EBP). EBP training tailored to their needs and practice was developed to address this gap. This study will be conducted to assess the effectiveness of a tailored EBP-training program for Filipino physiotherapists, in improving knowledge, skills, attitudes and behaviour to EBP. Participation in this program aims to improve capacity to EBP and engage with referring doctors to determine the most effective treatments for their patients. A double blind randomised controlled trial, assessing the effectiveness of the EBP training intervention, compared with a waitlist control, will be conducted. An adequately powered sample of 54 physiotherapists from the Philippines will be recruited and randomly allocated to EBP intervention or waitlist control. The EBP program for Filipino physiotherapists is a one-day program on EBP principles and techniques, delivered using effective adult education strategies. It consists of lectures and practical workshops. A novel component in this program is the specially-developed recommendation form, which participants can use after completing their training, to assist them to negotiate with referring doctors regarding evidence-based treatment choices for their patients.Pre and post measures of EBP knowledge, skills and attitudes will be assessed in both groups using the Adapted Fresno Test and the Questions to EBP attitudes. Behaviour to EBP will be measured using activity diaries for a period of three months. Should the EBP-training program be found to be effective in improving EBP-uptake in Filipino physiotherapists, it will form the basis of a much needed national intervention which is contextually appropriate to Filipino physiotherapists. It will therefore form the genesis for a model for building EBP capacity of other health professionals in the Philippines as well as physiotherapists in developing countries. Current Controlled Trials: ISRCTN74485061.

Subunit vaccines for the prevention of mucosal infection with Chlamydia trachomatis

PubMed Central

Yu, Hong; Karunakaran, Karuna P.; Jiang, Xiaozhou; Brunham, Robert C.

2016-01-01

Chlamydia trachomatis is the most common preventable cause of tubal infertility in women. In high-income countries, despite public health control efforts, C. trachomatis case rates continue to rise. Most medium and low-income countries lack any Chlamydia control program; therefore, a vaccine is essential for the control of Chlamydia infections. A rationally designed Chlamydia vaccine requires understanding of the immunological correlates of protective immunity, pathological responses to this mucosal pathogen, identification of optimal vaccine antigens and selection of suitable adjuvant delivery systems that engender protective immunity. Fortunately, Chlamydia vaccinology is facilitated by genomic knowledge and by murine models that reproduce many of the features of human C. trachomatis infection. This article reviews recent progress in these areas with a focus on subunit vaccine development. PMID:26938202

Public Health Interventions for Control of Malaria in the Population Living in the Terai Region of Nepal.

PubMed

Awasthi, Kiran Raj; Adefemi, Kazeem; Awasthi, Mamata Sherpa; Chalise, Binaya

2018-01-01

Infectious diseases are a major problem for developing countries. Controlling and eradicating these diseases have remained a challenge because of the multitudes of social and environmental factors involved. However, a multi-sectoral and collective effort in dealing with these diseases has been shown to result in positive outcomes. This paper looks at the current situation of Malaria in Nepal and a population that is at high risk. It explains the impact that social and environmental determinants have on this target population. This review then critically examines the various possible public health interventions that could potentially help in the control of malaria in this high risk population, drawing from evidences and experiences reported from other countries with suggestions for adapting these interventions to the Nepali environment.

Comperative investigations of non chemical weed management methods in Hungary.

PubMed

Pali, Orsolya; Reisinger, Peter; Pomsar, Peter

2007-01-01

Organic farming has an increasing tendency in Hungary because of growing consumers' demands according to organic products not only in inland but also in the countries of the European Union. Developments of weed control methods in organically cropped field plants have become conspicuous next to developing chemical weed management methods of convencionally cropped cultural plants. The aim of our investigations was to make comperative investigations of non chemical weed control methods in wide rowed plants.

Motion of a Moving Object

NASA Technical Reports Server (NTRS)

1998-01-01

SpaceAge Control, Inc., was established in 1968 to design, develop and manufacture pilot protection devices in support of space-based and high-performance test aircraft programs. In 1970, the company was awarded a NASA contract to produce precision, small-format position transducers for aircraft flight control testing. The successful completion of this contract led to the development and production of a complete line of position transducers. Today the company has over 600 customers in 20 industries and over 30 countries.

Parasites and vectors carry no passport: how to fund cross-border and regional efforts to achieve malaria elimination

PubMed Central

2012-01-01

Background Tremendous progress has been made in the last ten years in reducing morbidity and mortality caused by malaria, in part because of increases in global funding for malaria control and elimination. Today, many countries are striving for malaria elimination. However, a major challenge is the neglect of cross-border and regional initiatives in malaria control and elimination. This paper seeks to better understand Global Fund support for multi-country initiatives. Methods Documents and proposals were extracted and reviewed from two main sources, the Global Fund website and Aidspan.org. Documents and reports from the Global Fund Technical Review Panel, Board, and Secretariat documents such as guidelines and proposal templates were reviewed to establish the type of policies enacted and guidance provided from the Global Fund on multi-country initiatives and applications. From reviewing this information, the researchers created 29 variables according to eight dimensions to use in a review of Round 10 applications. All Round 10 multi-country applications (for HIV, malaria and tuberculosis) and all malaria multi-country applications (6) from Rounds 1 – 10 were extracted from the Global Fund website. A blind review was conducted of Round 10 applications using the 29 variables as a framework, followed by a review of four of the six successful malaria multi-country grant applications from Rounds 1 – 10. Findings During Rounds 3 – 10 of the Global Fund, only 5.8% of grants submitted were for multi-country initiatives. Out of 83 multi-country proposals submitted, 25.3% were approved by the Technical Review Panel (TRP) for funding, compared to 44.9% of single-country applications. The majority of approved multi-country applications were for HIV (76.2%), followed by malaria (19.0%), then tuberculosis (4.8%). TRP recommendations resulted in improvements to application forms, although guidance was generally vague. The in-depth review of Round 10 multi-country proposals showed that applicants described their projects in one of two ways: a regional ‘network approach’ by which benefits are derived from economies of scale or from enhanced opportunities for mutual support and learning or the development of common policies and approaches; or a ‘cross-border’ approach for enabling activities to be more effectively delivered towards border-crossing populations or vectors. In Round 10, only those with a ‘network approach’ were recommended for funding. The Global Fund has only ever approved six malaria multi-country applications. Four approved applications stated strong arguments for a multi-country initiative, combining both ‘cross-border’ and ‘network’ approaches. Conclusion With the cancellation of Round 11 and the proposal that the Global Fund adopt a more targeted and strategic approach to funding, the time is opportune for the Global Fund to develop a clear consensus about the key factors and criteria for funding malaria specific multi-country initiatives. This study found that currently there was a lack of guidance on the key features that a successful multi-country proposal needs to be approved and that applications directed towards the ‘network’ approach were most successful in Round 10. This type of multi-country proposal may favour other diseases such as HIV, whereas the need for malaria control and elimination is different, focusing on cross-border coordination and delivery of interventions to specific groups. The Global Fund should seek to address these issues and give better guidance to countries and regions and investigate disease-specific calls for multi-country and regional applications. PMID:23057734

Lessons from New Zealand's introduction of pictorial health warnings on tobacco packaging.

PubMed

Hoek, Janet; Wilson, Nick; Allen, Matthew; Edwards, Richard; Thomson, George; Li, Judy

2010-11-01

While international evidence suggests that featuring pictorial health warnings on tobacco packaging is an effective tobacco control intervention, the process used to introduce these new warnings has not been well documented. We examined relevant documents and interviewed officials responsible for this process in New Zealand. We found that, despite tobacco companies' opposition to pictorial health warnings and the resource constraints facing health authorities, the implementation process was generally robust and successful. Potential lessons for other countries planning to introduce or refresh existing pictorial health warnings include: (i) strengthening the link between image research and policy; (ii) requiring frequent image development and refreshment; (iii) using larger pictures (e.g. 80% of the front of the packet); (iv) developing themes that recognize concerns held by different smoker sub-groups; and (v) running integrated mass media campaigns when the warnings are introduced. All countries could also support moves by the World Health Organization Framework Convention on Tobacco Control's Secretariat to develop an international bank of copyright-free warnings.

Biologically Based Methods for Control of Fumonisin-Producing Fusarium Species and Reduction of the Fumonisins.

PubMed

Alberts, Johanna F; van Zyl, Willem H; Gelderblom, Wentzel C A

2016-01-01

Infection by the fumonisin-producing Fusarium spp. and subsequent fumonisin contamination of maize adversely affect international trade and economy with deleterious effects on human and animal health. In developed countries high standards of the major food suppliers and retailers are upheld and regulatory controls deter the importation and local marketing of fumonisin-contaminated food products. In developing countries regulatory measures are either lacking or poorly enforced, due to food insecurity, resulting in an increased mycotoxin exposure. The lack and poor accessibility of effective and environmentally safe control methods have led to an increased interest in practical and biological alternatives to reduce fumonisin intake. These include the application of natural resources, including plants, microbial cultures, genetic material thereof, or clay minerals pre- and post-harvest. Pre-harvest approaches include breeding for resistant maize cultivars, introduction of biocontrol microorganisms, application of phenolic plant extracts, and expression of antifungal proteins and fumonisin degrading enzymes in transgenic maize cultivars. Post-harvest approaches include the removal of fumonisins by natural clay adsorbents and enzymatic degradation of fumonisins through decarboxylation and deamination by recombinant carboxylesterase and aminotransferase enzymes. Although, the knowledge base on biological control methods has expanded, only a limited number of authorized decontamination products and methods are commercially available. As many studies detailed the use of natural compounds in vitro, concepts in reducing fumonisin contamination should be developed further for application in planta and in the field pre-harvest, post-harvest, and during storage and food-processing. In developed countries an integrated approach, involving good agricultural management practices, hazard analysis and critical control point (HACCP) production, and storage management, together with selected biologically based treatments, mild chemical and physical treatments could reduce fumonisin contamination effectively. In rural subsistence farming communities, simple, practical, and culturally acceptable hand-sorting, maize kernel washing, and dehulling intervention methods proved to be effective as a last line of defense for reducing fumonisin exposure. Biologically based methods for control of fumonisin-producing Fusarium spp. and decontamination of the fumonisins could have potential commercial application, while simple and practical intervention strategies could also impact positively on food safety and security, especially in rural populations reliant on maize as a dietary staple.

Using a Morphine Equivalence Metric to Quantify Opioid Consumption: Examining the Capacity to Provide Effective Treatment of Debilitating Pain at the Global, Regional, and Country Levels

PubMed Central

Gilson, Aaron M.; Maurer, Martha A.; Ryan, Karen M.; Cleary, James F.; Rathouz, Paul J.

2014-01-01

Context Morphine has been considered the gold standard for treating moderate to severe pain, although many new opioid products and formulations have been marketed in the last two decades and should be considered when examining opioid consumption. Understanding opioid consumption is improved by using an equianalgesic measure that controls for the strengths of all examined opioids. Objectives The research objective was to utilize a morphine equivalence metric to determine the extent that morphine consumption relates to the total consumption of all other study opioids. Methods A Morphine Equivalence (ME) metric was created for morphine and for the aggregate consumption of each study opioid (Total ME), adjusted for country population to allow for uniform equianalgesic comparisons. Graphical and statistical evaluations of morphine use and Total ME consumption trends (between 1980 and 2009) were made for the global and geographic regional levels, and for selected developed and developing countries. Results Global morphine consumption rose dramatically in the early 1980s but has been significantly outpaced by Total ME since 1996. As expected, the extent of morphine and Total ME consumption varied notably among regions, with the Americas, Europe, and Oceania regions accounting for the highest morphine use and Total ME in 2009. Developing and least developed countries, compared to developed countries, demonstrated lower overall Total ME consumption. Conclusion Generally, worldwide morphine use has not increased at the rate of Total ME, especially in recent years. Examining a country's ability to effectively manage moderate to severe pain should extend beyond morphine to account for all available potent opioids. PMID:23017614

The state of world population and its implications for the US.

PubMed

Fornos, W

1987-07-01

Before the end of the century, annual world population growth is expected to exceed 90 million. Among the consequences of this rapid population growth--most of which will take place in developing countries-- are environmental degradation, urban deterioration, unemployment, hunger, resource depletion, and economic stagnation. Despite this alarming situation, the US Government has reduced appropriations for international population aid from US$290 million in 1985 to $200 million in 1988. In addition, the US has stopped funding the 2 organizations that have been most effective in providing family planning assistance to developing countries: the United Nations Fund for Population Activities and the International Planned Parenthood Federation. The US has adapted a policy that asserts that population is a neutral factor in development and promotes capitalism as a means of lowering fertility. However, experience in developing countries such as Thailand, China, and the Philippines that have undergone dramatic fertility declines attests that family planning efforts can result in economic growth. Over 80% of developing countries have established population control policies yet they will require substantial financial and technical aid from industrialized nations. It is ironic that the US has turned away from a commitment to helping poor countries to voluntarily reduce their high fertility rates at a time when such countries have accepted the necessity of such a goal. It is further ironic that the US expresses concern about the threat of revolution in areas such as Central America, yet fails to comprehend the social unrest and threats to global stability that will emerge as a result of continued population growth. At least a doubling--preferably a tripling--of US population assistance is needed.

Fortification of flour with folic acid.

PubMed

Berry, Robert J; Bailey, Lynn; Mulinare, Joe; Bower, Carol

2010-03-01

After randomized, controlled trials established that consumption of folic acid before pregnancy and during the early weeks of gestation reduces the risk of a neural tube defect (NTD)-affected pregnancy, the United States Public Health Service recommended in 1992 that all women capable of becoming pregnant consume 400 microg folic acid daily. In 1998, folic acid fortification of all enriched cereal grain product flour was fully implemented in the United States and Canada. To provide guidance on national fortification of wheat and maize flours to prevent 50 to 70% of the estimated 300,000 NTD-affected pregnancies worldwide. An expert workgroup reviewed the latest evidence of effectiveness of folic acid flour fortification and the safety of folic acid. Recent estimates show that in the United States and Canada, the additional intake of about 100 to 150 microg/day of folic acid through food fortification has been effective in reducing the prevalence of NTDs at birth and increasing blood folate concentrations in both countries. Most potential adverse effects associated with folic acid are associated with extra supplement use not mandatory fortification. Fortification of wheat flour has a proven record of prevention in other developed countries. In 2009, 51 countries had regulations written for mandatory wheat flour fortification programs that included folic acid. NTDs remain an important cause of perinatal mortality and infantile paralysis worldwide. Mandatory fortification of flour with folic acid has proved to be one of the most successful public health interventions in reducing the prevalence of NTD-affected pregnancies. Most developing countries have few, if any, common sources of folic acid, unlike many developed countries, which have folic acid available from ready-to-eat cereals and supplements. Expanding the number of developed and developing countries with folic acid flour fortification has tremendous potential to safely eliminate most folic acid-preventable NTDs.

Pneumocystis and Pneumocystosis: first meeting of experts from Latin-American and Portuguese-speaking countries - a mini-review.

PubMed

Esteves, Francisco; Medrano, Francisco J; de Armas, Yaxsier; Wissmann, Gustavo; Calderón, Enrique J; Matos, Olga

2014-05-01

The Pneumocystis and Pneumocystosis: first meeting of experts from Latin-American and Portuguese-speaking countries was held in Lisbon, Portugal, on 24-26 October 2013. A total of 20 speakers from Latin America, Africa and Europe participated in the meeting. The epidemiological studies presented in this meeting begin to change the misconception that since the AIDS epidemic, Pneumocystis pneumonia (PcP) has become an infrequent disease, showing that today PcP remains a major opportunistic infection in HIV-infected patients in both developed and developing countries and an emerging problem in immunocompromised patients without HIV infection worldwide. PcP management remains a challenge. Right now, the combination of caspofungin and trimethoprim-sulfamethoxazole (TMP-SMX) is a promising therapeutic approach that needs to be assessed in controlled clinical trials.

[Tuberculosis and diabetes co-morbidity: an unresolved problem].

PubMed

Ugarte-Gil, César; Moore, David A J

2014-01-01

Co-morbidity between tuberculosis and diabetes has been described since the early 20th century. In developed countries, where there has been a decrease of infectious diseases with an increase of non-communicable diseases, as well as those countries who still have a high prevalence of infectious diseases but an increase of non-communicable diseases, it is observed that the prevalence of co-morbidity between tuberculosis and diabetes is increasing, making clinical management and control at the public health level a new challenge for health systems. This review aims to show the current available evidence that can inform research lines being developed to understand the problem. In countries like Peru, where there is an epidemiological transition, further research could allow us to understand and describe in a better way the characteristics and impact of this co-morbidity.

Disparities in birth weight and gestational age by ethnic ancestry in South American countries.

PubMed

Wehby, George L; Gili, Juan A; Pawluk, Mariela; Castilla, Eduardo E; López-Camelo, Jorge S

2015-03-01

We examine disparities in birth weight and gestational age by ethnic ancestry in 2000-2011 in eight South American countries. The sample included 60,480 singleton live births. Regression models were estimated to evaluate differences in birth outcomes by ethnic ancestry controlling for time trends. Significant disparities were found in seven countries. In four countries-Brazil, Ecuador, Uruguay, and Venezuela-we found significant disparities in both low birth weight and preterm birth. Disparities in preterm birth alone were observed in Argentina, Bolivia, and Colombia. Several differences in continuous birth weight, gestational age, and fetal growth rate were also observed. There were no systematic patterns of disparities between the evaluated ethnic ancestry groups across the study countries, in that no racial/ethnic group consistently had the best or worst outcomes in all countries. Racial/ethnic disparities in infant health are common in several South American countries. Differences across countries suggest that racial/ethnic disparities are driven by social and economic mechanisms. Researchers and policymakers should acknowledge these disparities and develop research and policy programs to effectively target them.

Success Counteracting Tobacco Company Interference in Thailand: An Example of FCTC Implementation for Low- and Middle-income Countries

PubMed Central

Charoenca, Naowarut; Mock, Jeremiah; Kungskulniti, Nipapun; Preechawong, Sunida; Kojetin, Nicholas; Hamann, Stephen L.

2012-01-01

Transnational tobacco companies (TTCs) interfere regularly in policymaking in low- and middle-income countries (LMICs). The WHO Framework Convention for Tobacco Control provides mechanisms and guidance for dealing with TTC interference, but many countries still face ‘how to’ challenges of implementation. For more than two decades, Thailand’s public health community has been developing a system for identifying and counteracting strategies TTCs use to derail, delay and undermine tobacco control policymaking. Consequently, Thailand has already implemented most of the FCTC guidelines for counteracting TTC interference. In this study, our aims are to describe strategies TTCs have used in Thailand to interfere in policymaking, and to examine how the public health community in Thailand has counteracted TTC interference. We analyzed information reported by three groups with a stake in tobacco control policies: Thai tobacco control advocates, TTCs, and international tobacco control experts. To identify TTC viewpoints and strategies, we also extracted information from internal tobacco industry documents. We synthesized these data and identified six core strategies TTCs use to interfere in tobacco control policymaking: (1) doing business with ‘two faces’, (2) seeking to influence people in high places, (3) ‘buying’ advocates in grassroots organizations, (4) putting up a deceptive front, (5) intimidation, and (6) undermining controls on tobacco advertising, promotion and sponsorship. We present three case examples showing where TTCs have employed multiple interference strategies simultaneously, and showing how Thai tobacco control advocates have successfully counteracted those strategies by: (1) conducting vigilant surveillance, (2) excluding tobacco companies from policymaking, (3) restricting tobacco company sales, (4) sustaining pressure, and (5) dedicating resources to the effective enforcement of regulations. Policy implications from this study are that tobacco control advocates in LMICs may be able to develop countermeasures similar to those we identified in Thailand based on FCTC guidelines to limit TTC interference. PMID:22690186

Success counteracting tobacco company interference in Thailand: an example of FCTC implementation for low- and middle-income countries.

PubMed

Charoenca, Naowarut; Mock, Jeremiah; Kungskulniti, Nipapun; Preechawong, Sunida; Kojetin, Nicholas; Hamann, Stephen L

2012-04-01

Transnational tobacco companies (TTCs) interfere regularly in policymaking in low- and middle-income countries (LMICs). The WHO Framework Convention for Tobacco Control provides mechanisms and guidance for dealing with TTC interference, but many countries still face 'how to' challenges of implementation. For more than two decades, Thailand's public health community has been developing a system for identifying and counteracting strategies TTCs use to derail, delay and undermine tobacco control policymaking. Consequently, Thailand has already implemented most of the FCTC guidelines for counteracting TTC interference. In this study, our aims are to describe strategies TTCs have used in Thailand to interfere in policymaking, and to examine how the public health community in Thailand has counteracted TTC interference. We analyzed information reported by three groups with a stake in tobacco control policies: Thai tobacco control advocates, TTCs, and international tobacco control experts. To identify TTC viewpoints and strategies, we also extracted information from internal tobacco industry documents. We synthesized these data and identified six core strategies TTCs use to interfere in tobacco control policymaking: (1) doing business with 'two faces', (2) seeking to influence people in high places, (3) 'buying' advocates in grassroots organizations, (4) putting up a deceptive front, (5) intimidation, and (6) undermining controls on tobacco advertising, promotion and sponsorship. We present three case examples showing where TTCs have employed multiple interference strategies simultaneously, and showing how Thai tobacco control advocates have successfully counteracted those strategies by: (1) conducting vigilant surveillance, (2) excluding tobacco companies from policymaking, (3) restricting tobacco company sales, (4) sustaining pressure, and (5) dedicating resources to the effective enforcement of regulations. Policy implications from this study are that tobacco control advocates in LMICs may be able to develop countermeasures similar to those we identified in Thailand based on FCTC guidelines to limit TTC interference.

[Strategies for reducing risks in smoking: opportunity or threat].

PubMed

Córdoba, Rodrigo; Nerín, Isabel

2009-12-01

The smoking control policies recommended by the World Health Organisation have achieved a slight decrease in smoking prevalence in the developed countries, although associated mortality is still very high. The use of tobacco products other than cigarettes and even medicinal nicotine (known as nicotine replacement therapy (NRT)) has been proposed as a risk reduction strategy. Among the tobacco products with less individual risk than cigarettes would be any type of tobacco without smoke (smokeless) with a low content in nitrosamines and modified cigarettes; both forms included under the PREP (Potentially Reduced Exposure Products) concept. The idea would be to promote these products among those who cannot quit smoking or wish to reduce their risk without giving up nicotine intake. The possible effects of risk reduction strategies, including PREP, on the decreased prevalence and morbidity and mortality are reviewed, and the possible implications that this measure could have in our country are analysed. Tobacco control measures in Spain are recent and still insufficient. Therefore, the current priority in Spain is the development of policies of control that have shown to more than effective. The marketing and advertising of new tobacco products, even with reduced potential risk, seems more a serious threat than an opportunity for the development of smoking control policies.

Migration and its influence on the knowledge and usage of birth control methods among Afghan women who stay behind.

PubMed

Roosen, I; Siegel, M

2018-05-01

The objective of this article is to investigate the link between migration and knowledge and use of birth control methods among female household members (of migrants) who stay behind in Afghanistan. Migrants can remit birth control information received in the destination country to non-migrants staying in the origin country, who may as a consequence adjust their health behaviour accordingly. The consequences of this interaction for knowledge and use are what we aim to test. Population-based secondary analysis of cross-sectional data. This study used cross-sectional data from the Afghan Mortality Survey (2010). Using ordinary least squares regression and propensity score matching, this research studies to what extent having a migrant in the household influences the knowledge and use of birth control among non-migrant Afghan women. Women who stay behind are defined in this research as those with a migrant household member who moved between 2005 and 2010. Results indicated that non-Pashtun women with a migrant household member showed greater knowledge of contraceptive methods using injectables, birth control pill and lactational amenorrhea method compared to those women without a migrant household member. Less knowledge of male sterilisation and emergency contraception is observed for all women (both Pashtun and non-Pashtun) with a migrant in their household on male sterilisation and emergency contraception compared to the women without a migrant in the household. In addition, we show that Pashtun women with a migrant in the household had lower levels of overall knowledge and were less likely to use birth control methods than women without a migrant household member. In Afghanistan, given the proximity, religious similarity and sociocultural customs mainly men migrate either to Pakistan or Iran. The findings suggest that migrants in different destination countries transfer different information (or fail to successfully transfer information) about birth control methods to members of their transnational networks, compounding disparities in knowledge and use of birth control methods among women staying in the origin country. Migrants have the potential to be health-related development agents, but the health information migrants receive while abroad and remit back to their home countries varies by destination country context. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

[Urbanization in tropical countries].

PubMed

Amat-Roze, J M

1983-01-01

Rural populations are still the most numerous in tropical countries. But we can witness an unprecedent process of urbanization. However the dynamics of the phenomenon differs greatly in different countries and in different towns. As a matter of fact, the greatest overcrowded metropolis attract the greatest part of the migrants from rural areas; the attractive factors are multifarious and universal. This not easily controllable trend seems to be irreversible. The migrant farmers will generally find a job within the informed economic sector. The zones of spontaneous and precarious settlement are often their first environmental living conditions. Some of these unhealthy dwelling areas are subject to development plans; some of them being extremely well designed.

Financing children's vaccines.

PubMed

Nelson, E Anthony S; Sack, David; Wolfson, Lara; Walker, Damian G; Seng, Lim Fong; Steele, Duncan

2009-11-20

A 2006 Commonwealth Association of Paediatric Gastroenterology and Nutrition workshop on financing children's vaccines highlighted the potential for vaccines to control diarrhoea and other diseases as well as spur economic development through better health. Clear communication of vaccination value to decision-makers is required, together with sustainable funding mechanisms. GAVI and partners have made great progress providing funding for vaccines for children in the poorest countries but other solutions may be required to achieve the same gains in middle- and high-income countries. World Health Organization has a wealth of freely available country-level data on immunisation that academics and advocates can use to communicate the economic and health benefits of vaccines to decision-makers.

Can a bank crisis break your heart?

PubMed Central

Stuckler, David; Meissner, Christopher M; King, Lawrence P

2008-01-01

Background To assess whether a banking system crisis increases short-term population cardiovascular mortality rates. Methods International, longitudinal multivariate regression analysis of cardiovascular disease mortality data from 1960 to 2002 Results A system-wide banking crisis increases population heart disease mortality rates by 6.4% (95% CI: 2.5% to 10.2%, p < 0.01) in high income countries, after controlling for economic change, macroeconomic instability, and population age and social distribution. The estimated effect is nearly four times as large in low income countries. Conclusion Banking crises are a significant determinant of short-term increases in heart disease mortality rates, and may have more severe consequences for developing countries. PMID:18197979

Drug-resistant tuberculosis in the European Union: opportunities and challenges for control.

PubMed

Fears, Robin; Kaufmann, Stefan; Ter Meulen, Volker; Zumla, Alimuddin

2010-05-01

Tuberculosis (TB) is a leading cause of death globally. TB had been considered conquered in Europe but has re-emerged as a significant problem, partly because of poor TB control programs and the link with HIV infection, migrants and other vulnerable populations, but also because a mood of complacency led to declining investment in research and public health infrastructure. In the European Union (EU), efforts initiated by the European Academies Science Advisory Council (EASAC) now assess how research can better inform policy development and indicate the gaps and uncertainties in the scientific evidence base. A growing number of Mycobacterium tuberculosis (Mtb) strains are now resistant to the first-line anti-TB drugs, necessitating use of second-line drugs which are more expensive, less effective and more toxic. The presence of extensively drug-resistant (XDR) TB in the EU illustrates that there are problems with TB management and control. In the EU, the aggregated rate of notified TB is approximately 18 cases per 100,000 population (range 4-120 cases/100,000 in different Member States). The highest rates are found in Eastern European countries. Only about half of EU countries routinely perform drug susceptibility testing linked to notification of TB cases. It is important for the European Commission (EC) to network regional reference laboratories to support molecular epidemiology and exchange of data via creation of interactive international databases of Mtb genotypic and phenotypic information. EU countries should help develop TB laboratory services by investing in training and provision of assistance to maintain quality control in neighbouring Eastern European countries. Improved TB care necessitates research across the spectrum to include fundamental and epidemiological science, research and development (R&D) for new drugs, diagnostics, vaccines, and operational research. Total R&D investment in TB by the EC and Member States is low by comparison with the USA despite Europe being on the frontline of the epidemic. Thus, alternative funding models for targeting TB research priorities by the EU are required. Increasing the visibility of TB as a priority issue for the EU requires the scientific community, with the academies of science, as appropriate, to communicate to politicians, healthcare providers, funders and the public at large about the current threat posed by drug-resistant TB. Any global strategy for TB control must also take into account measures to address the social, environmental and economic issues which are inextricably linked with TB. The academies conclude that, overall, the EU has failed so far to respond sufficiently to the global TB threat but can still draw on considerable strengths in its science. The EU also has a humanitarian responsibility to support TB control in developing countries. It remains very important for the EC that neither biomedical research nor investment in health services should become a casualty of the current economic recession. Copyright 2010 Elsevier Ltd. All rights reserved.

The Impact of United States Investment for Civil Infrastructure in Developing Countries

DTIC Science & Technology

2015-03-26

design of the experiment is a nonequivalent control group design (Patten, 2009). This experimental design is represented in...Additionally, in a true nonequivalent control group designed experiment, the individuals surveyed in round two are the same as in round one. Due to the...form of an experimental design to capture the HN citizens’ opinions in locations in both the treatment and control group over two survey

Cardiovascular, respiratory, and related disorders: key messages from Disease Control Priorities, 3rd edition

PubMed Central

Prabhakaran, Dorairaj; Anand, Shuchi; Watkins, David; Gaziano, Thomas; Wu, Yangfeng; Mbanya, Jean Claude; Nugent, Rachel

2018-01-01

Cardiovascular, respiratory, and related disorders (CVRDs) are the leading causes of adult death worldwide, and substantial inequalities in care of patients with CVRDs exist between countries of high income and countries of low and middle income. Based on current trends, the UN Sustainable Development Goal to reduce premature mortality due to CVRDs by a third by 2030 will be challenging for many countries of low and middle income. We did systematic literature reviews of effectiveness and cost-effectiveness to identify priority interventions. We summarise the key findings and present a costed essential package of interventions to reduce risk of and manage CVRDs. On a population level, we recommend tobacco taxation, bans on trans fats, and compulsory reduction of salt in manufactured food products. We suggest primary health services be strengthened through the establishment of locally endorsed guidelines and ensured availability of essential medications. The policy interventions and health service delivery package we suggest could serve as the cornerstone for the management of CVRDs, and afford substantial financial risk protection for vulnerable households. We estimate that full implementation of the essential package would cost an additional US$21 per person in the average low-income country and $24 in the average lower-middle-income country. The essential package we describe could be a starting place for low-income and middle-income countries developing universal health coverage packages. Interventions could be rolled out as disease burden demands and budgets allow. Our outlined interventions provide a pathway for countries attempting to convert the UN Sustainable Development Goal commitments into tangible action. PMID:29108723

Interviewing Key Informants: Strategic Planning for a Global Public Health Management Program

ERIC Educational Resources Information Center

Kun, Karen E.; Kassim, Anisa; Howze, Elizabeth; MacDonald, Goldie

2013-01-01

The Centers for Disease Control and Prevention's Sustainable Management Development Program (SMDP) partners with low- and middle-resource countries to develop management capacity so that effective global public health programs can be implemented and better health outcomes can be achieved. The program's impact however, was variable. Hence, there…

Development of a cardiovascular risk score for use in low- and middle-income countries

USDA-ARS?s Scientific Manuscript database

Summary measures of cardiovascular risk have long been used in public health, but few include nutritional predictors despite extensive evidence linking diet and heart disease. Study objectives were to develop and validate a novel risk score in a case-control study of myocardial infarction (MI) condu...

Background: Energy's holy grail. [The quest for controlled fusion

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

Not Available

This article presents a brief history of the pursuit and development of fusion as a power source. Starting with the 1950s through the present, the research efforts of the US and other countries is highlighted, including a chronology of hey developments. Other topics discussed include cold fusion and magnetic versus inertial fusion issues.

The NORSTAR Program: Space shuttle to space station

NASA Technical Reports Server (NTRS)

Fortunato, Ronald C.

1988-01-01

The development of G-325, the first high school student-run space flight project, is updated. An overview is presented of a new international program, which involves students from space station countries who will be utilizing Get Away Special technology to cooperatively develop a prototype experiment for controlling a space station research module environment.

Development and Female Crime: A Cross-National Test of Alternative Explanations.

ERIC Educational Resources Information Center

Steffensmeier, Darrell; And Others

1989-01-01

Interpol data from 69 countries indicate that the relationship between female percentage of arrests and national development status is mediated by opportunity for "female" consumer crimes and formalization of social control (which makes female crime more visible), but not by gender equality or female economic marginality. Contains 49 references.…

Activating a Vision

ERIC Educational Resources Information Center

Wilson, Carroll L.

1973-01-01

International Center of Insect Physiology and Ecology (ICIPE) is an organized effort to study physiology, endocrinology, genetics, and related processes of five insects. Location of the center in Kenya encourages developing countries to conduct research for the control of harmful insects. (PS)

Controlling cardiovascular diseases in low and middle income countries by placing proof in pragmatism

PubMed Central

Owolabi, Mayowa; Miranda, Jaime J; Yaria, Joseph; Ovbiagele, Bruce

2016-01-01

Low and middle income countries (LMICs) bear a huge, disproportionate and growing burden of cardiovascular disease (CVD) which constitutes a threat to development. Efforts to tackle the global burden of CVD must therefore emphasise effective control in LMICs by addressing the challenge of scarce resources and lack of pragmatic guidelines for CVD prevention, treatment and rehabilitation. To address these gaps, in this analysis article, we present an implementation cycle for developing, contextualising, communicating and evaluating CVD recommendations for LMICs. This includes a translatability scale to rank the potential ease of implementing recommendations, prescriptions for engaging stakeholders in implementing the recommendations (stakeholders such as providers and physicians, patients and the populace, policymakers and payers) and strategies for enhancing feedback. This approach can help LMICs combat CVD despite limited resources, and can stimulate new implementation science hypotheses, research, evidence and impact. PMID:27840737

Inherited haemoglobin disorders: an increasing global health problem.

PubMed Central

Weatherall, D. J.; Clegg, J. B.

2001-01-01

Despite major advances in our understanding of the molecular pathology, pathophysiology, and control and management of the inherited disorders of haemoglobin, thousands of infants and children with these diseases are dying through lack of appropriate medical care. This problem will undoubtedly increase over the next 20 years because, as the result of a reduction in childhood mortality due to infection and malnutrition, more babies with haemoglobin disorders will survive to present for treatment. Although WHO and various voluntary agencies have tried to disseminate information about these diseases, they are rarely mentioned as being sufficiently important to be included in setting health care priorities for the future. It takes considerable time to establish expertise in developing programmes for the control and management of these conditions, and the lessons learned in developed countries will need to be transmitted to those countries in which they occur at a high frequency. PMID:11545326

DEVELOPING A HUMAN RIGHTS-BASED PROGRAM FOR TUBERCULOSIS CONTROL IN GEORGIAN PRISONS

PubMed Central

Gegia, Medea; Kalandadze, Iagor; Madzgharashvili, Mikheil; Furin, Jennifer

2013-01-01

Tuberculosis (TB) is one of the leading infectious killers of adults globally. Incarcerated individuals represent a vulnerable population when it comes to TB exposure, development of disease, and poor treatment outcomes. The TB pandemic in prisons is a serious human rights issue, and multiple global organizations have called for human rights-based strategies to address it. There are, however, few countries implementing such programs on the ground. Georgia, a former Soviet republic located in the Caucasus Mountains, has high rates of TB and a large prison population. This paper describes a needs assessment carried out in one prison in Georgia and the human rights-based strategy being implemented by the Georgian National TB Program to address TB control in the prison setting. It is hoped that the proposed program can serve as a model for other countries with high rates of TB among incarcerated individuals. PMID:22773034

Why achievement motivation predicts success in business but failure in politics: the importance of personal control.

PubMed

Winter, David G

2010-12-01

Several decades of research have established that implicit achievement motivation (n Achievement) is associated with success in business, particularly in entrepreneurial or sales roles. However, several political psychology studies have shown that achievement motivation is not associated with success in politics; rather, implicit power motivation often predicts political success. Having versus lacking control may be a key difference between business and politics. Case studies suggest that achievement-motivated U.S. presidents and other world leaders often become frustrated and thereby fail because of lack of control, whereas power-motivated presidents develop ways to work with this inherent feature of politics. A reevaluation of previous research suggests that, in fact, relationships between achievement motivation and business success only occur when control is high. The theme of control is also prominent in the development of achievement motivation. Cross-national data are also consistent with this analysis: In democratic industrialized countries, national levels of achievement motivation are associated with strong executive control. In countries with low opportunity for education (thus fewer opportunities to develop a sense of personal control), achievement motivation is associated with internal violence. Many of these manifestations of frustrated achievement motivation in politics resemble authoritarianism. This conclusion is tested by data from a longitudinal study of 113 male college students, showing that high initial achievement motivation combined with frustrated desires for control is related to increases in authoritarianism (F-scale scores) during the college years. Implications for the psychology of leadership and practical politics are discussed. © 2010 The Author. Journal of Personality © 2010, Wiley Periodicals, Inc.

The national and international regulatory environment in tobacco control.

PubMed

Warner, Kenneth E

2015-07-09

Despite their lethality, cigarettes are subject to little regulation that directly restricts their contents or their legality. This may change in the near future with the Framework Convention on Tobacco Control (FCTC), the world's first global health treaty, now in force, as well as developments in a few individual countries. Cigarettes are subject to a substantial number of country-specific regulations regarding their conditions of sale: their price (mostly through taxation), the places where they can be consumed (clean indoor air laws), who can smoke them (prohibitions on their use by or sales to minors), how they can be advertised or promoted (if at all), and how they must be packaged (minimum pack sizes, warning labels, plain packaging). Such policies constitute the core of successful tobacco control. The FCTC has been ratified by 180 countries representing 90% of the world's population. The FCTC requires compliance with numerous provisions relating to the kinds of regulations noted above. The treaty also mandates explicit attention to direct product regulation. Several countries have such authority, at least in limited forms. In the US, for example, the Food and Drug Administration (FDA) now has the legal authority to regulate tobacco products, including their contents. The possibility exists that, in the foreseeable future, a country will mandate product standards that will substantially reduce the appeal of cigarettes and other combusted tobacco products, which are by far the leading sources of the death and disease associated with tobacco.

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

Leonard, J.F.; Scheinman, A.M.

The Clinton administration has taken office at a moment of unparalleled opportunity in its relations with countries of the developing world. The end of the Cold War rivalry presents arms control possibilities that until recently seemed no more than rheotorical goals or idle dreams. If the advanced industrialized countries will treat these countries as full partners in the effort, a stunning series of arms control and security achievements are possible in the coming years. In this partnership, India, with its sheer size, technological and industrial sophistication and intellectual and diplomatic leadership role from the earliest years of its independence, shouldmore » play a key part. For most of the past 40 years, US and Indian foreign policies have worked at cross-purposes far more often than not. But there are reasons to hope that this will change, particularly with regard to arms control and nuclear non-proliferation. Chances for success will improve dramatically if the United States treats non-proliferation as a first-order interest not submerged by competing foreign policy concerns, and simultaneously places relations with India on a more regularized and institutionalized basis.« less

The control of foreigners as researchers in Thailand.

PubMed

Ditton, Mary J; Lehane, Leigh

2009-09-01

AN IMPORTANT ASPECT OF ETHICAL CONDUCT of field research is for the researcher to have an appropriate relationship with the legitimate gatekeepers of the field site. This paper describes our experiences of obtaining approval from regulatory authorities in Thailand for field research on Burmese migrants, and discusses the nature and rationale of such government control in Asia and Western countries. It is intended to guide future humanitarian researchers who are planning to study oppressed groups at politically sensitive research sites where regulatory authorities monitor both research sites and research performance. Thailand, like several other Southeast Asian countries, operates a permit system for foreign researchers. This permit system is designed to promote research activities in Thailand so that the results can be used to further the country's development, and to enhance the cooperation and collaboration between Thai and foreign researchers providing opportunities for the exchange of knowledge, technical expertise, and experience. This control of foreign researchers is not prohibitive; foreign humanitarian researchers can organize research and advance the welfare of targeted oppressed populations in cooperation with government agencies.

Rhetoric and the law, or the law of rhetoric: How countries oppose novel tobacco control measures at the World Trade Organization

PubMed Central

Lencucha, Raphael; Drope, Jeffrey; Labonte, Ronald

2016-01-01

The tobacco industry has developed an extensive array of strategies and arguments to prevent or weaken government regulation. These strategies and arguments are well documented at the domestic level. However, there remains a need to examine how these arguments are reflected in the challenges waged by governments within the World Trade Organization (WTO). Decisions made at the WTO have the potential to shape how countries govern. Our analysis was conducted on two novel tobacco control measures: tobacco additives bans (Canada, United States and Brazil) and plain, standardized packaging of tobacco products (Australia, New Zealand, Ireland, EU and UK). We analyzed WTO documents (i.e. meeting minutes and submissions) (n=62) in order to identify patterns of argumentation and compare these patterns with well-documented industry arguments. The pattern of these arguments reveal that despite the unique institutional structure of the WTO, country representatives opposing novel tobacco control measures use the same non-technical arguments as those that the tobacco industry continues to use to oppose these measures at the domestic level. PMID:27475056

Oncology pharmacy units: a safety policy for handling hazardous drugs and related waste in low- and middle-income African countries-Angolan experience.

PubMed

da Conceição, Ana Vaz; Bernardo, Dora; Lopes, Lygia Vieira; Miguel, Fernando; Bessa, Fernanda; Monteiro, Fernando; Santos, Cristina; Oliveira, Blasques; Santos, Lúcio Lara

2015-01-01

In African countries, higher rates of late-stage cancers at the time of first diagnosis are a reality. In this context, hazardous drugs (HDs), such as chemotherapy, play an important role and have immense benefits for patients' treatment. HDs should be handled under specific conditions. At least a class 5 environment primary engineering control (PEC), physically located in an appropriate buffer area, is mandatory for sterile HDs compounding, as well as administrative control, personal protective equipment, work practices and other engineering and environmental controls, in order to protect the environment, patient, and worker. The aim of this study is to describe the Angolan experience regarding the development of oncology pharmacy units and discuss international evidence-based guidelines on handling HDs and related waste. Measures to incorporate modern and economical solutions to upgrade or build adequate and safe facilities and staff training, in order to comply with international guidelines in this area, are crucial tasks for African countries of low and middle income.

The Changing Legal Climate for Marketing and Advertising in Europe.

ERIC Educational Resources Information Center

Dunn, S. Watson

Although advertisers and marketers can expect stronger controls in all West European countries, especially by governments, they must be alert to country-by-country differences. Political moves to the left in any country will hasten controls. Consumerism is militant in some countries, practically dormat in others. Although self regulation is strong…

Where wealth matters more for health: the wealth-health gradient in 16 countries.

PubMed

Semyonov, Moshe; Lewin-Epstein, Noah; Maskileyson, Dina

2013-03-01

Researchers have long demonstrated that persons of high economic status are likely to be healthier than persons of low socioeconomic standing. Cross-national studies have also demonstrated that health of the population tends to increase with country's level of economic development and to decline with level of economic inequality. The present research utilizes data for 16 national samples (of populations fifty years of age and over) to examine whether the relationship between wealth and health at the individual-level is systematically associated with country's level of economic development and country's level of income inequality. The analysis reveals that in all countries rich persons tend to be healthier than poor persons. Furthermore, in all countries the positive association between wealth and health holds even after controlling for socio-demographic attributes and household income. Hierarchical regression analysis leads to two major conclusions: first, country's economic resources increase average health of the population but do not weaken the tie between wealth and health; second, a more equal distribution of economic resources (greater egalitarianism) does not raise health levels of the population but weakens the tie between wealth and health. The latter findings can be mostly attributed to the uniqueness of the US case. The findings and their significance are discussed in light of previous research and theory. Copyright © 2013 Elsevier Ltd. All rights reserved.

Forest cover, socioeconomics, and reported flood frequency in developing countries

NASA Astrophysics Data System (ADS)

Ferreira, Susana; Ghimire, Ramesh

2012-08-01

In this paper, we analyze the determinants of the number of large floods reported since 1990. Using the same sample of countries as Bradshaw et al. (2007), and, like them, omitting socioeconomic characteristics from the analysis, we found that a reduction in natural forest cover is associated with an increase in the reported count of large floods. This result does not hold in any of three new analyses we perform. First, we expand the sample to include all the developing countries and all countries for which data were available but were omitted in their study. Second, and more importantly, since forest management is just one possible channel through which humans can influence reported flood frequency, we account for other important human-flood interactions. People are typically responsible for deforestation, but they are also responsible for other land use changes (e.g., urbanization), for floodplain and flood emergency management, and for reporting the floods. Thus, in our analysis we account for population, urban population growth, income, and corruption. Third, we exploit the panel nature of the data to control for unobserved country and time heterogeneity. We conclude that not only is the link between forest cover and reported flood frequency at the country level not robust, it also seems to be driven by sample selection and omitted variable bias. The human impact on the reported frequency of large floods at the country level is not through deforestation.

Gender empowerment and female-to-male smoking prevalence ratios

PubMed Central

Fong, Geoffrey T

2011-01-01

Abstract Objective To determine whether in countries with high gender empowerment the female-to-male smoking prevalence ratio is also higher. Methods Bivariate and multiple regression analyses were performed to explore the relation between the United Nations Development Programme’s gender empowerment measure (GEM) and the female-to-male smoking prevalence ratio (calculated from the 2008 WHO global tobacco control report). Because a country’s progression through the various stages of the tobacco epidemic and its gender smoking ratio (GSR) are thought to be influenced by its level of development, we explored this correlation as well, with economic development defined in terms of gross national income (GNI) per capita and income inequality (Gini coefficient). Findings The GSR was significantly and positively correlated with the GEM (r = 0.680; P < 0.001). In addition, the GEM was the strongest predictor of the GSR (β, adjusted: 0.47; P < 0.0001) after controlling for GNI per capita and for Gini coefficient. Conclusion Whether progress towards gender empowerment can take place without a corresponding increase in smoking among women remains to be seen. Strong tobacco control measures are needed in countries where women are being increasingly empowered. PMID:21379415

Human Rabies in the WHO Southeast Asia Region: Forward Steps for Elimination

PubMed Central

Gongal, Gyanendra; Wright, Alice E.

2011-01-01

There are eleven Member States in the WHO southeast Asia region (Bangladesh, Bhutan, Democratic People's Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste) of which eight are endemic for rabies. More than 1.4 billion people in the Region are at risk of rabies infection, and approximately 45% of worldwide rabies deaths occur in Asia. Dog bites account for 96% of human rabies cases. Progress in preventing human rabies through control of the disease in dogs has been slow due to various factors. Innovative control tools and techniques have been developed and standardized in recent years. The introduction of cost-effective intradermal rabies vaccination regimens in Asian countries has increased the availability and affordability of postexposure prophylaxis. Elimination of rabies is not possible without regional and intersectoral cooperation. Considering the importance of consolidating achievements in rabies control in Member countries, the WHO Regional Office for southeast Asia has developed a regional strategy for elimination of human rabies transmitted by dogs in the Region. They have committed to provide technical leadership, to advocate national health authorities to develop major stakeholder consensus for a comprehensive rabies elimination programme, and to implement national strategies for elimination of human rabies. PMID:21991437

Combined sewer overflow control with LID based on SWMM: an example in Shanghai, China.

PubMed

Liao, Z L; Zhang, G Q; Wu, Z H; He, Y; Chen, H

2015-01-01

Although low impact development (LID) has been commonly applied across the developed countries for mitigating the negative impacts of combined sewer overflows (CSOs) on urban hydrological environment, it has not been widely used in developing countries yet. In this paper, a typical combined sewer system in an urbanized area of Shanghai, China was used to demonstrate how to design and choose CSO control solutions with LID using stormwater management model. We constructed and simulated three types of CSO control scenarios. Our findings support the notion that LID measures possess favorable capability on CSO reduction. Nevertheless, the green scenarios which are completely comprised by LID measures fail to achieve the maximal effectiveness on CSO reduction, while the gray-green scenarios (LID measure combined with gray measures) achieve it. The unit cost-effectiveness of each type of scenario sorts as: green scenario > gray-green scenario > gray scenario. Actually, as the storage tank is built in the case catchment, a complete application of green scenario is inaccessible here. Through comprehensive evaluation and comparison, the gray-green scenario F which used the combination of storage tank, bio-retention and rain barrels is considered as the most feasible one in this case.

Strengthening laboratory systems in resource-limited settings.

PubMed

Olmsted, Stuart S; Moore, Melinda; Meili, Robin C; Duber, Herbert C; Wasserman, Jeffrey; Sama, Preethi; Mundell, Ben; Hilborne, Lee H

2010-09-01

Considerable resources have been invested in recent years to improve laboratory systems in resource-limited settings. We reviewed published reports, interviewed major donor organizations, and conducted case studies of laboratory systems in 3 countries to assess how countries and donors have worked together to improve laboratory services. While infrastructure and the provision of services have seen improvement, important opportunities remain for further advancement. Implementation of national laboratory plans is inconsistent, human resources are limited, and quality laboratory services rarely extend to lower tier laboratories (eg, health clinics, district hospitals). Coordination within, between, and among governments and donor organizations is also frequently problematic. Laboratory standardization and quality control are improving but remain challenging, making accreditation a difficult goal. Host country governments and their external funding partners should coordinate their efforts effectively around a host country's own national laboratory plan to advance sustainable capacity development throughout a country's laboratory system.

Cost effective waste management through composting in Africa.

PubMed

Couth, R; Trois, C

2012-12-01

Greenhouse gas (GHG) emissions per person from urban waste management activities are greater in sub-Saharan African countries than in other developing countries, and are increasing as the population becomes more urbanised. Waste from urban areas across Africa is essentially dumped on the ground and there is little control over the resulting gas emissions. The clean development mechanism (CDM), from the 1997 Kyoto Protocol has been the vehicle to initiate projects to control GHG emissions in Africa. However, very few of these projects have been implemented and properly registered. A much more efficient and cost effective way to control GHG emissions from waste is to stabilise the waste via composting and to use the composted material as a soil improver/organic fertiliser or as a component of growing media. Compost can be produced by open windrow or in-vessel composting plants. This paper shows that passively aerated open windrows constitute an appropriate low-cost option for African countries. However, to provide an usable compost material it is recommended that waste is processed through a materials recovery facility (MRF) before being composted. The paper demonstrates that material and biological treatment (MBT) are viable in Africa where they are funded, e.g. CDM. However, they are unlikely to be instigated unless there is a replacement to the Kyoto Protocol, which ceases for Registration in December 2012. Copyright © 2012 Elsevier Ltd. All rights reserved.

A proven and highly cost-effective method of early detection of breast cancer for developing countries.

PubMed

Rebentisch, D P; Rebentisch, H D; Thomas, K; Karat, S; Jadhav, A J

1995-12-01

Carcinoma of the breast is the third most common cancer in Indian women. With rapid industrialization and effective control of communicable diseases, better diagnostic and treatment facilities, cancer is emerging as a major health problem. Since early detection is the only way to reduce morbidity and mortality from breast cancer, we undertook a pilot project to evaluate efficacy of using existing manpower and resources for screening women in the high risk group. Methodology pros and cons, results, and recommendations are presented. Our method can be adopted by any developing country interested in a screening programme for malignant disease.

DOE and AID stand-alone photovoltaic activities

NASA Technical Reports Server (NTRS)

Bifano, W. J.; Ratajczak, A. F.

1983-01-01

The NASA Lewis Research Center (LeRC) is managing stand-alone photovoltaic (PV) system activities sponsored by the U.S. Department of Energy (DOE) and the U.S. Agency for International Development (AID). The DOE project includes village PV power demonstration projects in Gabon (four sites) and the Marshall Islands, PV-powered medical refrigerators in six countries, PV system microprocessor control development activities and PV-hybrid system assessments. The AID project includes a large village system in Tunisia, a water pumping/grain grinding project in Upper Volta, five medical clinics in four countries, PV-powered remote earth station application. These PV activities and summarizes significant findings to data are reviewed.

Setting the agenda: a new model for collaborative tuberculosis epidemiologic research.

PubMed

Katz, Dolly; Albalak, Rachel; Wing, J S; Combs, V

2007-01-01

Success in reducing tuberculosis (TB) incidence in developed nations has created a paradoxical problem for researchers. In many countries, there are too few cases to support the research necessary to maintain and accelerate the decline. We describe an approach to applied TB research that supports and focuses efforts of researchers at 21 academic, clinical, and governmental sites in two countries. The Tuberculosis Epidemiologic Studies Consortium (TBESC), funded by the Centers for Disease Control and Prevention (CDC) and by outside sources, conducts programmatically relevant epidemiologic, behavioral, economic, laboratory, and operational research for TB prevention and control. Our experience may serve as a model for other types of applied health care research.

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

PubMed Central

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

2014-01-01

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

The economic impacts of foot and mouth disease – What are they, how big are they and where do they occur?

PubMed Central

Knight-Jones, T.J.D.; Rushton, J.

2013-01-01

Although a disease of low mortality, the global impact of foot and mouth disease (FMD) is colossal due to the huge numbers of animals affected. This impact can be separated into two components: (1) direct losses due to reduced production and changes in herd structure; and (2) indirect losses caused by costs of FMD control, poor access to markets and limited use of improved production technologies. This paper estimates that annual impact of FMD in terms of visible production losses and vaccination in endemic regions alone amount to between US$6.5 and 21 billion. In addition, outbreaks in FMD free countries and zones cause losses of >US$1.5 billion a year. FMD impacts are not the same throughout the world:1.FMD production losses have a big impact on the world's poorest where more people are directly dependent on livestock. FMD reduces herd fertility leading to less efficient herd structures and discourages the use of FMD susceptible, high productivity breeds. Overall the direct losses limit livestock productivity affecting food security.2.In countries with ongoing control programmes, FMD control and management creates large costs. These control programmes are often difficult to discontinue due to risks of new FMD incursion.3.The presence, or even threat, of FMD prevents access to lucrative international markets.4.In FMD free countries outbreaks occur periodically and the costs involved in regaining free status have been enormous. FMD is highly contagious and the actions of one farmer affect the risk of FMD occurring on other holdings; thus sizeable externalities are generated. Control therefore requires coordination within and between countries. These externalities imply that FMD control produces a significant amount of public goods, justifying the need for national and international public investment. Equipping poor countries with the tools needed to control FMD will involve the long term development of state veterinary services that in turn will deliver wider benefits to a nation including the control of other livestock diseases. PMID:23958457

Applying commodity chain analysis to changing modes of alcohol supply in a developing country.

PubMed

Jernigan, D H

2000-12-01

Development sociology has used global commodity chains as one way of analyzing the dynamics of power and profit-taking in globalized production networks made up of multiple firms and occurring in multiple national settings. A substantial portion of the alcohol supply in developing countries is now produced through such production networks. Particularly in the beer and spirits trade, a small number of transnational firms control networks of local producers, importers, advertisers and distributors. These networks serve to embed transnational or transnationally backed brands in the local culture, using the tools of market research, product design and marketing to influence local drinking practices. Case materials from Malaysia's beer industry help to illustrate how the transnational firms dominate in those links of the commodity chain in which monopoly or oligopoly control is most likely to be found: the design/recipe and marketing/advertising nodes. Their control of the commodity chains and extraction of monopoly or oligopoly profits from them places substantial resources and influence over drinking settings and practices in foreign hands. The impact of this influence on state efficacy and autonomy in setting alcohol policy is an important subject for future research on the creation and implementation of effective alcohol policies in developing societies.

The Role of Health Systems Factors in Facilitating Access to Psychotropic Medicines: A Cross-Sectional Analysis of the WHO-AIMS in 63 Low- and Middle-Income Countries

PubMed Central

McBain, Ryan; Norton, Daniel J.; Morris, Jodi; Yasamy, M. Taghi; Betancourt, Theresa S.

2012-01-01

Background Neuropsychiatric conditions comprise 14% of the global burden of disease and 30% of all noncommunicable disease. Despite the existence of cost-effective interventions, including administration of psychotropic medicines, the number of persons who remain untreated is as high as 85% in low- and middle-income countries (LAMICs). While access to psychotropic medicines varies substantially across countries, no studies to date have empirically investigated potential health systems factors underlying this issue. Methods and Findings This study uses a cross-sectional sample of 63 LAMICs and country regions to identify key health systems components associated with access to psychotropic medicines. Data from countries that completed the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) were included in multiple regression analyses to investigate the role of five major mental health systems domains in shaping medicine availability and affordability. These domains are: mental health legislation, human rights implementations, mental health care financing, human resources, and the role of advocacy groups. Availability of psychotropic medicines was associated with features of all five mental health systems domains. Most notably, within the domain of mental health legislation, a comprehensive national mental health plan was associated with 15% greater availability; and in terms of advocacy groups, the participation of family-based organizations in the development of mental health legislation was associated with 17% greater availability. Only three measures were related with affordability of medicines to consumers: level of human resources, percentage of countries' health budget dedicated to mental health, and availability of mental health care in prisons. Controlling for country development, as measured by the Human Development Index, health systems features were associated with medicine availability but not affordability. Conclusions Results suggest that strengthening particular facets of mental health systems might improve availability of psychotropic medicines and that overall country development is associated with affordability. Please see later in the article for the Editors' Summary PMID:22303288

Cost effective malaria risk control using remote sensing and environmental data

NASA Astrophysics Data System (ADS)

Rahman, Md. Z.; Roytman, Leonid; Kadik, Abdel Hamid

2012-06-01

Malaria transmission in many part of the world specifically in Bangladesh and southern African countries is unstable and epidemic. An estimate of over a million cases is reported annually. Malaria is heterogeneous, potentially due to variations in ecological settings, socio-economic status, land cover, and agricultural practices. Malaria control only relies on treatment and supply of bed networks. Drug resistance to these diseases is widespread. Vector control is minimal. Malaria control in those countries faces many formidable challenges such as inadequate accessibility to effective treatment, lack of trained manpower, inaccessibility of endemic areas, poverty, lack of education, poor health infrastructure and low health budgets. Health facilities for malaria management are limited, surveillance is inadequate, and vector control is insufficient. Control can only be successful if the right methods are used at the right time in the right place. This paper aims to improve malaria control by developing malaria risk maps and risk models using satellite remote sensing data by identifying, assessing, and mapping determinants of malaria associated with environmental, socio-economic, malaria control, and agricultural factors.

Pressure ulcer guideline development and dissemination in Europe.

PubMed

Meesterberends, Esther; Halfens, Ruud; Lohrmann, Christa; de Wit, Rianne

2010-06-01

To explore the current state of pressure ulcer guideline development and dissemination, from national to local level (i.e. nursing homes) in six European countries: England, Germany, Italy, the Netherlands, Portugal and Sweden. Pressure ulcers are a persistent problem in healthcare institutions. Their prevalence is influenced by many factors, one of them being the development and dissemination of pressure ulcer guidelines. These are difficult and complex processes and it is not clear whether they differ between European countries. Literature review and semi-structured interviews. Interviews were conducted in six countries at national and nursing home level. Four countries had national pressure ulcer prevention and treatment guidelines. Portugal had no national guidelines and Sweden had shifted the responsibility to regional level. All participating nursing homes had pressure ulcer guidelines except those in Portugal. Control and monitoring of guideline dissemination was carried out only in Sweden and England. All countries studied have national or regional pressure ulcer prevention and treatment guidelines, except Portugal. Portugal is also the only country where none of the nursing homes included had pressure ulcer guidelines. Because the dissemination of such guidelines does not imply actual implementation, further research should focus on the implementation process. Clinical guidelines, like pressure ulcer guidelines, are important tools in guiding the care processes in healthcare institutions. Successful dissemination of guidelines from national level to individual healthcare institutions is a first and necessary step in actually applying them. Monitoring of the guideline dissemination process is therefore essential.

Global distribution and evolvement of urbanization and PM2.5 (1998-2015)

NASA Astrophysics Data System (ADS)

Yang, Dongyang; Ye, Chao; Wang, Xiaomin; Lu, Debin; Xu, Jianhua; Yang, Haiqing

2018-06-01

PM2.5 concentrations increased and have been one of the major social issues along with rapid urbanization in many regions of the world in recent decades. The development of urbanization differed among regions, PM2.5 pollution also presented discrepant distribution across the world. Thus, this paper aimed to grasp the profile of global distribution of urbanization and PM2.5 and their evolutionary relationships. Based on global data for the proportion of the urban population and PM2.5 concentrations in 1998-2015, this paper investigated the spatial distribution, temporal variation, and evolutionary relationships of global urbanization and PM2.5. The results showed PM2.5 presented an increasing trend along with urbanization during the study period, but there was a variety of evolutionary relationships in different countries and regions. Most countries in East Asia, Southeast Asia, South Asia, and some African countries developed with the rapid increase in both urbanization and PM2.5. Under the impact of other socioeconomic factors, such as industry and economic growth, the development of urbanization increased PM2.5 concentrations in most Asian countries and some African countries, but decreased PM2.5 concentrations in most European and American countries. The findings of this study revealed the spatial distributions of global urbanization and PM2.5 pollution and provided an interpretation on the evolution of urbanization-PM2.5 relationships, which can contribute to urbanization policies making aimed at successful PM2.5 pollution control and abatement.

[New social and economical issues in the assessment of Romanian population's health status].

PubMed

Duma, Odetta

2008-01-01

Health status is determined by a combination of biological, environmental (physical and socio-economic), behavioural/lifestyle and medical care factors. The social and economic factors include many influences over which an individual may have limited control, such as economic status or educational level. The most important measures of these factors are represented by: gross domestic product per capita, employment rate, unemployment rate, literacy rate, poverty line, and human development index. From this point of view, the following positive issues have been recorded in Romania: a low unemployment rate (6.1%) compared to European Union countries; a high literacy rate (97.3%), very close to the maximum of 100% reported by all developed countries; and a human development index of 0.805 (rank 60 in the international hierarchy), specific to a country with a high human development. Negative issues have been reported in case of the following indicators: the reported gross domestic product per capita expressed in PPP US$ was 8480, among the lowest in Europe, specific to a country with a medium income; population living with less than 2 US$ per day of 13% and living with less than 1 US$ per day 2.1%; the employment rate was 57.4%, but in female population only 51.3%, whereas in male population it was 63.9%.

The road to GHS: worker right-to-know in the 21st century.

PubMed

Karstadt, Myra L

2012-01-01

Of the three communications standards discussed, HI is definitely the outlier, as it emphasizes worker control of the process of identifying hazard and deemphasizes employer control of identification of hazards and dissemination of hazard information. GHS may not be as protective of American workers as HazCom is, but for workers in less-developed countries, where regulation of workplace health and safety is less strong than in the United States, Canada, many countries in Europe, and Japan, GHS--if adequately enforced-will likely represent an improvement in information on chemical hazards in the workplace. American workers may well see a decline in workplace protection against chemical hazards while protection may improve for workers in less-developed countries. This trade-off is part of the ongoing debate about globalization, of which worker protection from chemical hazards should be an important aspect. The next paper in this series will compare the proposed and final versions of GHS, and will discuss possible improvements to GHS to better serve American workers. As OSHA moves forward with the GHS rule, people and organizations concerned with worker right-to-know should consider possible improvements to GHS to better serve workers in the United States and worldwide.

Endemic Venezuelan equine encephalitis in the Americas: hidden under the dengue umbrella

PubMed Central

Aguilar, Patricia V; Estrada-Franco, Jose G; Navarro-Lopez, Roberto; Ferro, Cristina; Haddow, Andrew D; Weaver, Scott C

2011-01-01

Venezuelan equine encephalitis (VEE) is an emerging infectious disease in Latin America. Outbreaks have been recorded for decades in countries with enzootic circulation, and the recent implementation of surveillance systems has allowed the detection of additional human cases in countries and areas with previously unknown VEE activity. Clinically, VEE is indistinguishable from dengue and other arboviral diseases and confirmatory diagnosis requires the use of specialized laboratory tests that are difficult to afford in resource-limited regions. Thus, the disease burden of endemic VEE in developing countries remains largely unknown, but recent surveillance suggests that it may represent up to 10% of the dengue burden in neotropical cities, or tens-of-thousands of cases per year throughout Latin America. The potential emergence of epizootic viruses from enzootic progenitors further highlights the need to strengthen surveillance activities, identify mosquito vectors and reservoirs and develop effective strategies to control the disease. In this article, we provide an overview of the current status of endemic VEE that results from spillover of the enzootic cycles, and we discuss public health measures for disease control as well as future avenues for VEE research. PMID:21765860

Contracting but not without caution: experience with outsourcing of health services in countries of the Eastern Mediterranean Region.

PubMed Central

Siddiqi, Sameen; Masud, Tayyeb Imran; Sabri, Belgacem

2006-01-01

The public sector in developing countries is increasingly contracting with the non-state sector to improve access, efficiency and quality of health services. We conducted a multicountry study to assess the range of health services contracted out, the process of contracting and its influencing factors in ten countries of the Eastern Mediterranean Region: Afghanistan, Bahrain, Egypt, Islamic Republic of Iran, Jordan, Lebanon, Morocco, Pakistan, the Syrian Arab Republic and Tunisia. Our results showed that Afghanistan, Egypt, Islamic Republic of Iran and Pakistan had experience with outsourcing of primary care services; Jordan, Lebanon and Tunisia extensively contracted out hospital and ambulatory care services; while Bahrain, Morocco and the Syrian Arab Republic outsourced mainly non-clinical services. The interest of the non-state sector in contracting was to secure a regular source of revenue and gain enhanced recognition and credibility. While most countries promoted contracting with the private sector, the legal and bureaucratic support in countries varied with the duration of experience with contracting. The inherent risks evident in the contracting process were reliance on donor funds, limited number of providers in rural areas, parties with vested interests gaining control over the contracting process, as well as poor monitoring and evaluation mechanisms. Contracting provides the opportunity to have greater control over private providers in countries with poor regulatory capacity, and if used judiciously can improve health system performance. PMID:17143460

Contracting but not without caution: experience with outsourcing of health services in countries of the Eastern Mediterranean Region.

PubMed

Siddiqi, Sameen; Masud, Tayyeb Imran; Sabri, Belgacem

2006-11-01

The public sector in developing countries is increasingly contracting with the non-state sector to improve access, efficiency and quality of health services. We conducted a multicountry study to assess the range of health services contracted out, the process of contracting and its influencing factors in ten countries of the Eastern Mediterranean Region: Afghanistan, Bahrain, Egypt, Islamic Republic of Iran, Jordan, Lebanon, Morocco, Pakistan, the Syrian Arab Republic and Tunisia. Our results showed that Afghanistan, Egypt, Islamic Republic of Iran and Pakistan had experience with outsourcing of primary care services; Jordan, Lebanon and Tunisia extensively contracted out hospital and ambulatory care services; while Bahrain, Morocco and the Syrian Arab Republic outsourced mainly non-clinical services. The interest of the non-state sector in contracting was to secure a regular source of revenue and gain enhanced recognition and credibility. While most countries promoted contracting with the private sector, the legal and bureaucratic support in countries varied with the duration of experience with contracting. The inherent risks evident in the contracting process were reliance on donor funds, limited number of providers in rural areas, parties with vested interests gaining control over the contracting process, as well as poor monitoring and evaluation mechanisms. Contracting provides the opportunity to have greater control over private providers in countries with poor regulatory capacity, and if used judiciously can improve health system performance.

Building tobacco control research in Thailand: meeting the need for innovative change in Asia.

PubMed

Hamann, Stephen L; Mock, Jeremiah; Hense, Sibasis; Charoenca, Naowarut; Kungskulniti, Nipapun

2012-01-28

In low- and middle-income countries (LMICs) over the past two decades locally relevant tobacco control research has been scant. Experience shows that tobacco control measures should be based on sound research findings to ensure that measures are appropriate for local conditions and that they are likely to have an impact. Research should also be integrated within tobacco control measures to ensure ongoing learning and the production of knowledge. Thailand, a middle-income country, has a public health community with a record of successful tobacco control and a longstanding commitment to research. Thailand's comprehensive approach includes taxation; bans on tobacco advertising, sponsorship and promotion; smoke-free areas; graphic cigarette pack warnings; social marketing campaigns; cessation counseling; and an established tobacco control research program. The purpose of this study was to document and analyze the development of tobacco control research capacity in Thailand and the impact of research on Thai tobacco control measures. We used mixed methods including review of historical documentation and policy reports, qualitative interviews with key members of Thailand's tobacco control community, and an analysis of research productivity. In Thailand, tobacco control research has evolved through three phases: (1) discovery of the value of research in the policymaking arena, (2) development of a structure to support research capacity building through international collaborations supported by foreign funding agencies, and (3) delivery of locally relevant research made possible largely through substantial stable funding from a domestic health promotion foundation. Over two decades, Thai tobacco control advocates have constructed five steppingstones to success: (1) adapting foreign research to inform policymaking and lobbying for more support for domestic research; (2) attracting foreign funding agencies to support small-scale research and capacity building; (3) participating in multi-country research and capacity building programs; (4) using collaborative experiences to demonstrate the need for domestic support of locally relevant research; and (5) maintaining an unwavering commitment to research while being vigilant to ensure continued research support. The evolution of tobacco control research in Thailand provides examples of steppingstones that LMICs may be able to use to construct their own tobacco control research pathways.

Building tobacco control research in Thailand: meeting the need for innovative change in Asia

PubMed Central

2012-01-01

Introduction In low- and middle-income countries (LMICs) over the past two decades locally relevant tobacco control research has been scant. Experience shows that tobacco control measures should be based on sound research findings to ensure that measures are appropriate for local conditions and that they are likely to have an impact. Research should also be integrated within tobacco control measures to ensure ongoing learning and the production of knowledge. Thailand, a middle-income country, has a public health community with a record of successful tobacco control and a longstanding commitment to research. Thailand's comprehensive approach includes taxation; bans on tobacco advertising, sponsorship and promotion; smoke-free areas; graphic cigarette pack warnings; social marketing campaigns; cessation counseling; and an established tobacco control research program. The purpose of this study was to document and analyze the development of tobacco control research capacity in Thailand and the impact of research on Thai tobacco control measures. Method We used mixed methods including review of historical documentation and policy reports, qualitative interviews with key members of Thailand's tobacco control community, and an analysis of research productivity. Findings In Thailand, tobacco control research has evolved through three phases: (1) discovery of the value of research in the policymaking arena, (2) development of a structure to support research capacity building through international collaborations supported by foreign funding agencies, and (3) delivery of locally relevant research made possible largely through substantial stable funding from a domestic health promotion foundation. Over two decades, Thai tobacco control advocates have constructed five steppingstones to success: (1) adapting foreign research to inform policymaking and lobbying for more support for domestic research; (2) attracting foreign funding agencies to support small-scale research and capacity building; (3) participating in multi-country research and capacity building programs; (4) using collaborative experiences to demonstrate the need for domestic support of locally relevant research; and (5) maintaining an unwavering commitment to research while being vigilant to ensure continued research support. Conclusion The evolution of tobacco control research in Thailand provides examples of steppingstones that LMICs may be able to use to construct their own tobacco control research pathways. PMID:22284811

Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: evidence from India.

PubMed

Roy, Kakoli; Chaudhuri, Anoshua

2008-05-01

Empirical studies from developed countries observe that women report worse health and higher healthcare utilization than men, but the health disadvantage diminishes with age; gender differences in self-rated health often vanish or are reversed in older ages. Comparable assessments of health during later life from developing countries are limited because of the lack of large-scale surveys that include older women. Our study attempts to address the shortage of developing country studies by examining gender differences in health and healthcare utilization among older adults in India. Both ordered and binary logit specifications were used to assess significant gender differences in subjective and objective health, and healthcare utilization after controlling for demographics, medical conditions, traditional indicators of socioeconomic status like education and income, and additional wealth indicators. The wealth indicators, measured by property ownership and economic independence, are regarded as financially empowering older adults to exercise greater control over their health and well-being. Data are drawn from a nationally representative decennial socioeconomic and health survey of 120,942 Indian households conducted during 1995-1996. The study sample comprises 34,086 older men and women aged >or= 60 years. Our results indicate that older women report worse self-rated health, higher prevalence of disabilities, marginally lower chronic conditions, and lower healthcare utilization than men. The health disadvantage and lower utilization among women cannot be explained by demographics and the differential distribution of medical conditions. While successive controls for education, income, and property ownership narrows the gender gap in both health and healthcare utilization, significant differentials still persist. Upon controlling for economic independence, gender differentials disappear or are reversed, with older women having equal or better health than otherwise similar men. Financial empowerment might confer older women the health advantage reflected in developed societies by enhancing a woman's ability to undertake primary and secondary prevention during the life course.

“Fighting a Hurricane”: Tobacco Industry Efforts to Counter the Perceived Threat of Islam

PubMed Central

Lee, Kelley; Ali, Haider; Nakkash, Rima

2015-01-01

Islamic countries are of key importance to transnational tobacco companies as growing markets with increasing smoking rates. We analyzed internal tobacco industry documents to assess the industry’s response to rising concerns about tobacco use within Islamic countries. The tobacco industry perceived Islam as a significant threat to its expansion into these emerging markets. To counter these concerns, the industry framed antismoking views in Islamic countries as fundamentalist and fanatical and attempted to recruit Islamic consultants to portray smoking as acceptable. Tobacco industry lawyers also helped develop theological arguments in favor of smoking. These findings are valuable to researchers and policymakers seeking to implement culturally appropriate measures in Islamic countries under the World Health Organization Framework Convention on Tobacco Control. PMID:25880961

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

PubMed

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

2011-03-01

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

Waste management activities and carbon emissions in Africa.

PubMed

Couth, R; Trois, C

2011-01-01

This paper summarizes research into waste management activities and carbon emissions from territories in sub-Saharan Africa with the main objective of quantifying emission reductions (ERs) that can be gained through viable improvements to waste management in Africa. It demonstrates that data on waste and carbon emissions is poor and generally inadequate for prediction models. The paper shows that the amount of waste produced and its composition are linked to national Gross Domestic Product (GDP). Waste production per person is around half that in developed countries with a mean around 230 kg/hd/yr. Sub-Saharan territories produce waste with a biogenic carbon content of around 56% (+/-25%), which is approximately 40% greater than developed countries. This waste is disposed in uncontrolled dumps that produce large amounts of methane gas. Greenhouse gas (GHG) emissions from waste will rise with increasing urbanization and can only be controlled through funding mechanisms from developed countries. Copyright © 2010 Elsevier Ltd. All rights reserved.

Health and safety—the downward trend in lead levels

NASA Astrophysics Data System (ADS)

Mayer, M. G.; Wilson, D. N.

Lead has been known and used by man for thousands of years and its toxic properties have been known for almost as long. In consequence, a wide body of legislation has built up and is designed to protect individuals in both the occupational and the general environments. At the occupational level, two types of controls are widely employed, namely, lead-in-air and lead-in-blood. Limits placed on the amount of lead-in-air are designed to ensure that individuals are not exposed to unsafe levels of lead via inhalation. Currently, the most common standard is 0.15 mg m -3 but there is a clear downward trend and levels as low as 0.05 mg m -3 are mandatory in some countries. Controls on the amount of lead-in-blood give a more direct indication of the exposure experienced by individuals. The most common level presently employed is 70 μg m -3 but, as knowledge of the health effects of lead improves, lower levels are being introduced and 50 μg m -3 is now fairly common. While women are no more sensitive to lead than men, some countries do employ lower blood-lead limits for women in the workplace in order to protect any developing foetus. This paper examines the levels currently in force in various countries and describes developments which are now taking place in the legislation that is being enacted in several parts of the world. As far as the general public is concerned, only a relatively small number of countries employ controls. Where controls do exist, however, they are set at much lower levels than for the occupational environment in order to protect the most sensitive members of the population. Several countries employ limits on lead in ambient air. Traditionally, these have been set at either 1.5 or 2.0 μg m -3, but several countries are currently considering sharp downward revisions to levels of the order of 0.5 μg m -3. A few countries offer guidance on acceptable blood levels for the general population, most commonly for children. Again downward revisions are taking place but where data are available, there is a very encouraging downward trend also in average blood-lead levels found amongst members of the population. These must be due to a combination of factors which have reduced exposures to lead. The net result is that, at least in the more industrialized countries, average blood-lead levels have fallen to extremely low levels and very few individuals can be found with blood lead levels above currently accepted levels of concern.

An international technology platform for influenza vaccines.

PubMed

Hendriks, Jan; Holleman, Marit; de Boer, Otto; de Jong, Patrick; Luytjes, Willem

2011-07-01

Since 2008, the World Health Organization has provided seed grants to 11 manufacturers in low- and middle-income countries to establish or improve their pandemic influenza vaccine production capacity. To facilitate this ambitious project, an influenza vaccine technology platform (or "hub") was established at the Netherlands Vaccine Institute for training and technology transfer to developing countries. During its first two years of operation, a robust and transferable monovalent pilot process for egg-based inactivated whole virus influenza A vaccine production was established under international Good Manufacturing Practice standards, as well as in-process and release assays. A course curriculum was designed, including a two-volume practical handbook on production and quality control. Four generic hands-on training courses were successfully realized for over 40 employees from 15 developing country manufacturers. Planned extensions to the curriculum include cell-culture based technology for viral vaccine production, split virion influenza production, and generic adjuvant formulation. We conclude that technology transfer through the hub model works well, significantly builds vaccine manufacturing capacity in developing countries, and thereby increases global and equitable access to vaccines of high public health relevance. Copyright © 2011 Elsevier Ltd. All rights reserved.

Protozoan Parasites in Drinking Water: A System Approach for Improved Water, Sanitation and Hygiene in Developing Countries

PubMed Central

Tussupova, Kamshat; Berndtsson, Ronny; Sharapatova, Kulyash

2018-01-01

Improved water, sanitation and hygiene (WASH) are significant in preventing diarrhea morbidity and mortality caused by protozoa in low- and middle-income countries. Due to the intimate and complex relationships between the different WASH components, it is often necessary to improve not just one but all of these components to have sustainable results. The objective of this paper was to review the current state of WASH-related health problems caused by parasitic protozoa by: giving an overview and classification of protozoa and their effect on people’s health, discussing different ways to improve accessibility to safe drinking water, sanitation services and personal hygiene behavior; and suggesting an institutional approach to ensure improved WASH. The findings indicate that Giardia and Cryptosporidium are more often identified during waterborne or water-washed outbreaks and they are less sensitive than most of the bacteria and viruses to conventional drinking water and wastewater treatment methods. There are various institutions of control and prevention of water-related diseases caused by protozoa in developed countries. Unfortunately, the developing regions do not have comparable systems. Consequently, the institutional and systems approach to WASH is necessary in these countries. PMID:29534511

Marketing in developing countries.

PubMed

Pickering, A H

1979-10-27

I fully support the views of Mr. Chetley of War on Want on the marketing of infant foods in developing countries (Oct. 6, p. 747). My experience of eight years medical work in West Africa prompts me to broaden the debate. Advertising and promotional practices used by many European and American pharmaceutical companies are in many instances directed primarily to the non-professional and often poorly educated general public and appear to be geared simply to achieve the maximum volume of sales. Likewise, the cynical disregard of cigarette manufacturers for the dangers of smoking is very apparent in the way in which advertising and promotional campaigns are conducted in developing countries. Fifteen years ago cigarettes were largely imported items but now, certainly in one major West African country, there is a large and flourishing tobacco industry which appears to be run primarily by European interests and which is obviously not there for the health benefit of the people. Is it not a sad reflection on the morality of the society in which we live that, while striving to control unethical and undesirable practices at home, we make little or no effort to regulate those practices abroad when profit is the objective?

Protozoan Parasites in Drinking Water: A System Approach for Improved Water, Sanitation and Hygiene in Developing Countries.

PubMed

Omarova, Alua; Tussupova, Kamshat; Berndtsson, Ronny; Kalishev, Marat; Sharapatova, Kulyash

2018-03-12

Improved water, sanitation and hygiene (WASH) are significant in preventing diarrhea morbidity and mortality caused by protozoa in low- and middle-income countries. Due to the intimate and complex relationships between the different WASH components, it is often necessary to improve not just one but all of these components to have sustainable results. The objective of this paper was to review the current state of WASH-related health problems caused by parasitic protozoa by: giving an overview and classification of protozoa and their effect on people's health, discussing different ways to improve accessibility to safe drinking water, sanitation services and personal hygiene behavior; and suggesting an institutional approach to ensure improved WASH. The findings indicate that Giardia and Cryptosporidium are more often identified during waterborne or water-washed outbreaks and they are less sensitive than most of the bacteria and viruses to conventional drinking water and wastewater treatment methods. There are various institutions of control and prevention of water-related diseases caused by protozoa in developed countries. Unfortunately, the developing regions do not have comparable systems. Consequently, the institutional and systems approach to WASH is necessary in these countries.

Incidence and Mortality and Epidemiology of Breast Cancer in the World.

PubMed

Ghoncheh, Mahshid; Pournamdar, Zahra; Salehiniya, Hamid

2016-01-01

Breast cancer is the most common malignancy in women around the world. Information on the incidence and mortality of breast cancer is essential for planning health measures. This study aimed to investigate the incidence and mortality of breast cancer in the world using age-specific incidence and mortality rates for the year 2012 acquired from the global cancer project (GLOBOCAN 2012) as well as data about incidence and mortality of the cancer based on national reports. It was estimated that 1,671,149 new cases of breast cancer were identified and 521,907 cases of deaths due to breast cancer occurred in the world in 2012. According to GLOBOCAN, it is the most common cancer in women, accounting for 25.1% of all cancers. Breast cancer incidence in developed countries is higher, while relative mortality is greatest in less developed countries. Education of women is suggested in all countries for early detection and treatment. Plans for the control and prevention of this cancer must be a high priority for health policy makers; also, it is necessary to increase awareness of risk factors and early detection in less developed countries.

A comparison of chronic pain prevalence in Japan, Thailand, and myanmar.

PubMed

Sakakibara, Toshihiko; Wang, Zhuo; Paholpak, Permsak; Kosuwon, Weerachai; Oo, Myint; Kasai, Yuichi

2013-01-01

Pain has been regarded as important in the improvement of quality of life (QOL). In the advanced countries of Europe and the North America, a number of large-scale epidemiological surveys on pain, particularly chronic pain, have thus been performed in general populations. However, few epidemiological surveys of chronic pain have been reported from developing countries, and no surveys appear to have examined chronic pain in the least developed countries. To compare the incidence of chronic pain in Asian countries, using Japan as an advanced country, Thailand as a developing country, and Myanmar as one of the least developed countries. Cross-sectional study in 4 hospitals. A university hospital and a general hospital in Japan, a university hospital in Thailand, and a general hospital in Myanmar. Patients were 1,000 nursing staff working in Japan, 448 nursing staff working in Thailand, and 405 nursing staff working in Myanmar. The survey was performed by requesting all nursing staff to anonymously answer the questionnaire. Data were used to calculate chronic pain prevalence, pain site, presence or absence of consultation with doctors, methods of handling pain other than consultation with doctors, and whether pain was controlled for each country. The results were then compared between countries. The prevalence of chronic pain in Myanmar was 5.9%, which was significantly lower (P < 0.01) than in Japan (17.5%) or Thailand (19.9%). The most frequent pain sites were the lower back, head, and shoulders in Japan, and the shoulders, ankle, upper back, and head in Thailand, whereas in Myanmar, no clear certain tendencies were observed. The most frequent method for handling pain other than consultation with doctors was over-the-counter drugs in Japan, massage in Thailand, and relaxation therapy (meditation) in Myanmar. Limitations of this study were the cross-sectional design study, the small number of hospitals included, the limitation of patients to nursing staff, and the omission from the questionnaire of questions regarding body height and weight, working situation, family background, trauma history, sports activity history, smoking history, psychological/character tests, QOL, and pain levels of patients. The prevalence of chronic pain was significantly lower in Myanmar than in Japan or Thailand. With regard to the site and treatment of chronic pain, no clear tendencies were observed between countries, suggesting that frequency and the character of chronic pain differ from country to country around the world.

Strengthening individual capacity in monitoring and evaluation of malaria control programmes to streamline M&E systems and enhance information use in malaria endemic countries.

PubMed

Garley, Ashley; Eckert, Erin; Sie, Ali; Ye, Maurice; Malm, Keziah; Afari, Edwin A; Sawadogo, Mamadou; Herrera, Samantha; Ivanovich, Elizabeth; Ye, Yazoume

2016-05-28

Malaria control interventions in most endemic countries have intensified in recent years and so there is a need for a robust monitoring and evaluation (M&E) system to measure progress and achievements. Providing programme and M&E officers with the appropriate skills is a way to strengthen malaria's M&E systems and enhance information use for programmes' implementation. This paper describes a recent effort in capacity strengthening for malaria M&E in sub-Saharan Africa (SSA). From 2010 to 2014, capacity-strengthening efforts consisted of organizing regional in-person workshops for M&E of malaria programmes for Anglophone and Francophone countries in SSA in collaboration with partners from Ghana and Burkina Faso. Open-sourced online courses were also available in English. A post-workshop assessment was conducted after 5 years to assess the effects of these regional workshops and identify gaps in capacity. The regional workshops trained 181 participants from 28 countries from 2010 to 2014. Trained participants were from ministries of health, national malaria control and elimination programmes, non-governmental organizations, and development partners. The average score (%) for participants' knowledge tests increased from pretest to posttest for Anglophone workshops (2011: 59 vs. 76, 2012: 41 vs. 63, 2013: 51 vs. 73; 2014: 50 vs. 74). Similarly, Francophone workshop posttest scores increased, but were lower than Anglophone due to higher scores at pretest. (2011: 70 vs. 76, 2012: 74 vs. 79, 2013: 61 vs. 68; 2014: 64 vs. 75). Results of the post-workshop assessment revealed that participants retained practical M&E knowledge and skills for malaria programs, but there is a need for a module on malaria surveillance adapted to the pre-elimination context. The workshops were successful because of the curriculum content, facilitation quality, and the engagement of partner institutions with training expertise. Results from the post-workshop assessment will guide the curriculum's development and restructuring for the next phase of workshops. Country-specific malaria M&E capacity needs assessments may also inform this process as countries reduce malaria burden.

Risk factors for neonatal encephalopathy in Kathmandu, Nepal, a developing country: unmatched case-control study

PubMed Central

Ellis, Matthew; Manandhar, Nilu; Manandhar, Dharma S; Costello, Anthony M de L

2000-01-01

Objective To determine the risk factors for neonatal encephalopathy among term infants in a developing country. Design Unmatched case-control study. Setting Principal maternity hospital of Kathmandu, Nepal. Subjects All 131 infants with neonatal encephalopathy from a population of 21 609 infants born over an 18 month period, and 635 unmatched infants systematically recruited over 12 months. Main outcome measures Adjusted odds ratio estimates for antepartum and intrapartum risk factors. Results The prevalence of neonatal encephalopathy was 6.1 per 1000 live births of which 63% were infants with moderate or severe encephalopathy. The risk of death from neonatal encephalopathy was 31%. The risk of neonatal encephalopathy increased with increasing maternal age and decreasing maternal height. Antepartum risk factors included primiparity (odds ratio 2.0) and non-attendance for antenatal care (2.1). Multiple births were at greatly increased risk (22). Intrapartum risk factors included non-cephalic presentation (3.4), prolonged rupture of membranes (3.8), and various other complications. Particulate meconium was strongly associated with encephalopathy (18). Induction of labour with oxytocin was associated with encephalopathy in 12 of 41 deliveries (5.7). Overall, 78 affected infants (60%) compared with 36 controls (6%) either had evidence of intrapartum compromise or were born after an intrapartum difficulty likely to result in fetal compromise. A concentration of maternal haemoglobin of less than 8.0 g/dl in the puerperium was significantly associated with encephalopathy (2.5) as was a maternal thyroid stimulating hormone concentration greater than 5 mIU/l (2.1). Conclusions Intrapartum risk factors remain important for neonatal encephalopathy in developing countries. There is some evidence of a protective effect from antenatal care. The use of oxytocin in low income countries where intrapartum monitoring is suboptimal presents a major risk to the fetus. More work is required to explore the association between maternal deficiency states and neonatal encephalopathy. PMID:10797030

Brain research to ameliorate impaired neurodevelopment--home-based intervention trial (BRAIN-HIT).

PubMed

Wallander, Jan L; McClure, Elizabeth; Biasini, Fred; Goudar, Shivaprasad S; Pasha, Omrana; Chomba, Elwyn; Shearer, Darlene; Wright, Linda; Thorsten, Vanessa; Chakraborty, Hrishikesh; Dhaded, Sangappa M; Mahantshetti, Niranjana S; Bellad, Roopa M; Abbasi, Zahid; Carlo, Waldemar

2010-04-30

This randomized controlled trial aims to evaluate the effects of an early developmental intervention program on the development of young children in low- and low-middle-income countries who are at risk for neurodevelopmental disability because of birth asphyxia. A group of children without perinatal complications are evaluated in the same protocol to compare the effects of early developmental intervention in healthy infants in the same communities. Birth asphyxia is the leading specific cause of neonatal mortality in low- and low-middle-income countries and is also the main cause of neonatal and long-term morbidity including mental retardation, cerebral palsy, and other neurodevelopmental disorders. Mortality and morbidity from birth asphyxia disproportionately affect more infants in low- and low-middle-income countries, particularly those from the lowest socioeconomic groups. There is evidence that relatively inexpensive programs of early developmental intervention, delivered during home visit by parent trainers, are capable of improving neurodevelopment in infants following brain insult due to birth asphyxia. This trial is a block-randomized controlled trial that has enrolled 174 children with birth asphyxia and 257 without perinatal complications, comparing early developmental intervention plus health and safety counseling to the control intervention receiving health and safety counseling only, in sites in India, Pakistan, and Zambia. The interventions are delivered in home visits every two weeks by parent trainers from 2 weeks after birth until age 36 months. The primary outcome of the trial is cognitive development, and secondary outcomes include social-emotional and motor development. Child, parent, and family characteristics and number of home visits completed are evaluated as moderating factors. The trial is supervised by a trial steering committee, and an independent data monitoring committee monitors the trial. Findings from this trial have the potential to inform about strategies for reducing neurodevelopmental disabilities in at-risk young children in low and middle income countries.

The drug regulatory and review process in Guyana.

PubMed

Woo-Ming, R B

1993-01-01

After the old "Sale of Food and Drugs" Ordinance, Cap. 144 was repealed, the new Food and Drugs Act was enacted in 1971. This new Act has considerable flexibility and gives the Minister extensive authority to make Regulations (for carrying out the purposes and provisions of the Act). The Act controls the manufacture, importation, sale, advertising, labeling, packaging, and distribution of drug samples, and the testing of drugs. The Act also controls raw materials and finished products of drugs at the point of entry into the country, with a single agency coordinating both the inspection and analytical services. Developing countries could ensure the procurement of safe, good quality, and effective drugs and devices with the enactment of a similar Food and Drugs Act only. Rapid assessment of Drug Safety, Quality and Efficacy is done through Guyana's participation in the WHO Certification Scheme on the Quality of Pharmaceutical Products moving in International Commerce. This certification scheme is highly commendable especially to third-world countries. The Food and Drug Regulations (1977) have several unique features for drug, cosmetic and device control and they allow for a system of centralized control with limited staff to enforce the legislation. In summary, enforcement of legislative control of imported pharmaceuticals and product evaluation can be considered strong points in the drug regulatory and review process in Guyana. A cautious attitude is observed so as to ensure efficacy, safety, and quality of drugs entering the market. This Drug Regulatory and Review Process is recommended for implementation by third-world countries with outdated drug legislation.(ABSTRACT TRUNCATED AT 250 WORDS)

Availability and affordability of blood pressure-lowering medicines and the effect on blood pressure control in high-income, middle-income, and low-income countries: an analysis of the PURE study data.

PubMed

Attaei, Marjan W; Khatib, Rasha; McKee, Martin; Lear, Scott; Dagenais, Gilles; Igumbor, Ehimario U; AlHabib, Khalid F; Kaur, Manmeet; Kruger, Lanthe; Teo, Koon; Lanas, Fernando; Yusoff, Khalid; Oguz, Aytekin; Gupta, Rajeev; Yusufali, Afzalhussein M; Bahonar, Ahmad; Kutty, Raman; Rosengren, Annika; Mohan, Viswanathan; Avezum, Alvaro; Yusuf, Rita; Szuba, Andrzej; Rangarajan, Sumathy; Chow, Clara; Yusuf, Salim

2017-09-01

Hypertension is considered the most important risk factor for cardiovascular diseases, but its control is poor worldwide. We aimed to assess the availability and affordability of blood pressure-lowering medicines, and the association with use of these medicines and blood pressure control in countries at varying levels of economic development. We analysed the availability, costs, and affordability of blood pressure-lowering medicines with data recorded from 626 communities in 20 countries participating in the Prospective Urban Rural Epidemiological (PURE) study. Medicines were considered available if they were present in the local pharmacy when surveyed, and affordable if their combined cost was less than 20% of the households' capacity to pay. We related information about availability and affordability to use of these medicines and blood pressure control with multilevel mixed-effects logistic regression models, and compared results for high-income, upper-middle-income, lower-middle-income, and low-income countries. Data for India are presented separately because it has a large generic pharmaceutical industry and a higher availability of medicines than other countries at the same economic level. The availability of two or more classes of blood pressure-lowering drugs was lower in low-income and middle-income countries (except for India) than in high-income countries. The proportion of communities with four drug classes available was 94% in high-income countries (108 of 115 communities), 76% in India (68 of 90), 71% in upper-middle-income countries (90 of 126), 47% in lower-middle-income countries (107 of 227), and 13% in low-income countries (nine of 68). The proportion of households unable to afford two blood pressure-lowering medicines was 31% in low-income countries (1069 of 3479 households), 9% in middle-income countries (5602 of 65 471), and less than 1% in high-income countries (44 of 10 880). Participants with known hypertension in communities that had all four drug classes available were more likely to use at least one blood pressure-lowering medicine (adjusted odds ratio [OR] 2·23, 95% CI 1·59-3·12); p<0·0001), combination therapy (1·53, 1·13-2·07; p=0·054), and have their blood pressure controlled (2·06, 1·69-2·50; p<0·0001) than were those in communities where blood pressure-lowering medicines were not available. Participants with known hypertension from households able to afford four blood pressure-lowering drug classes were more likely to use at least one blood pressure-lowering medicine (adjusted OR 1·42, 95% CI 1·25-1·62; p<0·0001), combination therapy (1·26, 1·08-1·47; p=0·0038), and have their blood pressure controlled (1·13, 1·00-1·28; p=0·0562) than were those unable to afford the medicines. A large proportion of communities in low-income and middle-income countries do not have access to more than one blood pressure-lowering medicine and, when available, they are often not affordable. These factors are associated with poor blood pressure control. Ensuring access to affordable blood pressure-lowering medicines is essential for control of hypertension in low-income and middle-income countries. Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, Canadian Institutes of Health Research Strategy for Patient Oriented Research through the Ontario SPOR Support Unit, the Ontario Ministry of Health and Long-Term Care, pharmaceutical companies (with major contributions from AstraZeneca [Canada], Sanofi Aventis [France and Canada], Boehringer Ingelheim [Germany amd Canada], Servier, and GlaxoSmithKline), Novartis and King Pharma, and national or local organisations in participating countries. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Novel strategies for controlling Streptococcus pyogenes infection and associated diseases: from potential peptide vaccines to antibody immunotherapy.

PubMed

Pandey, Manisha; Sekuloski, Silvana; Batzloff, Michael R

2009-07-01

Infections caused by group A streptococcus (GAS) represent a public health problem in both developing and developed countries. The current available methods of prevention are either inadequate or ineffective, which is highlighted by the resurgence in invasive GAS infections over the past two decades. The management of GAS and associated diseases requires new and improved approaches. This review discusses various potential approaches in controlling GAS infections, ranging from prophylactic vaccines to antibody immunotherapy.

SEATCA Tobacco Industry Interference Index: a tool for measuring implementation of WHO Framework Convention on Tobacco Control Article 5.3.

PubMed

Assunta, Mary; Dorotheo, E Ulysses

2016-05-01

To measure the implementation of WHO Framework Convention on Tobacco Control (FCTC) Article 5.3 at country level using a new Tobacco Industry Interference Index and to report initial results using this index in seven Southeast Asian countries. Score sheet based on WHO FCTC Article 5.3 Guidelines sent to correspondents in seven Southeast Asian countries, using a scoring system designed with the help of tobacco control experts and validated through focused group discussions. The seven countries ranked from the lowest level of interference to the highest are Brunei, Thailand, Lao PDR, Cambodia, Philippines, Malaysia and Indonesia. Countries that face high levels of unnecessary interaction with the tobacco industry also face high levels of tobacco industry influence in policy development. Most governments do not allow any tobacco industry representatives on their delegation to sessions of the Conference of the Parties or its subsidiary bodies nor accept their sponsorship for delegates, but most governments still accept or endorse offers of assistance from the tobacco industry in implementing tobacco control policies. Most governments also receive tobacco industry contributions (monetary or in kind) or endorse industry corporate social responsibility activities. Governments do not have a procedure for disclosing interactions with the tobacco industry, but Lao PDR, Philippines and Thailand have instituted measures to prevent or reduce industry interference. This Tobacco Industry Interference Index, based on the WHO FCTC Article 5.3 Guidelines, is a useful advocacy tool for identifying both progress and gaps in national efforts at implementing WHO FCTC Article 5.3. 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/

Controlling hepatitis C in Rwanda: a framework for a national response.

PubMed

Mbituyumuremyi, Aimable; Van Nuil, Jennifer Ilo; Umuhire, Jeanne; Mugabo, Jules; Mwumvaneza, Mutagoma; Makuza, Jean Damascene; Umutesi, Justine; Nsanzimana, Sabin; Gupta, Neil

2018-01-01

With the introduction of direct-acting antiviral drugs, treatment of hepatitis C is both highly effective and tolerable. Access to treatment for patients, however, remains limited in low- and middle-income countries due to the lack of supportive health infrastructure and the high cost of treatment. Poorer countries are being encouraged by international bodies to organize public health responses that would facilitate the roll-out of care and treatment on a national scale. Yet few countries have documented formal plans and policies. Here, we outline the approach taken in Rwanda to a public health framework for hepatitis C control and care within the World Health Organization hepatitis health sector strategy. This includes the development and implementation of policies and programmes, prevention efforts, screening capacity, treatment services and strategic information systems. We highlight key successes by the national programme for the control and management of hepatitis C: establishment of national governance and planning; development of diagnostic capacity; approval and introduction of direct-acting antiviral treatments; training of key personnel; generation of political will and leadership; and fostering of key strategic partnerships. Existing challenges and next steps for the programme include developing a detailed monitoring and evaluation framework and tools for monitoring of viral hepatitis. The government needs to further decentralize care and integrate hepatitis C management into routine clinical services to provide better access to diagnosis and treatment for patients. Introducing rapid diagnostic tests to public health-care facilities would help to increase case-finding. Increased public and private financing is essential to support care and treatment services.

Impediments to global surveillance of infectious diseases: consequences of open reporting in a global economy.

PubMed Central

Cash, R. A.; Narasimhan, V.

2000-01-01

Globalization has led to an increase in the spread of emerging and re-emerging infectious diseases. International efforts are being launched to control their dissemination through global surveillance, a major hindrance to which is the failure of some countries to report outbreaks. Current guidelines and regulations on emerging and re-emerging infectious diseases do not sufficiently take into account the fact that when developing countries report outbreaks they often derive few benefits and suffer disproportionately heavy social and economic consequences. In order to facilitate full participation in global surveillance by developing countries there should be: better and more affordable diagnostic capabilities to allow for timely and accurate information to be delivered in an open and transparent fashion; accurate, less sensationalist news reporting of outbreaks of diseases; adherence by countries to international regulations, including those of the World Trade Organization and the International Health Regulations; financial support for countries that are economically damaged by the diseases in question. The article presents two cases--plague in India and cholera in Peru--that illuminate some of the limitations of current practices. Recommendations are made on measures that could be taken by WHO and the world community to make global surveillance acceptable. PMID:11143197

Health systems' responsiveness and its characteristics: a cross-country comparative analysis.

PubMed

Robone, Silvana; Rice, Nigel; Smith, Peter C

2011-12-01

OBJECTIVES. Responsiveness has been identified as one of the intrinsic goals of health care systems. Little is known, however, about its determinants. Our objective is to investigate the potential country-level drivers of health system responsiveness. DATA SOURCE. Data on responsiveness are taken from the World Health Survey. Information on country-level characteristics is obtained from a variety of sources including the United Nations Development Program (UNDP). STUDY DESIGN. A two-step procedure. First, using survey data we derive a country-level measure of system responsiveness purged of differences in individual reporting behavior. Secondly, we run cross-sectional country-level regressions of responsiveness on potential drivers. PRINCIPAL FINDINGS. Health care expenditures per capita are positively associated with responsiveness, after controlling for the influence of potential confounding factors. Aspects of responsiveness are also associated with public sector spending (negatively) and educational development (positively). CONCLUSIONS. From a policy perspective, improvements in responsiveness may require higher spending levels. The expansion of nonpublic sector provision, perhaps in the form of increased patient choice, may also serve to improve responsiveness. However, these inferences are tentative and require further study. © Health Research and Educational Trust.

A survey of tobacco dependence treatment guidelines in 121 countries

PubMed Central

Piné-Abata, Hembadoon; McNeill, Ann; Raw, Martin; Bitton, Asaf; Rigotti, Nancy; Murray, Rachael

2013-01-01

Aims To report progress among Parties to the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in developing national tobacco treatment guidelines in accordance with FCTC Article 14 guideline recommendations. Design Cross-sectional study. Setting Electronic survey from December 2011 to August 2012; participants were asked to complete either an online or attached Microsoft Word questionnaire. Participants One hundred and sixty-three of the 173 Parties to the FCTC at the time of our survey. Measurements The 51-item questionnaire contained 30 items specifically on guidelines. Questions covered the areas of guidelines writing process, content, key recommendations and other characteristics. Findings One hundred and twenty-one countries (73%) responded. Fifty-three countries (44%) had guidelines, ranging from 75% among high-income countries to 11% among low-income countries. Nearly all guidelines recommended brief advice (93%), intensive specialist support (93%) and medications (96%), while 66% recommended quitlines. Fifty-seven percent had a dissemination strategy, 76% stated funding source and 68% had professional endorsement. Conclusion Fewer than half of the Parties to the WHO FCTC have developed national tobacco treatment guidelines, but, where guidelines exist, they broadly follow FCTC Article 14 guideline recommendations. PMID:23437892

Is the reporting timeliness gap for avian flu and H1N1 outbreaks in global health surveillance systems associated with country transparency?

PubMed

Tsai, Feng-Jen; Tseng, Eva; Chan, Chang-Chuan; Tamashiro, Hiko; Motamed, Sandrine; Rougemont, André C

2013-03-25

This study aims to evaluate the length of time elapsed between reports of the same incidents related to avian flu and H1N1 outbreaks published by the WHO and ProMED-mail, the two major global health surveillance systems, before and after the amendment of the International Health Regulations in 2005 (IHR 2005) and to explore the association between country transparency and this timeliness gap. We recorded the initial release dates of each report related to avian flu or H1N1 listed on the WHO Disease Outbreak News site and the matching outbreak report from ProMED-mail, a non-governmental program for monitoring emerging diseases, from 2003 to the end of June 2009. The timeliness gap was calculated as the difference in days between the report release dates of the matching outbreaks in the WHO and ProMED-mail systems. Civil liberties scores were collected as indicators of the transparency of each country. The Human Development Index and data indicating the density of physicians and nurses were collected to reflect countries' development and health workforce statuses. Then, logistic regression was performed to determine the correlation between the timeliness gap and civil liberties, human development, and health workforce status, controlling for year. The reporting timeliness gap for avian flu and H1N1 outbreaks significantly decreased after 2003. On average, reports were posted 4.09 (SD = 7.99) days earlier by ProMED-mail than by the WHO. Countries with partly free (OR = 5.77) and free civil liberties scores (OR = 10.57) had significantly higher likelihoods of longer timeliness gaps than non-free countries. Similarly, countries with very high human development status had significantly higher likelihoods of longer timeliness gaps than countries with middle or low human development status (OR = 5.30). However, no association between the timeliness gap and health workforce density was found. The study found that the adoption of IHR 2005, which contributed to countries' awareness of the importance of timely reporting, had a significant impact in improving the reporting timeliness gap. In addition, the greater the civil liberties in a country (e.g., importance of freedom of the media), the longer the timeliness gap.

Geographical aspects of geo-arbitrage: work in Canada and live in countries with low cost of living

NASA Astrophysics Data System (ADS)

Penney, J.; Dramowicz, K.

2016-04-01

The term geo-arbitrage means taking advantage of the difference in living costs between different geographic locations. This paper focuses on geographical aspects of international geo-arbitrage based on differences in the cost of living from one country to another. More precisely, the paper shows the perspective for a Canadian (student, volunteer, entrepreneur, IT person, or retiree) with some sort of mobile income or savings can take advantage of price differences by traveling to other countries. The paper is based on world development indicators, which cover a wide range of criteria when moving to another country. The data were collected for approximately 200 countries and represent the following categories of criteria: cost of living (economic factors), standard of living (such as safety, health care, environmental issues), and personal preferences (such as distance to home, Internet access or popularity of English language). The user input is required to rank or weight the importance of each of the criteria when moving to another country. One model was developed to emphasize the cost of living by controlling the weights ‘behind-the-scenes’. The results produce a list of the top suitable countries to practice geo-arbitrage. Another model allows the user to input weights for each criteria instead of ranks. The results from both models are mapped based on resulting suitability values. The top selected suitable countries are mapped, and the more specific information on each selected country is presented to the user, including the detailed cost of living, and current travel warning.