Health seeking behaviour and health service utilization in Pakistan: challenging the policy makers.

PubMed

Shaikh, Babar T; Hatcher, Juanita

2005-03-01

There is a growing literature on health seeking behaviours and the determinants of health services utilization especially in the context of developing countries. However, very few focused studies have been seen in Pakistan in this regard. This paper presents an extensive literature review of the situation in developing countries and relates the similar factors responsible for shaping up of a health seeking behaviour and health service utilization in Pakistan. The factors determining the health behaviours may be seen in various contexts: physical, socio-economic, cultural and political. Therefore, the utilization of a health care system, public or private, formal or non-formal, may depend on socio-demographic factors, social structures, level of education, cultural beliefs and practices, gender discrimination, status of women, economic and political systems environmental conditions, and the disease pattern and health care system itself. Policy makers need to understand the drivers of health seeking behaviour of the population in an increasingly pluralistic health care system. Also a more concerted effort is required for designing behavioural health promotion campaigns through inter-sectoral collaboration focusing more on disadvantaged segments of the population.

Health Seeking Behaviour among Undergraduates in the Faculty of Health Sciences and Technology, University of Nigeria Enugu Campus

ERIC Educational Resources Information Center

Ajaegbu, Okechukwu Odinaka; Ubochi, Ijendu Ihuarulam

2016-01-01

Health is essential for social and economic development of any country. Nearly 10 million children in developing countries die each year before reaching the age of five from ailments, mostly pneumonia, diarrhea, and malaria. The socio-cultural belief about the causation of disease and its curability has direct correlation with the treatment…

A profile of students receiving counselling services at a university in post-apartheid South Africa.

PubMed

Bowman, Brett; Payne, Jarrod

2011-12-01

The purpose of this study was to describe a profile of students seeking counselling at a racially diverse university in post-apartheid South Africa as a means to demonstrate the importance of routinely collecting and analysing student counselling data at university-based centres across the country. Student data were extracted from the only two counselling centres based at the University of the Witwatersrand in Johannesburg that provided services to 831 students during 2008. The 26 243 students that did not seek counselling during this period formed the comparison group. These data were analysed using logistic regression. Black, female and students within the 21-25 year age category were more likely to receive counselling, and presenting problems varied by population group. Given the country's past and continued levels of social asymmetry, we argue that the development of standardised university-based reporting systems able to describe the characteristics and presenting problems of students seeking counselling across South African universities should be prioritised by its higher education sector. Timely access to information of this kind is crucial to the generation of evidence-based mental health interventions in a population that is especially important to the country's development vision.

Factors Influencing Professional Help-Seeking for Suicidality.

PubMed

Han, Jin; Batterham, Philip J; Calear, Alison L; Randall, Rebecca

2018-05-01

Evidence suggests that the majority of people with suicidality do not seek help. Little systematic evaluation of factors influencing professional help-seeking has been done. To systematically evaluate the factors that influence professional help-seeking for suicidality. Published quantitative and qualitative studies in Medline and PsycInfo databases were reviewed following PRISMA. In all, 55 relevant studies were identified. Of these, 15 studies examined professional help-seeking intentions for perceived suicidal ideation, among people with or without suicidality; 21 studies examined professional help-seeking behavior among people with suicidality; and 19 studies examined suicidal decedents' health services use. Several potential important barriers were identified including high self-reliance, lack of perceived need for treatment, and stigmatizing attitudes toward suicide, toward mental health issues, and toward seeking professional treatment. The presence of suicidality and mental health issues was found to generally decrease help-seeking intentions for perceived suicidal ideation while facilitating actual service use. Social support and informal support from family and friends also played an important role in professional help-seeking. Although the majority of the included studies were of sound quality, some of the factors identified in the review were assessed in relatively few studies, and most of the included studies were conducted in industrialized countries. Further quantitative and qualitative studies examining the potential important factors in broader community samples, especially in developing countries, are needed.

Mapping publication trends and identifying hot spots of research on Internet health information seeking behavior: a quantitative and co-word biclustering analysis.

PubMed

Li, Fan; Li, Min; Guan, Peng; Ma, Shuang; Cui, Lei

2015-03-25

The Internet has become an established source of health information for people seeking health information. In recent years, research on the health information seeking behavior of Internet users has become an increasingly important scholarly focus. However, there have been no long-term bibliometric studies to date on Internet health information seeking behavior. The purpose of this study was to map publication trends and explore research hot spots of Internet health information seeking behavior. A bibliometric analysis based on PubMed was conducted to investigate the publication trends of research on Internet health information seeking behavior. For the included publications, the annual publication number, the distribution of countries, authors, languages, journals, and annual distribution of highly frequent major MeSH (Medical Subject Headings) terms were determined. Furthermore, co-word biclustering analysis of highly frequent major MeSH terms was utilized to detect the hot spots in this field. A total of 533 publications were included. The research output was gradually increasing. There were five authors who published four or more articles individually. A total of 271 included publications (50.8%) were written by authors from the United States, and 516 of the 533 articles (96.8%) were published in English. The eight most active journals published 34.1% (182/533) of the publications on this topic. Ten research hot spots were found: (1) behavior of Internet health information seeking about HIV infection or sexually transmitted diseases, (2) Internet health information seeking behavior of students, (3) behavior of Internet health information seeking via mobile phone and its apps, (4) physicians' utilization of Internet medical resources, (5) utilization of social media by parents, (6) Internet health information seeking behavior of patients with cancer (mainly breast cancer), (7) trust in or satisfaction with Web-based health information by consumers, (8) interaction between Internet utilization and physician-patient communication or relationship, (9) preference and computer literacy of people using search engines or other Web-based systems, and (10) attitude of people (especially adolescents) when seeking health information via the Internet. The 10 major research hot spots could provide some hints for researchers when launching new projects. The output of research on Internet health information seeking behavior is gradually increasing. Compared to the United States, the relatively small number of publications indexed by PubMed from other developed and developing countries indicates to some extent that the field might be still underdeveloped in many countries. More studies on Internet health information seeking behavior could give some references for health information providers.

Establishment of the International Power Institute. Final technical report

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

Julius E. Coles

The International Power Institute, in collaboration with American industries, seeks to address technical, political, economic and cultural issues of developing countries in the interest of facilitating profitable transactions in power related infrastructure projects. IPI works with universities, governments and commercial organizations to render project-specific recommendations for private-sector investment considerations. IPI also established the following goals: Facilitate electric power infrastructure transactions between developing countries and the US power industry; Collaborate with developing countries to identify development strategies to achieve energy stability; and Encourage market driven solutions and work collaboratively with other international trade energy, technology and banking organizations.

Brain drain from developing countries: how can brain drain be converted into wisdom gain?

PubMed Central

Dodani, Sunita; LaPorte, Ronald E

2005-01-01

Brain drain is defined as the migration of health personnel in search of the better standard of living and quality of life, higher salaries, access to advanced technology and more stable political conditions in different places worldwide. This migration of health professionals for better opportunities, both within countries and across international borders, is of growing concern worldwide because of its impact on health systems in developing countries. Why do talented people leave their countries and go abroad? What are the consequences of such migrations especially on the educational sector? What policies can be adopted to stem such movements from developing countries to developed countries? This article seeks to raise questions, identify key issues and provide solutions which would enable immigrant health professionals to share their knowledge, skills and innovative capacities and thereby enhancing the economic development of their countries. PMID:16260795

International Assistance for Low-Emission Development Planning: Coordinated Low Emissions Assistance Network (CLEAN) Inventory of Activities and Tools--Preliminary Trends

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

Cox, S.; Benioff, R.

2011-05-01

The Coordinated Low Emissions Assistance Network (CLEAN) is a voluntary network of international practitioners supporting low-emission planning in developing countries. The network seeks to improve quality of support through sharing project information, tools, best practices and lessons, and by fostering harmonized assistance. CLEAN has developed an inventory to track and analyze international technical support and tools for low-carbon planning activities in developing countries. This paper presents a preliminary analysis of the inventory to help identify trends in assistance activities and tools available to support developing countries with low-emission planning.

GPE's Engagement on Domestic Financing for Education. Policy Brief

ERIC Educational Resources Information Center

Martinez, Raphaelle; Terway, Arushi

2016-01-01

The Global Partnership for Education (GPE) is a global, multi-stakeholder partnership that seeks to strengthen education systems in low- and lower-middle-income countries and in countries affected by fragility and conflict to ensure equitable, quality education for all. GPE plays a unique role in helping governments to develop and finance the…

LEDS Global Partnership in Action: Advancing Climate-Resilient Low Emission Development Around the World (Fact Sheet)

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

Not Available

2013-11-01

Many countries around the globe are designing and implementing low emission development strategies (LEDS). These LEDS seek to achieve social, economic, and environmental development goals while reducing long-term greenhouse gas (GHG) emissions and increasing resiliency to climate change impacts. The LEDS Global Partnership (LEDS GP) harnesses the collective knowledge and resources of more than 120 countries and international donor and technical organizations to strengthen climate-resilient low emission development efforts around the world.

BRIC in the Backyard: Brazil’s Economic Rise and What it Means for the United States (CSL Issue Paper, Volume 14-11, July 2011)

DTIC Science & Technology

2011-07-01

component in the administration’s plans to generate future growth for the country . To develop and optimize export opportunities, the government is...seeking expanded trade ties with developing countries , as well as a strengthening of the Common Market of the South – Mercosul (Mercosur in Spanish...one of these of these geo-political risers and it is perhaps the most underestimated of the so-called BRIC countries . The term BRIC was coined by Jim

Unravelling the spirits’ message: a study of help-seeking steps and explanatory models among patients suffering from spirit possession in Uganda

PubMed Central

2014-01-01

As in many cultures, also in Uganda spirit possession is a common idiom of distress associated with traumatic experiences. In the DSM-IV and -5, possession trance disorders can be classified as dissociative disorders. Dissociation in Western countries is associated with complicated, time-consuming and costly therapies. Patients with spirit possession in SW Uganda, however, often report partial or full recovery after treatment by traditional healers. The aim of this study is to explore how the development of symptoms concomitant help-seeking steps, and explanatory models (EM) eventually contributed to healing of patients with spirit possession in SW Uganda. Illness narratives of 119 patients with spirit possession referred by traditional healers were analysed using a mixed-method approach. Treatments of two-thirds of the patients were unsuccessful when first seeking help in the medical sector. Their initially physical symptoms subsequently developed into dissociative possession symptoms. After an average of two help-seeking steps, patients reached a healing place where 99% of them found satisfactory EM and effective healing. During healing sessions, possessing agents were summoned to identify themselves and underlying problems were addressed. Often-mentioned explanations were the following: neglect of rituals and of responsibilities towards relatives and inheritance, the call to become a healer, witchcraft, grief, and land conflicts. The results demonstrate that traditional healing processes of spirit possession can play a role in restoring connections with the supra-, inter-, intra-, and extra-human worlds. It does not always seem necessary to address individual traumatic experiences per se, which is in line with other research in this field. The study leads to additional perspectives on treatment of trauma-related dissociation in Western countries and on developing effective mental health services in low -and middle-income countries. PMID:24940355

Unravelling the spirits' message: a study of help-seeking steps and explanatory models among patients suffering from spirit possession in Uganda.

PubMed

van Duijl, Marjolein; Kleijn, Wim; de Jong, Joop

2014-01-01

As in many cultures, also in Uganda spirit possession is a common idiom of distress associated with traumatic experiences. In the DSM-IV and -5, possession trance disorders can be classified as dissociative disorders. Dissociation in Western countries is associated with complicated, time-consuming and costly therapies. Patients with spirit possession in SW Uganda, however, often report partial or full recovery after treatment by traditional healers. The aim of this study is to explore how the development of symptoms concomitant help-seeking steps, and explanatory models (EM) eventually contributed to healing of patients with spirit possession in SW Uganda. Illness narratives of 119 patients with spirit possession referred by traditional healers were analysed using a mixed-method approach. Treatments of two-thirds of the patients were unsuccessful when first seeking help in the medical sector. Their initially physical symptoms subsequently developed into dissociative possession symptoms. After an average of two help-seeking steps, patients reached a healing place where 99% of them found satisfactory EM and effective healing. During healing sessions, possessing agents were summoned to identify themselves and underlying problems were addressed. Often-mentioned explanations were the following: neglect of rituals and of responsibilities towards relatives and inheritance, the call to become a healer, witchcraft, grief, and land conflicts. The results demonstrate that traditional healing processes of spirit possession can play a role in restoring connections with the supra-, inter-, intra-, and extra-human worlds. It does not always seem necessary to address individual traumatic experiences per se, which is in line with other research in this field. The study leads to additional perspectives on treatment of trauma-related dissociation in Western countries and on developing effective mental health services in low -and middle-income countries.

Mapping Publication Trends and Identifying Hot Spots of Research on Internet Health Information Seeking Behavior: A Quantitative and Co-Word Biclustering Analysis

PubMed Central

Li, Fan; Li, Min; Guan, Peng; Ma, Shuang

2015-01-01

Background The Internet has become an established source of health information for people seeking health information. In recent years, research on the health information seeking behavior of Internet users has become an increasingly important scholarly focus. However, there have been no long-term bibliometric studies to date on Internet health information seeking behavior. Objective The purpose of this study was to map publication trends and explore research hot spots of Internet health information seeking behavior. Methods A bibliometric analysis based on PubMed was conducted to investigate the publication trends of research on Internet health information seeking behavior. For the included publications, the annual publication number, the distribution of countries, authors, languages, journals, and annual distribution of highly frequent major MeSH (Medical Subject Headings) terms were determined. Furthermore, co-word biclustering analysis of highly frequent major MeSH terms was utilized to detect the hot spots in this field. Results A total of 533 publications were included. The research output was gradually increasing. There were five authors who published four or more articles individually. A total of 271 included publications (50.8%) were written by authors from the United States, and 516 of the 533 articles (96.8%) were published in English. The eight most active journals published 34.1% (182/533) of the publications on this topic. Ten research hot spots were found: (1) behavior of Internet health information seeking about HIV infection or sexually transmitted diseases, (2) Internet health information seeking behavior of students, (3) behavior of Internet health information seeking via mobile phone and its apps, (4) physicians’ utilization of Internet medical resources, (5) utilization of social media by parents, (6) Internet health information seeking behavior of patients with cancer (mainly breast cancer), (7) trust in or satisfaction with Web-based health information by consumers, (8) interaction between Internet utilization and physician-patient communication or relationship, (9) preference and computer literacy of people using search engines or other Web-based systems, and (10) attitude of people (especially adolescents) when seeking health information via the Internet. Conclusions The 10 major research hot spots could provide some hints for researchers when launching new projects. The output of research on Internet health information seeking behavior is gradually increasing. Compared to the United States, the relatively small number of publications indexed by PubMed from other developed and developing countries indicates to some extent that the field might be still underdeveloped in many countries. More studies on Internet health information seeking behavior could give some references for health information providers. PMID:25830358

Policies to Support Wind Power Deployment: Key Considerations and Good Practices

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

Cox, Sadie; Tegen, Suzanne; Baring-Gould, Ian

2015-05-19

Policies have played an important role in scaling up wind deployment and increasing its economic viability while also supporting country-specific economic, social, and environmental development goals. Although wind power has become cost-competitive in several contexts, challenges to wind power deployment remain. Within the context of country-specific goals and challenges, policymakers are seeking

JPRS Report, East Asia, Southeast Asia.

DTIC Science & Technology

1988-10-11

has suddenly appeared. NICs are countries that are between developed and undeveloped . No one knows for sure. Even those who invented this term are...Tuesday—Australia will seek the sup- port of Asian and Pacific countries for a regional initia- tive against the spread of chemical weapons. The move...spread beyond the Iran-Iraq conflict. The use of chemical weapons in the war between these two countries resulted recently in the death of an esti

A Study of Computer Center Management

DTIC Science & Technology

1988-06-01

the United States and the rest of the western world and do not take into consideration the various economic and culture factors in developing countries...Mortagy, Thesis Advisor John B Isett, Second Reader David R. Whipple -airman Department of . .&;-sation Science mes M.mgen, Act ng Dean of nm_ Jon and oli...take into consideration the various economic and culture factors in developing countries. This thesis seeks to present a number of new techniques in

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

PubMed

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

2016-05-01

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

East-West transport corridor feasibility study : phase 1, vol. 2 : development plans : final report

DOT National Transportation Integrated Search

1998-04-01

This study, conducted by Bechtel International, was funded by the U.S. Trade and Development Agency. The member countries of the South Balkan Initiative Program (Albania, Macedonia, and Bulgaria) are seeking to improve their transportation infrastruc...

GEOGRAPHIC FACTORS IN EMPLOYMENT AND MANPOWER DEVELOPMENT.

ERIC Educational Resources Information Center

Department of Labor, Washington, DC.

THIS COUNTRY MUST FACE THE ECONOMIC AND SOCIAL CONSEQUENCES OF CHANGING PATTERNS OF EMPLOYMENT LOCATION WHICH RESULT FROM SHIFTING CURRENTS OF TECHNOLOGICAL CHANGE, PRODUCT DEMAND, AND JOB AND PROFIT SEEKING. ECONOMIC DEVELOPMENT PROGRAMS OF THE LAST 7 YEARS, EMPLOYING A WIDE VARIETY OF APPROACHES TO THEIR COMMON GOAL OF ECONOMIC DEVELOPMENT AND…

New Liberian President Seeks to Rehabilitate Country's Education System: Finding Teachers Still Country's Main Hurdle

ERIC Educational Resources Information Center

Powell, Tracie

2007-01-01

Troubled by the difficulties of training teachers in Liberia, President Ellen Johnson Sirleaf says she hopes to attract them from U.S. colleges and universities. Sirleaf envisions the Liberian Education Trust as a way to help repair a country devastated by two civil wars. The trust seeks to raise money so that the West African country can build 50…

The Spiral Gallery: Non-Market Creativity and Belonging in an Australian Country Town

ERIC Educational Resources Information Center

Waitt, Gordon; Gibson, Chris

2013-01-01

This paper seeks to explore creative practice in an Australian country town, and in so doing, to unsettle market-orientated interpretations of creativity that privilege the urban. Instead of focusing on creative practice as a means to develop industries, we focus on how creativity is a means to establish a cooperative gallery space that helps to…

Slow progress in diarrhea case management in low and middle income countries: evidence from cross-sectional national surveys, 1985-2012.

PubMed

Sreeramareddy, Chandrashekhar T; Low, Yue-Peng; Forsberg, Birger Carl

2017-03-21

Diarrhea remains to be a main cause of childhood mortality. Diarrhea case management indicators reflect the effectiveness of child survival interventions. We aimed to assess time trends and country-wise changes in diarrhea case management indicators among under-5 children in low-and-middle-income countries. We analyzed aggregate data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys done from 1986 to 2012 in low-and-middle-income countries. Two-week prevalence rates of diarrhea, caregiver's care seeking behavior and three case management indicators were analyzed. We assessed overall time trends across the countries using panel data analyses and country-level changes between two sequential surveys. Overall, yearly increase in case management indicators ranged from 1 · 3 to 2 · 5%. In the year 2012, <50% of the children were given correct treatment (received oral rehydration and increased fluids) for diarrhea. Annually, an estimated 300 to 350 million children were not given oral rehydration solutions, or recommended home fluids or 'increased fluids' and 304 million children not taken to a healthcare provider during an episode of diarrhea. Overall, care seeking for diarrhea, increased from pre-2000 to post-2000, i.e. from 35 to 45%; oral rehydration rates increased by about 7% but the rate of 'increased fluids' decreased by 14%. Country-level trends showed that care seeking had decreased in 15 countries but increased in 33 countries. Care seeking from a healthcare provider increased by ≥10% in about 23 countries. Oral rehydration rates had increased by ≥10% in 15 countries and in 30 countries oral rehydration rates increased by <10%. Very limited progress has been made in the case management of childhood diarrhea. A better understanding of caregiver's care seeking behavior and health care provider's case management practices is needed to improve diarrhea case management in low- and-middle-income countries.

Providing ethical guidance for collaborative research in developing countries

PubMed Central

Morris, Nina

2015-01-01

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

Policies of access to healthcare services for accompanied asylum-seeking children in the Nordic countries.

PubMed

Sandahl, Hinuga; Norredam, Marie; Hjern, Anders; Asher, Henry; Nielsen, Signe Smith

2013-08-01

Asylum-seeking children constitute a vulnerable group with high prevalence and risk for mental health problems. The aim of this study was to compare policies of access to healthcare services, including physical examination and screening for mental health problems on arrival, for accompanied asylum-seeking children in the Nordic countries. This study was based on the national reports "Reception of refugee children in the Nordic countries" written by independent national experts for the Nordic Network for Research on Refugee Children, supplemented by information from relevant authorities. In Sweden, Norway and Iceland, asylum-seeking children had access to healthcare services equal to children in the general population. On a policy level, Denmark imposed restrictions on non-acute hospitalisations and prolonged specialist treatments. Regarding health examinations, Sweden deviated from the Nordic pattern by not performing these systematically. In Denmark, Iceland, and some counties in Sweden, but not in Norway, screening for mental health problems was offered to asylum-seeking children. Access to healthcare services for asylum-seeking children differs in the Nordic countries; the consequences of these systematic differences for the individual asylum-seeking child are unknown. For asylum-seeking children, access to healthcare has to be considered in a wider context that includes the core conditions of being an asylum-seeker. A comparative study at policy level needs to be supplemented with empirical follow-up studies of the well-being of the study population to document potential consequences of policies in practice.

China QIUSHI SEEKING TRUTH no 3, 1 August 1988

DTIC Science & Technology

1988-09-16

next. It is a critical moment now. Whether or not we can get over this difficulty has a most impor- tant bearing on the future of China’s reform and...game. Once a country, especially a developing country, takes the road of inflation, it will find it difficult to get out of inflation. As inflation...in the prices of industrial production means factored in, our country’s general price level rose by more than 50 percent. How - ever, just like the

Health care seeking practices of caregivers of children under 5 with diarrhea in two informal settlements in Nairobi, Kenya.

PubMed

Mukiira, Carol; Ibisomi, Latifat

2015-06-01

In Kenya, as in other developing countries, diarrhea is among the leading causes of child mortality. Despite being easy to prevent and treat, care seeking for major child illnesses including diarrhea remains poor in the country. Mortality due to diarrhea is even worse in informal settlements that are characterized by poor sanitary conditions and largely unregulated health care system among other issues. The study aims to examine the health care seeking practices of caregivers of children under 5 with diarrhea in two informal settlements in Nairobi, Kenya. The article used data from a maternal and child health (MCH) prospective study conducted between 2006 and 2010. Results show that more than half (55%) of the caregivers sought inappropriate health care in the treatment of diarrhea of their child. Of the 55%, about 35% sought no care at all. Use of oral rehydration solution and zinc supplements, which are widely recommended for management of diarrhea, was very low. The critical predictors of health care seeking identified in the study are duration of illness, informal settlement of residence, and the child's age. The study showed that appropriate health care seeking practices for childhood diarrhea remain a great challenge among the urban poor in Kenya. © The Author(s) 2013.

Divorce, divorce rates, and professional care seeking for mental health problems in Europe: a cross-sectional population-based study.

PubMed

Bracke, Piet F; Colman, Elien; Symoens, Sara A A; Van Praag, Lore

2010-04-29

Little is known about differences in professional care seeking based on marital status. The few existing studies show more professional care seeking among the divorced or separated compared to the married or cohabiting. The aim of this study is to determine whether, in a sample of the European general population, the divorced or separated seek more professional mental health care than the married or cohabiting, regardless of self-reported mental health problems. Furthermore, we examine whether two country-level features--the supply of mental health professionals and the country-level divorce rates--contribute to marital status differences in professional care-seeking behavior. We use data from the Eurobarometer 248 on mental well-being that was collected via telephone interviews. The unweighted sample includes 27,146 respondents (11,728 men and 15,418 women). Poisson hierarchical regression models were estimated to examine whether the divorced or separated have higher professional health care use for emotional or psychological problems, after controlling for mental and somatic health, sociodemographic characteristics, support from family and friends, and degree of urbanization. We also considered country-level divorce rates and indicators of the supply of mental health professionals, and applied design and population weights. We find that professional care seeking is strongly need based. Moreover, the divorced or separated consult health professionals for mental health problems more often than people who are married or who cohabit do. In addition, we find that the gap between the divorced or separated and the married or cohabiting is highest in countries with low divorce rates. The higher rates of professional care seeking for mental health problems among the divorced or separated only partially correlates with their more severe mental health problems. In countries where marital dissolution is more common, the marital status gap in professional care seeking is narrower, partially because professional care seeking is more common among the married or cohabiting.

Teachers' Continuing Professional Development: Contested Concepts, Understandings and Models

ERIC Educational Resources Information Center

Fraser, Christine; Kennedy, Aileen; Reid, Lesley; Mckinney, Stephen

2007-01-01

Teachers' continuing professional development (CPD) is being given increasing importance in countries throughout the world. In Scotland, the changing professional and political context has resulted in unprecedented investment in CPD. However, analysis and evaluation of CPD policies, practice and impact is complex. In seeking to understand some of…

Consequences of infertility in developing countries.

PubMed

Rouchou, Brittany

2013-05-01

Infertility affects more than 10% of the world's population. In developing countries, there are severe social, psychological and economic consequences for infertile men and women. All of the cited references are compiled from primary peer-reviewed research articles that were conducted through one-to-one interviews or focus groups in countries of developing regions, such as Africa, Asia and the Middle East. The following paper seeks to raise awareness of the consequences of infertility in developing nations and identify infertility as an under-observed, but significant public health issue. It is proposed that education programmes tailored to each society's specific religious beliefs and grounded traditions must be implemented in order to reverse the social stigma, detrimental psychological effects, and loss of economic security that results from infertility.

Another Approach to Measuring Human Development: The Composite Dynamic Human Development Index

ERIC Educational Resources Information Center

Bilbao-Ubillos, Javier

2013-01-01

This paper seeks mainly to contribute to the debate on how the relative degree of development of a country should be measured by proposing an indicator to build on the valuable starting point provided by the Human Development Index (HDI). The indicator proposed is called the "Composite, Dynamic Human Development Index". It incorporates in a simple…

Compulsory licensing of patented pharmaceutical inventions: evaluating the options

PubMed Central

Reichman, Jerome H.

2010-01-01

In this Comment, the author traces the relevant legislative history pertaining to compulsory licensing of patented pharmaceuticals from the TRIPS (Trade-Related Aspects of Intellectual Property Rights) Agreement of 1994 to the 2003 waiver to, and later proposed amendment of, article 31, which enables poor countries to obtain needed medicines from other countries that possess manufacturing capacity. The Comment then evaluates recent, controversial uses of the relevant legislative machinery as viewed from different critical perspectives. The Comment shows how developing countries seeking access to essential medicines can collaborate in ways that would avoid undermining incentives to innovation and other social costs attributed to compulsory licensing. It ends by defending the legality of recent measures taken to promote public health in developing countries, and by reminding developed countries that unilateral retaliation against such measures is demonstratably illegal under WTO foundational law and jurisprudence. PMID:19493070

Teaching clinical skills in developing countries: are clinical skills centres the answer?

PubMed

Stark, Patsy; Fortune, F

2003-11-01

There is growing international interest in teaching clinical skills in a variety of contexts, one of which is Clinical Skills Centres. The drivers for change making Skills Centres an important adjunct to ward and ambulatory teaching come both from within and outside medical education. Educationally, self-directed learning is becoming the accepted norm, encouraging students to seek and maximize learning opportunities. There are global changes in health care practice, increased consumerism and increasing student numbers. In some countries, professional recommendations influence what is taught. Increasingly, core skills curricula and outcome objectives are being defined. This explicit definition encourages assessment of the core skills. In turn, all students require equal opportunities to learn how to practise the skills safely and competently. The moves towards interprofessional education make joint learning in a"neutral" setting, like a Clinical Skills Centre, appear particularly attractive. To discuss the potential role of Clinical Skills Centres in skills training in developing countries and to consider alternative options. Many developing countries seek to establish Clinical Skills Centres to ensure effective and reliable skills teaching. However, the model may not be appropriate,because fully equipped Clinical Skills Centres are expensive to set up, staff; and run. They are not the only way to achieve high quality clinical teaching. Suggested options are based on the philosophy and teaching methods successfully developed in Clinical Skills Centres that may fulfil the local needs to achieve low cost and high quality clinical teaching which is reflective of the local health needs and cultural expectations.

The Development of Jomo Kenyatta International Airport as a Regional Aviation Hub

NASA Technical Reports Server (NTRS)

Irandu, Evaristus M.; Rhoades, Dawna L.

2006-01-01

Air transportation plays an important role in the social and economic development of the global system and the countries that seek to participate in it. As Africa seeks to take its place in the global economy, it is increasingly looking to aviation as the primary means of connecting its people and goods with the world. It has been suggested that Africa as a continent needs to move toward a system of hubs to optimize its scarce resources. Jomo Kenyatta International Airport in Nairobi, Kenya, is one of the airports in the eastern region of Africa that is seeking to fill this role. This paper discusses the prospects for success and the challenges that it will need to overcome, including projections through 2020 for the growth in passenger and cargo traffic.

Outward Foreign Direct Investment and Human Capital Development: A Small Country Perspective

ERIC Educational Resources Information Center

McDonnell, Anthony

2008-01-01

Purpose: The purpose of this paper is to examine the pattern of outward foreign direct investment (FDI) by Irish MNCs, and more specifically, to investigate their approach to human capital development and how these correspond to foreign MNCs in Ireland. In particular, it seeks to investigate training and development expenditure, adoption of…

Using Impact Bonds to Achieve Early Childhood Development Outcomes in Low- and Middle-Income Countries

ERIC Educational Resources Information Center

Gustafsson-Wright, Emily; Gardiner, Sophie

2016-01-01

The Sustainable Development Goals (SDGs, or Global Goals) and their associated targets set out by the United Nations in 2015 explicitly seek to address some of the largest challenges facing children around the world. Early Childhood Development (ECD) interventions have been found to improve adult health and education levels, reduce crime, and…

Sexual Health Help-Seeking Behavior among Migrants from Sub-Saharan Africa and South East Asia living in High Income Countries: A Systematic Review.

PubMed

Rade, Donna Angelina; Crawford, Gemma; Lobo, Roanna; Gray, Corie; Brown, Graham

2018-06-22

The number of migrants has increased globally. This phenomenon has contributed to increasing health problems amongst migrants in high-income countries, including vulnerability for HIV acquisition and other sexual health issues. Adaptation processes in destination countries can present difficulties for migrants to seek help from and gain access to health services. This study examined migrants’ from sub-Saharan Africa (SSA) and South East Asia (SEA) sexual health help-seeking behavior in high-income countries with universal health coverage. The systematic review followed PRISMA guidelines and was registered with PROSPERO. Several databases were searched from 2000 to 2017. Of 2824 studies, 15 met the inclusion criteria. These consisted of 12 qualitative and three quantitative studies conducted in Australia, Spain, the United Kingdom, Belgium, Scotland, Ireland, and Sweden. Migrants experienced a range of difficulties accessing health services, specifically those related to sexual health, in high-income countries. Few studies described sources of sexual health help-seeking or facilitators to help-seeking. Barriers to access were numerous, including: stigma, direct and indirect costs, difficulty navigating health systems in destination countries and lack of cultural competency within health services. More culturally secure health services, increased health service literacy and policy support to mitigate costs, will improve health service access for migrants from SSA and SEA. Addressing the structural drivers for stigma and discrimination remains an ongoing and critical challenge.

Medical tourism today: what is the state of existing knowledge?

PubMed

Hopkins, Laura; Labonté, Ronald; Runnels, Vivien; Packer, Corinne

2010-07-01

One manifestation of globalization is medical tourism. As its implications remain largely unknown, we reviewed claimed benefits and risks. Driven by high health-care costs, long waiting periods, or lack of access to new therapies in developed countries, most medical tourists (largely from the United States, Canada, and Western Europe) seek care in Asia and Latin America. Although individual patient risks may be offset by credentialing and sophistication in (some) destination country facilities, lack of benefits to poorer citizens in developing countries offering medical tourism remains a generic equity issue. Data collection, measures, and studies of medical tourism all need to be greatly improved if countries are to assess better both the magnitude and potential health implications of this trade.

IT Policies for Development: Analysis and Recommendations of Free Libre Open Source Software Initiatives of the Bolivarian Republic of Venezuela

ERIC Educational Resources Information Center

Maldonado Rangel, Edgar A.

2009-01-01

In recent years the two concepts of economic development and technological advancement have become entwined so that they have, in many cases, come to mean the same thing. For countries seeking economic development through engagement with the Information Economy, policies supporting technological development claim privileged positions in national…

Economic development, urbanization, technological change and overweight: What do we learn from 244 Demographic and Health Surveys?

PubMed Central

Goryakin, Yevgeniy; Suhrcke, Marc

2014-01-01

Obesity and overweight are spreading fast in developing countries, and have reached world record levels in some of them. Capturing the size, patterns and trends of the problem has, however, been severely hampered by the lack of comparable data in low and middle income countries. We seek to begin to fill this gap by testing several hypotheses on the determinants/correlates of overweight among women, related to the influence of economic and technological development. We undertake econometric analysis of nationally representative data on about 878,000 women aged 15–49 from 244 Demographic and Health Surveys (DHS) for 56 countries over the years 1991–2009. Our findings support most previously expressed hypotheses of what might explain obesity patterns in developing countries, but they also reject some prior notions and add considerable nuance to the emerging pattern. PMID:24457038

Adopting and Implementing Globalised Policies of Intercultural Education: The Example of Cyprus

ERIC Educational Resources Information Center

Hajisoteriou, Christina; Angelides, Panayiotis

2017-01-01

Globalisation has heavily influenced the terrain of intercultural education policy development and implementation in multiple countries around the world. To this end, in this article, we seek to introduce a broader focus of analysis encompassing not only the development of globalised policies of intercultural education, but also the adoption,…

Demographic Aspects of Educational Planning. Fundamentals of Educational Planning-9.

ERIC Educational Resources Information Center

Chau, Ta Ngoc

This booklet is one of a series primarily intended for those engaged in or preparing for educational planning and administration, especially in developing countries; and for those government officials and civic leaders who seek a more general understanding of educational planning and its role in overall national development. The text examines…

Toward a Culturally Responsive Model of Mental Health Literacy: Facilitating Help-Seeking Among East Asian Immigrants to North America.

PubMed

Na, Sumin; Ryder, Andrew G; Kirmayer, Laurence J

2016-09-01

Studies have consistently found that East Asian immigrants in North America are less likely to use mental health services even when they experience levels of distress comparable to Euro-Americans. Although cultural factors that may prevent East Asian immigrants from seeking mental health care have been identified, few studies have explored ways to foster appropriate help-seeking and use of mental health services. Recent work on mental health literacy provides a potential framework for strategies to increase appropriate help-seeking and use of services. This paper reviews the literature on help-seeking for mental health problems among East Asian immigrants living in Western countries to critically assess the relevance of the mental health literacy approach as a framework for interventions to improve appropriate use of services. Modifications needed to develop a culturally responsive framework for mental health literacy are identified. © Society for Community Research and Action 2016.

Strategic Resources of Iraq, Turkey and Iran and the Development of Kurdish Nationalism: The Domestic, Regional and International Context

DTIC Science & Technology

1989-12-01

well as regional and international relations in these three nations have been complicated by the Kurdish issue in varying degrees. In each country , the... Country : The Kurds and Kurdistan (London: Zed Press, 1980), p. 115. 5 Kurds "who are Ali-Ilahi, a sect even farther from the Sunni creed than the Shia...as to the boundaries of the country that Kurdish nationalists seek to establish. Due to population shifts over the years, Kurds have settled in

Effectiveness of interventions to promote help-seeking for mental health problems: systematic review and meta-analysis.

PubMed

Xu, Ziyan; Huang, Fangfang; Kösters, Markus; Staiger, Tobias; Becker, Thomas; Thornicroft, Graham; Rüsch, Nicolas

2018-06-01

Help-seeking is important to access appropriate care and improve mental health. However, individuals often delay or avoid seeking help for mental health problems. Interventions to improve help-seeking have been developed, but their effectiveness is unclear. A systematic review and meta-analysis were therefore conducted to examine the effectiveness of mental health related help-seeking interventions. Nine databases in English, German and Chinese were searched for randomised and non-randomised controlled trials. Effect sizes were calculated for attitudes, intentions and behaviours to seek formal, informal and self-help. Ninety-eight studies with 69 208 participants were included. Interventions yielded significant short-term benefits in terms of formal help-seeking, self-help, as well as mental health literacy and personal stigma. There were also positive long-term effects on formal help-seeking behaviours. The most common intervention types were strategies to increase mental health literacy, destigmatisation (both had positive short-term effects on formal help-seeking behaviours) as well as motivational enhancement (with positive long-term effects on formal help-seeking behaviours). Interventions improved formal help-seeking behaviours if delivered to people with or at risk of mental health problems, but not among children, adolescents or the general public. There was no evidence that interventions increased the use of informal help. Few studies were conducted in low- and middle-income countries (LMICs). This study provides evidence for the effectiveness of help-seeking interventions in terms of improving attitudes, intentions and behaviours to seek formal help for mental health problems among adults. Future research should develop effective interventions to improve informal help-seeking, for specific target groups and in LMICs settings.

Implementing the United Kingdom Government's 10-Year Teenage Pregnancy Strategy for England (1999-2010): Applicable Lessons for Other Countries.

PubMed

Hadley, Alison; Chandra-Mouli, Venkatraman; Ingham, Roger

2016-07-01

Teenage pregnancy is an issue of inequality affecting the health, well-being, and life chances of young women, young men, and their children. Consequently, high levels of teenage pregnancy are of concern to an increasing number of developing and developed countries. The UK Labour Government's Teenage Pregnancy Strategy for England was one of the very few examples of a nationally led, locally implemented evidence-based strategy, resourced over a long duration, with an associated reduction of 51% in the under-18 conception rate. This article seeks to identify the lessons applicable to other countries. The article focuses on the prevention program. Drawing on the detailed documentation of the 10-year strategy, it analyzes the factors that helped and hindered implementation against the World Health Organization (WHO) ExpandNet Framework. The Framework strives to improve the planning and management of the process of scaling-up of successful pilot programs with a focus on sexual and reproductive health, making it particularly suited for an analysis of England's teenage pregnancy strategy. The development and implementation of the strategy matches the Framework's key attributes for successful planning and scaling up of sexual and reproductive health programs. It also matched the attributes identified by the Centre for Global Development for scaled up approaches to complex public health issues. Although the strategy was implemented in a high-income country, analysis against the WHO-ExpandNet Framework identifies many lessons which are transferable to low- and medium-income countries seeking to address high teenage pregnancy rates. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

East-West transport corridor feasibility study : phase 1, vol. 1 : existing characteristics : final report

DOT National Transportation Integrated Search

1998-04-01

This study, conducted by Bechtel International, was funded by the U.S. Trade and Development Agency. The member countries of the South Balkan Initiative program (Albania, Macedonia, and Bulgaria) are seeking to improve their transportation infrastruc...

The introduction of new vaccines into developing countries. IV: Global Access Strategies.

PubMed

Mahoney, Richard T; Krattiger, Anatole; Clemens, John D; Curtiss, Roy

2007-05-16

This paper offers a framework for managing a comprehensive Global Access Strategy for new vaccines in developing countries. It is aimed at strengthening the ability of public-sector entities to reach their goals. The Bill and Melinda Gates Foundation and The Rockefeller Foundation have been leaders in stimulating the creation of new organizations - public/private product development partnerships (PDPs) - that seek to accelerate vaccine development and distribution to meet the health needs of the world's poor. Case studies of two of these PDPs - the Salmonella Anti-pneumococcal Vaccine Program and the Pediatric Dengue Vaccine Initiative - examine development of such strategies. Relying on the application of innovation theory, the strategy leads to the identification of six Components of Innovation which cover all aspects of the vaccine innovation process. Appropriately modified, the proposed framework can be applied to the development and introduction of other products in developing countries including drugs, and nutritional and agricultural products.

Resident Teachers Take an Inquiry Stance: The Impact of Guided Collaborative Inquiry Groups on the Development of Guided Reading Instructional Practices

ERIC Educational Resources Information Center

Crain de Galarce, Patricia

2014-01-01

Urban schools are struggling to hire and retain effective literacy teachers. Alternative certification programs throughout the country seek to bridge the achievement gap and to bring qualified teachers to underserved classrooms. This dissertation explores the transformative inquiry of developing "resident" teachers in their journey as…

Seeking Help in Domestic Violence Among Muslim Women in Muslim-Majority and Non-Muslim-Majority Countries: A Literature Review.

PubMed

Afrouz, Rojan; Crisp, Beth R; Taket, Ann

2018-01-01

Women from different backgrounds and cultures are at risk of domestic violence. Disclosing the abusive experience and seeking help is not straightforward and easy and might be a complicated and long-term process. Muslim women, like other groups of women, may face various barriers to disclose abusive relationships and for seeking help. Some of the barriers may be common for the majority of Muslim women in different contexts, while others might be related to women's situations and the wider society they live. To identify these barriers and make recommendations for future studies, this article reviews related papers conducted in both Muslim-majority and non-Muslim-majority countries. A critical systematic review of the literature was conducted for identifying Muslim women's barriers in disclosing abuse and seeking help. Twenty-one studies met the inclusion criteria. The main identified barriers are discussed into under four themes: social context, family context, individual factors, and expectations of service providers. Although the researchers tried to investigate various barriers in seeking help, many of them have not focused on structural obstacles. Besides, in many Muslim-majority countries, the issue has not been explored. Therefore, the results of the current article will not apply to those countries. Recommendation for future research comprises more qualitative research compatible with the women's cultures and backgrounds in different societies, focusing more on structural and cultural factors to explore and find women's barriers to seek help.

Care seeking for fatal illness episodes in Neonates: a population-based study in rural Bangladesh

PubMed Central

2011-01-01

Background Poor neonatal health is a major contributor to under-five mortality in developing countries. A major constraint to effective neonatal survival programme has been the lack of population level data in developing countries. This study investigated the consultation patterns of caregivers during neonatal fatal illness episodes in the rural Matlab sub-district of eastern Bangladesh. Methods Neonatal deaths were identified through a population-based demographic surveillance system in Matlab ICDDR,B maternal and child health (MCH) project area and an adjoining government service area. Trained project staff administered a structured questionnaire on care seeking to mothers at home who had experienced a neonatal death. Univariate, bivariate and binary multivariate logistic regressions were performed to describe care seeking during the fatal illness episode. Results Of the 365 deaths recorded during 2003 and 2004, 84% died in the early (0-7 days) neonatal period, with the remaining deaths occurring over the subsequent 8 to 28 days. The first resort of care by parents was a qualified doctor or paramedic in 37% of cases, followed by traditional and unqualified health care providers in 25%, while 38% sought no care. Thus, almost two thirds (63%) of neonates who died received only traditional and unqualified care or no care at all during their final illness episode. About 22% sought care from more than one provider, including 6% from 3 or more providers. Such plurality in care seeking was more likely among male infants, in the late neonatal period, and in the MCH project area. Conclusions The high proportion of neonatal deaths that had received traditional care or no medical care in a rural area of Bangladesh highlights the need to develop community awareness about prompt medical care seeking for neonatal illnesses and to improve access to effective health care. Integration of traditional care providers into mainstream health programs should also be considered. PMID:21999253

Why Breast Cancer Patients Seek Traditional Healers

PubMed Central

Muhamad, Mazanah; Merriam, Sharan; Suhami, Norhasmilia

2012-01-01

Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or “bomoh” at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1) recommendation from family and friends, (2) sanction from family, (3) perceived benefit and compatibility, (4) healer credibility, and (5) reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities. PMID:22295249

Ethical questions regarding health insurance in India.

PubMed

Mathur, Vineesh

2011-01-01

Improved health and healthcare are of vital concern to the welfare of Indian society. The nascent health insurance system of the country is experiencing an explosive expansion and various models of health insurance provision are under trial by different agencies. Since the country has been relatively late in introducing health insurance, it can study the effects of different systems of healthcare and insurance and develop a system of health coverage which addresses the unique social character of our country as well as the ethical questions of comprehensiveness and inclusion. This article seeks to explore these issues in detail.

Public attitudes toward depression and help-seeking in four European countries baseline survey prior to the OSPI-Europe intervention.

PubMed

Coppens, Evelien; Van Audenhove, Chantal; Scheerder, Gert; Arensman, Ella; Coffey, Claire; Costa, Susana; Koburger, Nicole; Gottlebe, Katrin; Gusmão, Ricardo; O'Connor, Rory; Postuvan, Vita; Sarchiapone, Marco; Sisask, Merike; Székely, András; van der Feltz-Cornelis, Christina; Hegerl, Ulrich

2013-09-05

Stigmatizing attitudes toward depression and toward help-seeking are important barriers for people with mental health problems to obtain adequate professional help. This study aimed to examine: (1) population attitudes toward depression and toward seeking professional help in four European countries; (2) the relation between depression stigma and attitudes toward help-seeking; (3) the relation between both attitudes and socio-demographic characteristics; and (4) differences in attitudes across countries. A representative general population survey (n=4011) was conducted in Germany, Hungary, Ireland, and Portugal, assessing attitudes toward depression and toward help-seeking, and a number of socio-demographic variables. Respondents showed a moderate degree of personal stigma toward depression and a strikingly higher degree of perceived stigma. Although a substantial majority showed openness to seek professional help, only half of the people perceived professional help as valuable. More negative attitudes were found in Hungary and were associated with male gender, older age, lower educational level and living alone. Also, personal stigma was related to less openness to and less perceived value of professional treatment. The survey was cross-sectional, so no causal inferences could be drawn. Personal and perceived stigma toward depression deserves public health attention, since they impact upon the intention of people with depression to seek professional help. Public media campaigns should focus on the credibility of the mental health care sector, and target males, older people, and those with a lower educational level and living alone. The content of each campaign should be adapted to the cultural norms of the country for which it is intended. Copyright © 2013 Elsevier B.V. All rights reserved.

Education Hubs and Talent Development: Policymaking and Implementation Challenges

ERIC Educational Resources Information Center

Lee, Jack T.

2014-01-01

The discourse on the internationalization of higher education emphasizes revenue generation while neglecting other diverse rationales pursued by governments and institutions. For countries that are seeking to venture into a knowledge economy or accrue greater competitive advantages under globalization, many policymakers view cross-border higher…

Primary Schooling and Economic Development: A Review of the Evidence. World Bank Staff Working Paper No. 399.

ERIC Educational Resources Information Center

Colclough, Christopher

By reviewing pertinent studies and data, this paper seeks to define the economic benefits of primary schooling within a worldwide context. The author concludes that investment in primary schooling results in more productivity at work and in the home. The returns from primary schooling in most developing countries are higher than from other forms…

Economics of Education in Developing Countries: Current Trends and New Priorities.

ERIC Educational Resources Information Center

Blaug, Mark

In the 1950s and 1960s, educational economists led the developing nations of Asia, Africa, and Latin American onto an educational merry-go-round where all the educated could do was seek further education. These nations have turned in the 1970s to political scientists, sociologists, and educationists in an attempt to rectify the situation. In place…

Battling Costs for Quality and Quantity: Emerging Responses in Early Childhood Care and Education. Notes, Comments...(Child, Family, Community). Digest No. II.

ERIC Educational Resources Information Center

Prakasha, Veda

This digest explores the possibilities of cost reduction in extending the coverage and upgrading the quality of preschool education especially in developing countries. The digest also seeks to highlight the importance of community participation in developing and managing preschool institutions and programs. Chapters cover the following topics: the…

Community participation in formulating the post-2015 health and development goal agenda: reflections of a multi-country research collaboration.

PubMed

Brolan, Claire E; Hussain, Sameera; Friedman, Eric A; Ruano, Ana Lorena; Mulumba, Moses; Rusike, Itai; Beiersmann, Claudia; Hill, Peter S

2014-10-10

Global discussion on the post-2015 development goals, to replace the Millennium Development Goals when they expire on 31 December 2015, is well underway. While the Millennium Development Goals focused on redressing extreme poverty and its antecedents for people living in developing countries, the post-2015 agenda seeks to redress inequity worldwide, regardless of a country's development status. Furthermore, to rectify the UN's top-down approach toward the Millennium Development Goals' formulation, widespread negotiations are underway that seek to include the voices of people and communities from around the globe to ground each post-2015 development goal. This reflexive commentary, therefore, reports on the early methodological challenges the Go4Health research project experienced in its engagement with communities in nine countries in 2013. Led by four research hubs in Uganda, Bangladesh, Australia and Guatemala, the purpose of this engagement has been to ascertain a 'snapshot' of the health needs and priorities of socially excluded populations particularly from the Global South. This is to inform Go4Health's advice to the European Commission on the post-2015 global goals for health and new governance frameworks. Five methodological challenges were subsequently identified from reflecting on the multidisciplinary, multiregional team's research practices so far: meanings and parameters around qualitative participatory research; representation of marginalization; generalizability of research findings; ethical research in project time frames; and issues related to informed consent. Strategies to overcome these methodological hurdles are also examined. The findings from the consultations represent the extraordinary diversity of marginal human experience requiring contextual analysis for universal framing of the post-2015 agenda. Unsurprisingly, methodological challenges will, and did, arise. We conclude by advocating for a discourse to emerge not only critically examining how and whose voices are being obtained at the community-level to inform the post-2015 health and development goal agenda, but also how these voices are being translated and integrated into post-2015 decision-making at national and global levels.

Analysis of University Management of Emerging Technologies and Recommendations for Developing Countries

ERIC Educational Resources Information Center

Villa Enciso, Eliana María; Picón Jácome, Edgar; Valencia-Arias, Alejandro; Jiménez Hernández, Claudia Nelcy

2017-01-01

University management seeks to achieve the objectives established by higher education's institutions, including their third mission, which corresponds to the transfer of research results into the industry; in this regard, emerging technologies play an important role to solve problems identified in the industry. Emerging technologies are those…

Two Studies on Unemployment Among Educated Young People.

ERIC Educational Resources Information Center

Morio, Simone; Zoctizoum, Yarrise

These studies concentrate on unemployment among educated young people in Western Europe and Africa. The first study focuses on unemployment among educated young people in the developed market-economy countries. In seeking to outline problems relating to youth unemployment, the study first attempts to define unemployment. An analysis is then made…

Understanding Student Learning in Environmental Education in Aotearoa New Zealand

ERIC Educational Resources Information Center

Eames, Chris; Barker, Miles

2011-01-01

This paper seeks to provide a perspective on environmental education in Aotearoa New Zealand. To contextualise this perspective, it illustrates how environmental, socio-cultural and political imperatives have shaped the development of environmental education in this land. These imperatives illuminate the natural history of the country, the…

[Skin eruption and itching after travel to Asia--a case report].

PubMed

Ólafsson, Guðmundur Dagur; Sigurðsson, Emil L; Sigurðardóttir, Bryndís

2015-09-01

One of the more common reasons patients seek medical advice after traveling in tropical countries are skin eruptions. Here we describe two cases of individuals who, after traveling to south east Asia, developed a skin eruption later diagnosed as cutaneous larva migrans. This particular skin condition is common among travelers to countries where the hookworm responsible is endemic. The diagnosis is based on travel history and clinical examination. The patients were treated with albendazole with good results and complete resolution of the symptoms.

Merging Remote Sensing and Socioeconomic Data to Improve Disaster Risk Assessment

NASA Astrophysics Data System (ADS)

Yetman, G.; Chen, R. S.; Huyck, C. K.

2015-12-01

Natural disasters disproportionately impact developing country economies while also impacting business operations for multi-national corporations that rely on supplies and manufacturing in affected areas. Understanding natural hazard risk is only a first step towards preparedness and mitigation—data on facilities, transportation, critical infrastructure, and populations that may be exposed to disasters is required to plan for events and properly assess risks. Detailed exposure data can be used in models to predict casualty rates, aggregate estimates of building damage or destruction, impacts on business operations, and the scale of recovery efforts required. These model outputs are useful for disaster preparedness planning by national and international organizations, as well as for corporations and the reinsurance industry seeking to better understand their risk exposure. Many of these data are lacking for developing countries. Rapid assessment in areas with minimal data for disaster modeling is possible by combing remote sensing data, sample data on construction methods, facility and critical infrastructure data, and economic and demographic census information. This presentation focuses on the methods used to fuse the physical and socioeconomic data by presenting the results from two projects. The first project seeks to improve earthquake risk assessments in Asia using for the reinsurance industry, while the second project builds an integrated exposure database across five countries in Africa for use by international development organizations.

Stigma towards people with mental illness in developing countries in Asia.

PubMed

Lauber, Christoph; Rössler, Wulf

2007-04-01

There is a wide range of literature on stigmatization and discrimination of people with mental illness. Most studies, however, derive from Western countries. This review aims at summarizing results from developing countries in Asia published between 1996-2006. Medline search focusing on English-speaking literature. Comparable to Western countries, there is a widespread tendency to stigmatize and discriminate people with mental illness in Asia. People with mental illness are considered as dangerous and aggressive which in turn increases the social distance. The role of supernatural, religious and magical approaches to mental illness is prevailing. The pathway to care is often shaped by scepticism towards mental health services and the treatments offered. Stigma experienced from family members is pervasive. Moreover, social disapproval and devaluation of families with mentally ill individuals are an important concern. This holds true particularly with regards to marriage, marital separation and divorce. Psychic symptoms, unlike somatic symptoms, are construed as socially disadvantageous. Thus, somatisation of psychiatric disorders is widespread in Asia. The most urgent problem of mental health care in Asia is the lack of personal and financial resources. Thus, mental health professionals are mostly located in urban areas. This increases the barriers to seek help and contributes to the stigmatization of the mentally ill. The attitude of mental health professionals towards people with mental illness is often stigmatizing. This review revealed that the stigmatization of people with mental illness is widespread in Asia. The features of stigmatization-beliefs about causes of and attitudes towards mental illness, consequences for help-seeking-have more commonalities than differences to Western countries.

An integrated approach to scale up the market penetration of low carbon technologies in developing countries and water scarce regions

NASA Astrophysics Data System (ADS)

Thompson, Michelle Angela

Water scarcity is a global challenge that stifles social and economic growth. There is a growing concern to examine the water-energy nexus to understand the importance of applying energy and water interactions to technology. In developing countries there are many communities that live off-grid in remote region with no access to electricity or clean water. Additionally, there are developed countries that are located in regions with electricity but no access to clean water. Recent developments in renewable energy technology and energy policies have greatly reduced the costs of renewable energy making them more attractive and affordable. The purpose of this dissertation is to evaluate the main barriers to deploying renewables to non-Organization for Economic Co-operation and Development (non-OECD) countries and member countries of the Organization for Economic Co-operation and Development (OECD). This dissertation examines the potential of renewable desalination technology systems across emerging countries. The findings of this research can serve as the basis for investors interested in entering this market. The combined chapters seek to address potential problems regarding the costs, methods, and tools required for the implementation of the appropriate water purification technologies for off-grid, community scale infrastructures.

Travel characteristics and risk-taking attitudes in youths traveling to nonindustrialized countries.

PubMed

Han, Pauline; Balaban, Victor; Marano, Cinzia

2010-01-01

International travel to developing countries is increasing with rising levels of disposable income; this trend is seen in both adults and children. Risk-taking attitude is fundamental to research on the prevention of risky health behaviors, which can be an indicator of the likelihood of experiencing illness or injury during travel. The aim of this study is to investigate whether risk-taking attitudes of youths are associated with travel characteristics and likelihood of experiencing illness or injury while traveling to nonindustrialized countries. Data were analyzed from the 2008 YouthStyles survey, an annual mail survey gathering demographics and health knowledge, attitudes, and practices of individuals from 9 through 18 years of age. Travelers were defined as respondents who reported traveling in the last 12 months to a destination other than the United States, Canada, Europe, Japan, Australia, or New Zealand. Risk-taking attitude was measured by using a four-item Brief Sensation-Seeking Scale. All p values ≤ 0.05 were considered significant. Of 1,704 respondents, 131 (7.7%) traveled in the last 12 months. Females and those with higher household income were more likely to travel (odds ratio = 1.6,1.1). Of those who traveled, 16.7% reported seeking pretravel medical care, with most visiting a family doctor for that care (84.0%). However, one-fifth of respondents reported illness and injury during travel; of these, 83.3% traveled with their parents. Males and older youths had higher mean sensation-seeking scores. Further, travelers had a higher mean sensation-seeking score than nontravelers. Those who did not seek pretravel medical care also had higher mean sensation-seeking scores (p = 0.1, not significant). Our results show an association between risk-taking attitudes and youth travel behavior. However, adult supervision during travel and parental directives prior to travel should be taken into consideration. Communication messages should emphasize the importance of pretravel advice, target parents of children who are traveling, and be communicated through family doctors. © 2010 International Society of Travel Medicine.

Sex differences in health care-seeking behavior for acute coronary syndrome in a low income country, Peru.

PubMed

Pastorius Benziger, Catherine; Bernabe-Ortiz, Antonio; Miranda, J Jaime; Bukhman, Gene

2011-06-01

: Recognizing reasons for prehospital delay after symptoms of acute coronary syndrome (ACS) is established in developed countries yet evidence from Latin America is limited. We aimed to assess ACS symptom recognition, health care-seeking behavior, and confidence in local health care facilities to take care of ACS by gender in a sample of Peruvians. : A community-based interview survey in a peri-urban area in Lima, Peru. The 24-item study instrument included vignettes and questions assessing identification of urgent and emergent ACS symptoms, anticipated help-seeking behaviors, and confidence in local health care facilities. : In the study population (90 people; 45.6% men; mean age, 43.5 years), women were 4 times less likely to correctly attribute symptoms of chest pain to the heart (OR = 0.23; 95% CI: 0.063-0.87; P = 0.03). Women were much more likely to respond that a man would "Seek help" (OR = 4.54; 95% CI: 1.21-16.90; P = 0.024) and that "Yes," a woman would be less likely to seek help for chest pain symptoms (OR = 3.26; 95% CI: 1.13-9.41 P = 0.029) after adjusting for age, education level, age at migration, and history of chest pain. Women were less likely than men to think that their local Health Care Post would help them if they had a heart attack (2.1% vs. 14.6%; P = 0.04), and only 18.7% of women believed that their local emergency room would help them. : Our findings suggest women are less likely to seek help for chest pain and women and men in a peri-urban area in Peru are not confident in their local health care facility to treat urgent or emergent ACS symptoms.

Care seeking behaviour for children with suspected pneumonia in countries in sub-Saharan Africa with high pneumonia mortality.

PubMed

Noordam, Aaltje Camielle; Carvajal-Velez, Liliana; Sharkey, Alyssa B; Young, Mark; Cals, Jochen W L

2015-01-01

Pneumonia is the leading cause of childhood mortality in sub-Saharan Africa (SSA). Because effective antibiotic treatment exists, timely recognition of pneumonia and subsequent care seeking for treatment can prevent deaths. For six high pneumonia mortality countries in SSA we examined if children with suspected pneumonia were taken for care, and if so, from which type of care providers, using national survey data of 76530 children. We also assessed factors independently associated with care seeking from health providers, also known as 'appropriate' providers. We report important differences in care seeking patterns across these countries. In Tanzania 85% of children with suspected pneumonia were taken for care, whereas this was only 30% in Ethiopia. Most of the children living in these six countries were taken to a primary health care facility; 86, 68 and 59% in Ethiopia, Tanzania and Burkina Faso respectively. In Uganda, hospital care was sought for 60% of children. 16-18% of children were taken to a private pharmacy in Democratic Republic of Congo (DRC), Tanzania and Nigeria. In Tanzania, children from the richest households were 9.5 times (CI 2.3-39.3) more likely to be brought for care than children from the poorest households, after controlling for the child's age, sex, caregiver's education and urban-rural residence. The influence of the age of a child, when controlling for sex, urban-rural residence, education and wealth, shows that the youngest children (<2 years) were more likely to be brought to a care provider in Nigeria, Ethiopia and DRC. Urban-rural residence was not significantly associated with care seeking, after controlling for the age and sex of the child, caregivers education and wealth. The study suggests that it is crucial to understand country-specific care seeking patterns for children with suspected pneumonia and related determinants using available data prior to planning programmatic responses.

Alternative method of highway traffic safety analysis for developing countries using delphi technique and Bayesian network.

PubMed

Mbakwe, Anthony C; Saka, Anthony A; Choi, Keechoo; Lee, Young-Jae

2016-08-01

Highway traffic accidents all over the world result in more than 1.3 million fatalities annually. An alarming number of these fatalities occurs in developing countries. There are many risk factors that are associated with frequent accidents, heavy loss of lives, and property damage in developing countries. Unfortunately, poor record keeping practices are very difficult obstacle to overcome in striving to obtain a near accurate casualty and safety data. In light of the fact that there are numerous accident causes, any attempts to curb the escalating death and injury rates in developing countries must include the identification of the primary accident causes. This paper, therefore, seeks to show that the Delphi Technique is a suitable alternative method that can be exploited in generating highway traffic accident data through which the major accident causes can be identified. In order to authenticate the technique used, Korea, a country that underwent similar problems when it was in its early stages of development in addition to the availability of excellent highway safety records in its database, is chosen and utilized for this purpose. Validation of the methodology confirms the technique is suitable for application in developing countries. Furthermore, the Delphi Technique, in combination with the Bayesian Network Model, is utilized in modeling highway traffic accidents and forecasting accident rates in the countries of research. Copyright © 2016 Elsevier Ltd. All rights reserved.

LATIN AMERICAN AND CARIBBEAN WORKSHOP ON THE SUSTAINABILITY OF RADIOACTIVE SOURCE PHYSICAL PROTECTION UPGRADES HOSTED IN GUATEMALA

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

Greenberg, Raymond; Watson, Erica E.; Morris, Frederic A.

2009-10-07

The Global Threat Reduction Initiative (GTRI) reduces and protects vulnerable nuclear and radiological material located at civilian sites worldwide. The GTRI program has worked successfully to remove and protect nuclear and radioactive materials, including orphaned and disused high-activity sources, and is now working to ensure sustainability. Internationally, over 40 countries are cooperating with GTRI to enhance the security of radiological materials. GTRI is now seeking to develop and enhance sustainability by coordinating its resources with those of the partner country, other donor countries, and international organizations such as the International Atomic Energy Agency (IAEA).

World Trade Organization, ILO conventions, and workers' compensation.

PubMed

LaDou, Joseph

2005-01-01

The World Trade Organization, the World Bank, and the International Monetary Fund can assist in the implementation of ILO Conventions relating to occupational safety and health in developing countries. Most countries that seek to trade globally receive permission to do so from the WTO. If the WTO required member countries to accept the core ILO Conventions relating to occupational safety and health and workers' compensation, it could accomplish something that has eluded international organizations for decades. International workers' compensation standards are seldom discussed, but may at this time be feasible. Acceptance of a minimum workers' compensation insurance system could be a requirement imposed on applicant nations by WTO member states.

Transboundary movements of hazardous wastes: the case of toxic waste dumping in Africa.

PubMed

Anyinam, C A

1991-01-01

Developed and developing countries are in the throes of environmental crisis. The planet earth is increasingly being literally choked by the waste by-products of development. Of major concern, especially to industrialized countries, is the problem of what to do with the millions of tons of waste materials produced each year. Owing to mounting pressure from environmental groups, the "not-in-mu-backyard" movement, the close monitoring of the activities of waste management agents, an increasing paucity of repositories for waste, and the high cost of waste treatment, the search for dumping sites for waste disposal has, in recent years, extended beyond regional and national boundaries. The 1980s have seen several attempts to export hazardous wastes to third world countries. Africa, for example, is gradually becoming the prime hunting ground for waste disposal companies. This article seeks to examine, in the context of the African continent, the sources and destinations of this form of relocation-diffusion of pollution, factors that have contributed to international trade in hazardous wastes between developed and developing countries, the potential problems such exports would bring to African countries, and measures being taken to abolish this form of international trade.

Inclusive Education in Bulgaria and Bosnia and Herzegovina: Policy and Practice

ERIC Educational Resources Information Center

Tsokova, Diana; Becirevic, Majda

2009-01-01

This paper examines developments in inclusive education in Bulgaria (BG) and Bosnia and Herzegovina (B&H) in the context of actual and desired accession to the European Union respectively. It seeks to provide insights into the national special education traditions in these countries and aims to establish how these have influenced current…

National Policy on Education and Higher Education

ERIC Educational Resources Information Center

Varughese, Rajan

2017-01-01

The Ministry of Human Resource Development (MHRD) has come out with the draft of 'National Education Policy (NEP) 2016' in April 2016. The new NEP 2016 seeks to create conditions to improve the quality of teaching, learning and assessment, and promote transparency in the management of education in the country. The policy prescriptions enunciated…

Design and Validation of a Questionnaire to Measure Research Skills: Experience with Engineering Students

ERIC Educational Resources Information Center

Cobos Alvarado, Fabián; Peñaherrera León, Mónica; Ortiz Colon, Ana María

2016-01-01

Universities in Latin American countries are undergoing major changes in its institutional and academic settings. One strategy for continuous improvement of teaching and learning process is the incorporation of methods and teaching aids seeking to develop scientific research skills in students from their undergraduate studies. The aim of this…

Leadership Practices of Clinical Trials Office Leaders in Academic Health Centers

ERIC Educational Resources Information Center

Naser, Diana D.

2012-01-01

In the ever-changing clinical research environment, academic health centers seek leaders who are visionary and innovative. Clinical trials offices across the country are led by individuals who are charged with promoting growth and change in order to maximize performance, develop unique research initiatives, and help institutions achieve a…

Information Literacy in Postsecondary Education in the United Kingdom, the United States, Australia, and New Zealand

ERIC Educational Resources Information Center

Folk, Amanda L.

2016-01-01

This comparison seeks to determine if the three documents addressing information literacy skills and competence developed by professional library associations for postsecondary education in four predominantly English-speaking countries--the United Kingdom, the United States, Australia, and New Zealand--have similar or varying conceptions of…

Rural-Urban Gaps in Academic Achievement, Schooling Conditions, Student, and Teachers' Characteristics in Pakistan

ERIC Educational Resources Information Center

Tayyaba, Saadia

2012-01-01

Purpose: Recent educational research has demonstrated rural-urban gaps in achievement and schooling conditions. Evidence from developing countries is still sparse. This study seeks to report rural-urban disparities in achievement, student, teacher, and school characteristics based on a nationally representative sample of grade four students from…

Crisis in the Community: Waiting Lists for MR/DD Services

ERIC Educational Resources Information Center

Stasko, Sheila

2005-01-01

Waiting lists for people with intellectual disabilities who seek services from Mental Retardation (MR) or Development Disability (DD) systems are a very visible problem across the country and have forced people with disabilities, families and caregivers to respond by pressing their states into action. People living at home with their parents or…

Thailand--Secondary Education for Employment, Volume I: A Policy Note.

ERIC Educational Resources Information Center

Abelmann, Charles; Johanson, Richard; Kohtbantau, Achariya; Moock, Peter; Poshyananda, Tanaporn; Trivisvavet, Supamas

In Thailand, the need for skills in the labor force will become even greater in the next decade as the country's industrial and service companies seek to increase productivity through technological and organizational change. Historically, the limited provision of secondary education was a major bottleneck in skills development in Thailand. Major…

The Self in Movement: Being Identified and Identifying Oneself in the Process of Migration and Asylum Seeking.

PubMed

Watzlawik, Meike; Brescó de Luna, Ignacio

2017-06-01

How migration influences the processes of identity development has been under longstanding scrutiny in the social sciences. Usually, stage models have been suggested, and different strategies for acculturation (e.g., integration, assimilation, separation, and marginalization) have been considered as ways to make sense of the psychological transformations of migrants as a group. On an individual level, however, identity development is a more complex endeavor: Identity does not just develop by itself, but is constructed as an ongoing process. To capture these processes, we will look at different aspects of migration and asylum seeking; for example, the cultural-specific values and expectations of the hosting (European) countries (e.g., as identifier), but also of the arriving individuals/groups (e.g., identified as refugees). Since the two may contradict each other, negotiations between identities claims and identity assignments become necessary. Ways to solve these contradictions are discussed, with a special focus on the experienced (and often missing) agency in different settings upon arrival in a new country. In addition, it will be shown how sudden events (e.g., 9/11, the Charlie Hebdo attack) may challenge identity processes in different ways.

"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.

Thrill and adventure seeking in risky driving at work: The moderating role of safety climate.

PubMed

Wishart, Darren; Somoray, Klaire; Evenhuis, Amanda

2017-12-01

Introduction Within many industrialized countries, the leading cause of worker fatalities and serious injuries can be attributed to road trauma. In non-occupational research, high levels of sensation seeking personality, and specifically thrill and adventure seeking, have been associated with risky driving behaviors. In work driving literature, high organizational safety climate has been associated with reduced risky driving in work drivers. However, the extent that factors such as safety climate and thrill seeking interact in regard to work driving safety remains unclear, and the current research examined this interaction. Methods A total of 1,011 work drivers from four organizations participated in the research. Surveys were distributed online and hardcopies were sent via mail. The survey included measures of thrill and adventure seeking, safety climate and work-related driving behaviors, as well as questions relating to participant demographics and information about their work driving. Results The results demonstrated that safety climate significantly moderated the effect of thrill and adventure seeking trait on driving errors, driving violations, and driving while fatigued. Conclusion These results suggest that the development of a strong safety climate has the potential to improve work driving safety outcomes by reducing the impact of particular personality traits such as thrill seeking within an organizational context. Practical application To improve work driving safety, organizations and management need to develop strategies to encourage and foster positive work driving safety climate, particularly within work settings that may attract thrill and adventure seeking employees. Copyright © 2017. Published by Elsevier Ltd.

The health migration crisis: the role of four Organisation for Economic Cooperation and Development countries.

PubMed

Pond, Bob; McPake, Barbara

2006-04-29

The crisis of human resources for health that is affecting low-income countries and especially sub-Saharan Africa has been attributed, at least in part, to increasing rates of migration of qualified health staff to high-income countries. We describe the conditions in four Organisation for Economic Cooperation and Development (OECD) health labour markets that have led to increasing rates of immigration. Popular explanations of these trends include ageing populations, growing incomes, and feminisation of the health workforce. Although these explanations form part of the larger picture, analysis of the forces operating in the four countries suggests that specific policy measures largely unrelated to these factors have driven growing demand for health staff. On this basis we argue that specific policy measures are equally capable of reversing these trends and avoiding the exploitation of low-income countries' scarce resources. These policies should seek to ensure local stability in health labour markets so that shortages of staff are not solved via the international brain drain.

Predicting help-seeking intention of women with urinary incontinence in Jinan, China: a theory of planned behaviour model.

PubMed

Wu, Chen; Wang, Kefang; Sun, Tao; Xu, Dongjuan; Palmer, Mary H

2015-02-01

To develop and test a predictive model of women's help-seeking intention for urinary incontinence that was developed using the theory of planned behaviour and to identify factors that influenced women's help-seeking intention. Urinary incontinence is a chronic progressive condition if left untreated, but few women seek help from healthcare providers. Reasons for not seeking help have been studied in Western countries while relatively little information is available from mainland China. Questionnaire-based cross-sectional survey was performed in this study. From May-October 2011, a cross-sectional survey was conducted with a representative sample of 346 incontinent women from three communities in Jinan using strict inclusion and exclusion criteria. Data were collected via a self-administered pencil-and-paper survey that consisted of a multi-item questionnaire. Predictive model estimation was performed using structural equation model. The resultant model demonstrated that incontinent women's help-seeking intention could be predicted by their perceived self-efficacy and perceived social impact from urine loss. Perceived self-efficacy was the negative predictor, while the perceived social impact was the positive one. Overall, the predictive model explained 36% of the variance for incontinent women's help-seeking intention. The theory of planned behaviour can be used to predict help-seeking intention in women who have urinary incontinence. Community nurses should increase patients' help-seeking intention by addressing perceived social impact and perceived self-efficacy in managing incontinent symptoms. Our findings suggest that high perceived self-efficacy in dealing with incontinent symptoms could hinder incontinent women from seeking help from healthcare providers. The strong social impact women perceived, however, facilitates intention to seek help. Nurses should understand and address these factors through education and evidence-based practices to increase help-seeking in incontinent women. © 2014 John Wiley & Sons Ltd.

[Population policies in Latin America: 10 years' experience].

PubMed

1983-12-01

The 1974 World Population Plan of Action (WPPA) recommended that the developing countries reduce their rate of population growth to 2.0% by 1985. The population of Latin America, which reached 357 million in 1980, grew at a rate of 2.41% in 1975-80; the rate for 1980-85 is estimated at 2.32%. Birth rates decreased in all countries; the overall rate is close to the WPPA target of 3%, although many countries exceed this rate. The fertility rate decreased in all countries except Argentina; the relative declines varied from 15% (Mexico) to less than 3% (Bolivia, Haiti). Global fertility rates ranged from 6 to less than 3 children. The WPPA goal of a life expectancy of 62 years in 1985 has been reached. Bolivia is the only country with an infant mortality exceeding the WPPA level of 120/1000 live births. Migration trends include a rise in urbanization (from 49.6% in 1960 to 63% in 1980), an increase (from 11 to 26) in the number of cities with more than 1 million inhabitants, and the movement of unskilled workers in search of jobs. Countries having explicit population policies comprise 2 groups: 1) those seeking to decrease their rate of population growth, and 2), those who want to increase their population. The former, which comprise 38% of the region's inhabitants, are trying to reduce fertility by promoting family planning through both public and private efforts. The 2nd group (Argentina, Bolivia, Chile), seek to increase fertility by hindering access to contraceptives and providing incentives for childbearing. Most Latin American countries, however, lack an explicit population policy; they provide family planning as part of their health services, but have not adopted specific demographic goals. Only a few countries are attempting to bring about a better distribution of their population. A review of the Latin American experience during the past decade leads to the following proposals: the integration of demographic policies within socioeconomic development plans, the development of regional plans of action within the WPPA, the adoption of population targets, the creation of national institutions to deal with population policy and implementation, the strengthening of training in population, the development of demographic information and research activities, and the integration of the WPPA with other plans of action.

The health transition: the cultural inflation of morbidity during the decline of mortality.

PubMed

Johansson, S R

1991-04-01

It has become commonplace to observe that as mortality falls, morbidity levels rise. The question is why? The explanation offered here stresses the multidimensional nature of morbidity, and the important role that diverse cultural forces have on the patterns of behaviour which underlie reporting behaviour during modernization. These forces involve rising health expectations on the part of ordinary people, including their ability to perceive illness and their willingness to seek professional help, and institutional pressures on medical professionals which reward them for discovering and treating an ever-growing set of non-fatal diseases. Since non-Western developing countries are training physicians to practice scientific medicine, are educating their citizens to think about disease along modern lines, and measure morbidity as developed countries do, there is every reason to suppose that as mortality falls in these countries, morbidity will rise, just as it has done in the developed world.

Towards climate justice: how do the most vulnerable weigh environment-economy trade-offs?

PubMed

Running, Katrina

2015-03-01

The world's poor are especially vulnerable to environmental disasters, including the adverse consequences of climate change. This creates a challenge for climate justice advocates who seek to ensure that those least responsible for causing climate change do not bear unwanted burdens of mitigation. One way to promote climate justice could be to pay particular attention to the environmental policy preferences of citizens from poorer, lower-emitting countries. This paper examines opinions on environment-economy trade-offs and willingness to make personal financial contributions to protect the environment among residents of 42 developed and developing countries using data from the 2005-2008 World Values Survey, the 2010 Climate Risk Index, and World Bank development indicators. Results reveal that individuals in developing countries are less likely to support policies to prioritize environmental protection over economic growth but are more willing to donate personal income for pro-environmental efforts compared to citizens of more developed nations. Published by Elsevier Inc.

Motivating green public procurement in China: an individual level perspective.

PubMed

Zhu, Qinghua; Geng, Yong; Sarkis, Joseph

2013-09-15

Green public procurement (GPP) practices have been recognized as an effective policy tool for sustainable production and consumption. However, GPP practices adoption, especially in developing countries, is still an issue. Seeking to help understand these adoption issues, we develop a conceptual model which hypothesizes moderation effects of GPP knowledge on the relationships between GPP drivers and practices. Using primary data collected from 193 Chinese government officials, we find that regulations, rewards & incentive gains, and stakeholders exert pressure to motivate adoption of GPP practices. Knowledge of GPP regulations, responsibilities and experiences in developed countries is found to be limited. The study also found that voluntary regulations may actually be demotivating GPP practices. This study contributes to further theoretical and practical understanding of GPP practices. The findings can be helpful for policy makers, especially those in developing countries, to establish promotion and diffusion mechanisms for GPP practices as an important sustainable development tool. Copyright © 2013 Elsevier Ltd. All rights reserved.

Traditional medicine for the rich and knowledgeable: challenging assumptions about treatment-seeking behaviour in rural and peri-urban Nepal

PubMed Central

Thorsen, Rikke Stamp; Pouliot, Mariève

2016-01-01

Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household survey data collected from 571 households in three rural and peri-urban sites in Nepal in 2012. Questions encompassed household socioeconomic characteristics, illness characteristics, and treatment-seeking behaviour. Treatment choice was investigated through bivariate analyses. Results show that traditional medicine, and especially self-treatment with medicinal plants, prevail as treatment options in both rural and peri-urban populations. Contrarily to what is commonly assumed, high income is an important determinant of use of traditional medicine. Likewise, knowledge of medicinal plants, age, education, gender and illness chronicity were also significant determinants. The importance of self-treatment with medicinal plants should inform the development of health policy tailored to people’s treatment-seeking behaviour. PMID:26130610

Opinions of researchers based in the UK on recruiting subjects from developing countries into randomized controlled trials.

PubMed

Newton, Sam K; Appiah-Poku, John

2007-12-01

Explaining technical terms in consent forms prior to seeking informed consent to recruit into trials can be challenging in developing countries, and more so when the studies are randomized controlled trials. This study was carried out to examine the opinions of researchers on ways of dealing with these challenges in developing countries. Recorded in-depth interviews with 12 lecturers and five doctoral students, who had carried out research in developing countries, at a leading school of public health in the United Kingdom. A purposive, snowballing approach was used to identify interviewees. Researchers were divided on the feasibility of explaining technical trials in illiterate populations; the majority of them held the view that local analogies could be used to explain these technical terms. Others were of the opinion that this could not be done since it was too difficult to explain technical trials, such as randomized controlled trials, even to people in developed countries. Researchers acknowledged the difficulty in explaining randomized controlled trials but it was also their perception that this was an important part of the ethics of the work of scientific research involving human subjects. These difficulties notwithstanding, efforts should be made to ensure that subjects have sufficient understanding to consent, taking into account the fact that peculiar situations in developing countries might compound this difficulty.

Prevalence of Abortion and Contraceptive Practice among Women Seeking Repeat Induced Abortion in Western Nigeria.

PubMed

Lamina, Mustafa Adelaja

2015-01-01

Induced abortion contributes significantly to maternal mortality in developing countries yet women still seek repeat induced abortion in spite of availability of contraceptive services. The aim of this study is to determine the rate of abortion and contraceptive use among women seeking repeat induced abortion in Western Nigeria. A prospective cross-sectional study utilizing self-administered questionnaires was administered to women seeking abortion in private hospitals/clinics in four geopolitical areas of Ogun State, Western Nigeria, from January 1 to December 31 2012. Data were analyzed using SPSS 17.0. The age range for those seeking repeat induced abortion was 15 to 51 years while the median age was 25 years. Of 2934 women seeking an abortion, 23% reported having had one or more previous abortions. Of those who had had more than one abortion, the level of awareness of contraceptives was 91.7% while only 21.5% used a contraceptive at their first intercourse after the procedure; 78.5% of the pregnancies were associated with non-contraceptive use while 17.5% were associated with contraceptive failure. The major reason for non-contraceptive use was fear of side effects. The rate of women seeking repeat abortions is high in Nigeria. The rate of contraceptive use is low while contraceptive failure rate is high.

Standards to Assure Quality in Tertiary Education: The Case of Tanzania

ERIC Educational Resources Information Center

Manyaga, Timothy

2008-01-01

Purpose: The purpose of this paper is to provide information on development of standards in Tanzania which may be of help to training providers in other countries as they seek to improve the quality and standards of their provision. Design/methodology/approach: The need to provide quality assured tertiary qualifications in Tanzania to win both…

The Gains and Pains of Mixed National Group Work at University

ERIC Educational Resources Information Center

Spencer-Oatey, Helen; Dauber, Daniel

2017-01-01

According to a recent report, the top skill that employers are looking for in graduates is an ability to work collaboratively with teams of people from a range of backgrounds and countries. So as universities seek to internationalise, an important question is how successful they are in developing this skill. Both research and anecdotal evidence…

Education in Action: An Engine of Change, Creativity, Innovation, Leadership and Social Commitment

ERIC Educational Resources Information Center

Ulate Sanchez, Rosita

2014-01-01

In this commentary, Rosita Ulate Sanchez states that Venezuela, like other Latin American countries, begins the 21st century by confronting realities that require changes in its learning and education systems. The purpose of Venezuela's education system is to generate social renovation and economic development. It seeks to achieve this through…

Knowing and Doing Vocational Education and Training Reform: Evidence, Learning and the Policy Process

ERIC Educational Resources Information Center

McGrath, Simon; Lugg, Rosemary

2012-01-01

Much of VET policy internationally draws on a toolkit that has been seriously questioned for its logic, international relevance and effectiveness by considerable amounts of academic research. Reflecting primarily on our experiences of leading a complex, multi-country policy study, we develop an account that seeks to explore ways in which the…

Social Studies and Citizenship for Participation in Singapore: How One State Seeks to Influence Its Citizens

ERIC Educational Resources Information Center

Sim, Jasmine B. -Y.

2011-01-01

Singapore is an example of a country where there is centralised control of the school curriculum and where political leaders wield direct influence over citizenship education. Co-ordinated and sustained effort is made to transmit the salient knowledge and values, develop the "right" instincts and attitudes, to help students become…

The Spaces between Numbers: Getting International Data on Higher Education Straight

ERIC Educational Resources Information Center

Adelman, Clifford

2009-01-01

This report seeks to answer four questions about data used every day in comparing higher education in the United States with that in other countries, particularly the 30 advanced post-industrial democracies, including the United States, that are members of the Organization for Economic Cooperation and Development (OECD). These questions are: (1)…

Beyond Resistance: Exploring Health Managers' Propensity for Participatory Evaluation in a Developing Country

ERIC Educational Resources Information Center

Smits, Pernelle A.; Champagne, Francois; Farand, Lambert

2012-01-01

The evaluation of interventions is becoming increasing common and now often seeks to involve managers in the process. Such practical participatory evaluation (PPE) aims to increase the use of evaluation results through the participation of stakeholders. This study focuses on the propensity of health managers for PPE, as measured through the…

Influence of the International Academic and Labor Mobility on the Activity of Open Innovations

ERIC Educational Resources Information Center

Madina, Tulegenova; Mansurova, Benazir

2016-01-01

This article presents the analysis of the new tendencies: openness of technologies, growth of the migration flows of the youth that are seeking for the quality education, and highly qualified professionals, who offer their unique abilities to large companies and research centers of the developed countries. The subjects of the world market…

Workload and Interaction: Unisa's Signature Courses--A Design Template for Transitioning to Online DE?

ERIC Educational Resources Information Center

Hülsmann, Thomas; Shabalala, Lindiwe

2016-01-01

The principal contradiction of online distance education is the disparity that exists between economies of scale and the new interactive capabilities of digital technologies. This is particularly felt where mega-universities in developing countries seek to make better use of these affordances while at the same time protecting their economies of…

An Analysis of the Information Behaviour of Geography Teachers in a Developing African Country--Lesotho

ERIC Educational Resources Information Center

Bitso, Constance

2012-01-01

Information behaviour studies have the potential to inform the design of effective information services that incorporate the information needs, information-seeking and preferences for information sources of target users; hence a doctoral study was conducted on the information behaviour of geography teachers in Lesotho with the aim of guiding the…

Energy development in the Great Basin

Treesearch

Nora Devoe

2008-01-01

The United States, with less than 5 percent of the world’s population, consumes 40 percent of the oil and 23 percent of natural gas annual global production. Fluctuating and rising energy prices can be expected to continue with political instability in producing countries and intensifying supply competition from expanding Asian economies. The United States seeks to...

Poverty in Albania: A Qualitative Assessment. World Bank Technical Paper.

ERIC Educational Resources Information Center

De Soto, Hermine; Gordon, Peter; Gedeshi, Ilir; Sinoimeri, Zamira

This World Bank qualitative assessment of poverty in Albania outlines five objectives: (1) it seeks to develop the understanding of poverty in the country by involving poor Albanians in a process of exploring the causes, nature, extent of poverty and its effects; (2) it is intended to support the Growth and Poverty Reduction Strategy Paper (GPRS),…

Earning While Learning: Maintaining Income While Upgrading Skills. Advancement for Low-Wage Workers

ERIC Educational Resources Information Center

Prince, Heath

2004-01-01

Drawing on innovative workforce development efforts around the country, Jobs for the Future (JJF) publications, tool kits, and other resources respond to the challenges to advancement for low-wage workers. Occasional papers in the series Advancement for Low-Wage Workers seeks to elevate discussion of this issue within and outside the workforce…

Medical resource utilisation and cost of care for women seeking treatment for urinary incontinence in an outpatient setting. Examples from three countries participating in the PURE study.

PubMed

Papanicolaou, Sotiria; Pons, Montserrat Espuna; Hampel, Christian; Monz, Brigitta; Quail, Deborah; Schulenburg, Matthias Graf von der; Wagg, Adrian; Sykes, David

2005-11-30

To describe the medical resource use and direct costs of treatment for women with urinary incontinence (UI) in European countries. PURE is a non-interventional, observational study of patients seeking treatment for UI in an outpatient setting. Investigators being either general practitioners (GPs) and/or specialists, i.e. urologists and gynaecologists, in 14 European countries participated in PURE. The results for medical resource use and cost of treatment in Germany, Spain and the UK/Ireland recorded retrospectively at the enrolment visit for the preceding 12 months are presented here. Treatment-seeking women aged over 18 years who were under treatment or seeking treatment for UI, and who presented within the normal course of care for UI were enrolled in the 6 months study. Information on the incontinence resource use was gathered on standard data collection forms. The direct medical costs were calculated by attaching the unit costs from the perspective of the relevant health insurance in each country to the country-specific resource use. Furthermore, the contribution of patients to the costs of pads, or any treatment for UI was assessed. Variation in medical resource use and cost of treatment between the three countries was observed, reflective of the differences in the healthcare systems and whether specialists and/or GPs provided the care. We found that women in Spain and Germany are more likely to have consulted a specialist for their UI symptoms, which had implications for utilisation of diagnostic procedures. Conservative treatment, particularly pelvis floor muscle exercises, was more common in patients in the UK/Ireland treated in primary care by GPs. In all three countries most of the women had used protective pads, which more than half the patients paying for them out-of-pocket, despite potential healthcare reimbursement schemes. Mean total UI-related costs per year ranged from 359 in the UK/Ireland for patients predominantly treated in the GP setting to 515 in Germany and 655 in Spain for patients treated by specialists and GPs. Our study provides an estimation of resource use and costs associated with UI in treatment-seeking European women, exemplified here in three countries.

Use of family planning and child health services in the private sector: an equity analysis of 12 DHS surveys.

PubMed

Chakraborty, Nirali M; Sprockett, Andrea

2018-04-24

A key component of universal health coverage is the ability to access quality healthcare without financial hardship. Poorer individuals are less likely to receive care than wealthier individuals, leading to important differences in health outcomes, and a needed focus on equity. To improve access to healthcare while minimizing financial hardships or inequitable service delivery we need to understand where individuals of different wealth seek care. To ensure progress toward SDG 3, we need to specifically understand where individuals seek reproductive, maternal, and child health services. We analyzed Demographic and Health Survey data from Bangladesh, Cambodia, DRC, Dominican Republic, Ghana, Haiti, Kenya, Liberia, Mali, Nigeria, Senegal and Zambia. We conducted weighted descriptive analyses on current users of modern FP and the youngest household child under age 5 to understand and compare country-specific care seeking patterns in use of public or private facilities based on urban/rural residence and wealth quintile. Modern contraceptive prevalence rate ranged from 8.1% to 52.6% across countries, generally rising with increasing wealth within countries. For relatively wealthy women in all countries except Ghana, Liberia, Mali, Senegal and Zambia, the private sector was the dominant source. Source of FP and type of method sought across facilities types differed widely across countries. Across all countries women were more likely to use the public sector for permanent and long-acting reversible contraceptive methods. Wealthier women demonstrated greater use of the private sector for FP services than poorer women. Overall prevalence rates for diarrhea and fever/ARI were similar, and generally not associated with wealth. The majority of sick children in Haiti did not seek treatment for either diarrhea or fever/ARI, while over 40% of children with cough or fever did not seek treatment in DRC, Haiti, Mali, and Senegal. Of all children who sought care for diarrhea, more than half visited the public sector and just over 30% visited the private sector; differences are more pronounced in the lower wealth quintiles. Use of the private sector varies widely by reason for visit, country and wealth status. Given these differences, country-specific examination of the role of the private sector furthers our understanding of its utility in expanding access to services across wealth quintiles and providing equitable care.

The ethical physician encounters international medical travel.

PubMed

Crozier, G K D; Baylis, Françoise

2010-05-01

International medical travel occurs when patients cross national borders to purchase medical goods and services. On occasion, physicians in home countries will be the last point of domestic contact for patients seeking healthcare information before they travel abroad for care. When this is the case, physicians have a unique opportunity to inform patients about their options and help guide them towards ethical practices. This opportunity brings to the fore an important question: What role should physicians in more-developed home countries play in promoting or constraining international medical travel towards less-developed destination countries? In our view, critical attention to the decision spaces of patients-defined by the personal circumstances, socio-cultural cues, and legal constraints that inform decision-making-is a useful starting point for evaluating the proper response of physicians to various forms of international medical travel.

Appraising forensic anthropology in the Philippines: Current status and future directions.

PubMed

Go, Matthew C

2018-07-01

The increasing significance of forensic anthropology in the 21st century, yet unequitable worldwide distribution of expertise, necessitates a stocktaking of the discipline on a local scale. The purpose of this work is to appraise the current state of forensic anthropology in the Philippines and provide the rationale for its further development within the country. Recent efforts in research, education, and legislation that seek to boost Philippine forensic anthropology specifically and forensic sciences generally are highlighted. Furthermore, this work hopes to serve as a springboard for future students, scholars, and practitioners seeking to advance the field in the Philippines. Copyright © 2018 Elsevier B.V. All rights reserved.

“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

Nursing shortages and international nurse migration.

PubMed

Ross, S J; Polsky, D; Sochalski, J

2005-12-01

The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce. To predict the international migration of nurses to the UK using widely available data on country characteristics. The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country-level data from sources such as the World Bank and the World Health Organization. The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low-income, English-speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK. Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery.

Breast-feeding: the role of multinational corporations in Latin America.

PubMed

Bader, M B

1976-01-01

The decline in birthrates in the developed countries of the world has forced multinational corporations engaged in the production of infant formula to seek out new markets in the developing countries, where burgeoning population rates potentially guarantee the long-term profitability of these corporations. This development, ostensibly benign and nutritionally advantageous to infants in developing countries, has serious public health consequences, due to the high relative cost of purchased formula and the paucity of hygienic facilities essential to the sterile preparation of bottle formula. This paper delineates in detail economic and contraceptive advantages of breast-feeding, and examines the role of health personnel and multinational advertising techniques which have catalyzed the decline in breast-feeding. In addition, the paper focuses on the question of cultural imperialism and current efforts to regulate the multinational firms through both United Nations groups and stock-holders' suits. Finally, some suggestions are made concerning ameliorative public policy approaches to the breast-feeding controversy.

Advancing Development and Greenhouse Gas Reductions in Vietnam's Wind Sector

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

Bilello, D.; Katz, J.; Esterly, S.

2014-09-01

Clean energy development is a key component of Vietnam's Green Growth Strategy, which establishes a target to reduce greenhouse gas (GHG) emissions from domestic energy activities by 20-30 percent by 2030 relative to a business-as-usual scenario. Vietnam has significant wind energy resources, which, if developed, could help the country reach this target while providing ancillary economic, social, and environmental benefits. Given Vietnam's ambitious clean energy goals and the relatively nascent state of wind energy development in the country, this paper seeks to fulfill two primary objectives: to distill timely and useful information to provincial-level planners, analysts, and project developers asmore » they evaluate opportunities to develop local wind resources; and, to provide insights to policymakers on how coordinated efforts may help advance large-scale wind development, deliver near-term GHG emission reductions, and promote national objectives in the context of a low emission development framework.« less

Multicenter EuroTravNet/GeoSentinel Study of Travel-related Infectious Diseases in Europe

PubMed Central

Gautret, Philippe; Schlagenhauf, Patricia; Gaudart, Jean; Castelli, Francesco; Brouqui, Philippe; von Sonnenburg, Frank; Loutan, Louis

2009-01-01

We analyzed prospective data on 17,228 European patients who sought treatment at GeoSentinel sites from 1997 to 2007. Gastrointestinal illness (particularly in tourists), fever (those visiting friends and relatives [VFRs]), and skin disorders (in tourists) were the most common reasons for seeking medical care. Diagnoses varied by country of origin, region visited, or categories of travelers. VFRs who returned from sub-Saharan Africa and Indian Ocean islands were more likely to experience falciparum malaria than any other group. Multiple correspondence analysis identified Italian, French, and Swiss VFRs and expatriate travelers to sub-Saharan Africa and Indian Ocean Islands as most likely to exhibit febrile illnesses. German tourists to Southeast and south-central Asia were most likely to seek treatment for acute diarrhea. Non-European travelers (12,663 patients from other industrialized countries) were less likely to acquire certain travel-associated infectious diseases. These results should be considered in the practice of travel medicine and development of health recommendations for European travelers. PMID:19891866

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.

Generating political priority for newborn survival in three low-income countries.

PubMed

Smith, Stephanie L; Shiffman, Jeremy; Kazembe, Abigail

2014-01-01

Deaths to babies in their first 28 days of life now account for more than 40% of global under-5 child mortality. High neonatal mortality poses a significant barrier to achieving the child survival Millennium Development Goal. Surmounting the problem requires national-level political commitment, yet only a few nation-states have prioritised this issue. We compare Bolivia, Malawi and Nepal, three low-income countries with high neonatal mortality, with a view to understanding why countries prioritise or neglect the issue. The three have had markedly different trajectories since 2000: attention grew steadily in Nepal, stagnated then grew in Malawi and grew then stagnated in Bolivia. The comparison suggests three implications for proponents seeking to advance attention to neglected health issues in low-income countries: the value of (1) advancing solutions with demonstrated efficacy in low-resource settings, (2) building on existing and emerging national priorities and (3) developing a strong network of domestic and international allies. Such actions help policy communities to weather political storms and take advantage of policy windows.

[An epidemiologic study of health care seeking behavior of children under 5 years of age by sex in developing countries].

PubMed

Tursz, A; Crost, M

1999-10-01

Since the end of the 1970's, excess mortality among girls, from the end of the neonatal period until the age of 4 years, has been observed in some South Asian countries. Explanatory hypotheses for this situation have in fact noted differences by sex in food allocation and in care during illness. In some North African and sub-Saharan countries in Africa, mortality data suggest the same type of phenomenon, but less reliable statistics and a lack of data analysis by sex on use of health services does not really allow clarification of the problem. The objective of this study was to analyse health seeking behaviour by sex and to identify explanatory factors for any differences found. A cross sectional study of 1560 consultations of under-5 children was carried out in 6 university and regional hospitals in 3 African countries: Algeria (the zones of Aïn Taya and Tigzirt); Togo (the zones of Lomé, Atakpamé and Kara) and the Congo (Brazzaville). Results confirm the existence of discrimination against girls. In ways which vary according to zones, and in comparison to boys, observations of girls show: under-representation among outpatients (29% in Tigzirt, 40% in Kara), especially when they have many siblings, of which some are sisters; longer duration of the development of symptoms before first resort (leading to increased severity of symptoms); less investment in health care; detrimental feeding practices. Higher SES of the father plays a favourable role, especially for girls, and children of both sexes benefit when the mother has a good educational level. The large regional differences demonstrate the complex interaction among explanatory factors: rurality, problems of access to the hospital, low economic level, low social status of women. This research opens the way so that, in Africa, research will no longer be carried out on health seeking behaviour and utilisation of health services without examining separately the situation of boys and girls, and analysing the possible causes of any differences.

Exploring the influence of culture on hearing help-seeking and hearing-aid uptake.

PubMed

Zhao, Fei; Manchaiah, Vinaya; St Claire, Lindsay; Danermark, Berth; Jones, Lesley; Brandreth, Marian; Krishna, Rajalakshmi; Goodwin, Robin

2015-07-01

The purpose of this paper was to highlight the importance of cultural influence in understanding hearing-help seeking and hearing-aid uptake. Information on audiological services in different countries and 'theories related to cross-culture' is presented, followed by a general discussion. Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the influence of cross-cultural factors in this area calls for an immediate need for research. This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed.

Exploring Awareness of Online Reading Strategies Used by EFL Learners in a Developing Country: A Study on Undergraduate Students in Bangladesh

ERIC Educational Resources Information Center

Islam, Mohammad Shahedul; Rahman, Mohammad Shamsur; Haque, Enamul

2015-01-01

Information and Communication Technology plays an increasingly important role in the lives of learners around the world. The opportunity to seek information through computer has made reading an important language skill. In this hi-tech era, students of undergraduate programs should have high reading ability to comprehend knowledge available online…

Development of Examination Behaviour Inventory: An Integrity Measure for Prevention of Cheating in School Exams

ERIC Educational Resources Information Center

Ossai, Moses C.; Ethe, Nathaniel; Okwudei, Chukuka A.; Edougha, Dennis E.

2014-01-01

Cheating in examinations is an educational menace that has threatened the very essence of schooling in most countries of the world. Therefore, it has become imperative for researchers in education to seek alternative strategies for curbing it in order to restore the dignity of school examinations as an instrument for assessing actual educational…

The Significance of Context for Curriculum Development in Engineering Education: A Case Study across Three African Countries

ERIC Educational Resources Information Center

Case, Jennifer M.; Fraser, Duncan M.; Kumar, Anil; Itika, Ambrose

2016-01-01

Curriculum reform is a key topic in the engineering education literature, but much of this discussion proceeds with little engagement with the impact of the local context in which the programme resides. This article thus seeks to understand the influence of local contextual dynamics on curriculum reform in engineering education. The empirical…

Whose History and Who Is Denied? Politics and the History Curriculum in Lebanon and Australia

ERIC Educational Resources Information Center

Maadad, Nina; Rodwell, Grant

2016-01-01

This paper seeks to explain and develop a better understanding of the relationship between the History curriculum and the consequences of political motive. It compares the History curricula of Australia and Lebanon, and is relevant to understanding the purpose of the History curricula in the two countries as well as, more generally, other…

22 CFR 41.63 - Two-year home-country physical presence requirement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Two-year home-country physical presence...-year home-country physical presence requirement. (a) Statutory basis for rule. Section 212(e) of the... exchange visitor who seeks a waiver of the two-year home-country residence and physical presence...

22 CFR 41.63 - Two-year home-country physical presence requirement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Two-year home-country physical presence...-year home-country physical presence requirement. (a) Statutory basis for rule. Section 212(e) of the... exchange visitor who seeks a waiver of the two-year home-country residence and physical presence...

22 CFR 41.63 - Two-year home-country physical presence requirement.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Two-year home-country physical presence...-year home-country physical presence requirement. (a) Statutory basis for rule. Section 212(e) of the... exchange visitor who seeks a waiver of the two-year home-country residence and physical presence...

22 CFR 41.63 - Two-year home-country physical presence requirement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Two-year home-country physical presence...-year home-country physical presence requirement. (a) Statutory basis for rule. Section 212(e) of the... exchange visitor who seeks a waiver of the two-year home-country residence and physical presence...

Do time perspective and sensation-seeking predict quitting activity among smokers? Findings from the International Tobacco Control (ITC) Four Country Survey.

PubMed

Hall, Peter A; Fong, Geoffrey T; Yong, Hua-Hie; Sansone, Genevieve; Borland, Ron; Siahpush, Mohammad

2012-12-01

Personality factors such as time perspective and sensation-seeking have been shown to predict smoking uptake. However, little is known about the influences of these variables on quitting behavior, and no prior studies have examined the association cross-nationally in a large probability sample. In the current study it was hypothesized that future time perspective would enhance - while sensation-seeking would inhibit - quitting activity among smokers. It was anticipated that the effects would be similar across English speaking countries. Using a prospective cohort design, this cross-national study of adult smokers (N=8845) examined the associations among time perspective, sensation-seeking and quitting activity using the first three waves of data gathered from the International Tobacco Control Four Country Survey (ITC-4), a random digit dialed telephone survey of adult smokers from the United Kingdom, United States, Canada and Australia. Findings revealed that future time perspective (but not sensation-seeking) was a significant predictor of quitting attempts over the 8-month follow-up after adjusting for socio-demographic variables, factors known to inhibit quitting (e.g., perceived addiction, enjoyment of smoking, and perceived value of smoking), and factors known to enhance quitting (e.g., quit intention strength, perceived benefit of quitting, concerns about health effects of smoking). The latter, particularly intention, were significant mediators of the effect of time perspective on quitting activity. The effects of time perspective on quitting activity were similar across all four English speaking countries sampled. If these associations are causal in nature, it may be the case that interventions and health communications that enhance future-orientation may foster more quit attempts among current smokers. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Shifting policy responses to domestic violence in the Netherlands and Spain (1980-2009).

PubMed

Roggeband, Conny

2012-07-01

This article seeks to understand differences in the evolution of policies to combat domestic violence against women in the Netherlands and Spain. Although policy change is often viewed as incremental change toward more progressive policies, the two countries studied here reflect opposing dynamics. The Netherlands moved from being a pioneering country to one that gradually marginalized the policy issue, whereas Spain, in contrast, recently developed innovative and far-reaching policies after a long period of low to moderate state responses. The case study points to the central role of frame negotiation, left-wing governments, and strong feminist mobilization.

Migrant workers’ occupation and healthcare-seeking preferences for TB-suspicious symptoms and other health problems: a survey among immigrant workers in Songkhla province, southern Thailand

PubMed Central

2012-01-01

Background Much of the unskilled and semi-skilled workforce in Thailand comprises migrant workers from neighbouring countries. While, in principle, healthcare facilities in the host country are open to those migrants registered with the Ministry of Labour, their actual healthcare-seeking preferences and practices, as well as those of unregistered migrants, are not well documented. This study aimed to describe the patterns of healthcare-seeking behaviours of immigrant workers in Thailand, emphasizing healthcare practices for TB-suspicious symptoms, and to identify the role of occupation and other factors influencing these behaviours. Methods A survey was conducted among 614 immigrant factory workers (FW), rubber tappers (RT) and construction workers (CW), in which information was sought on socio-demography, history of illness and related healthcare-seeking behaviour. Mixed effects logistic regression modeling was employed in data analysis. Results Among all three occupations, self-medication was the most common way of dealing with illnesses, including the development of TB-suspicious symptoms, for which inappropriate drugs were used. Only for GI symptoms and obstetric problems did migrant workers commonly seek healthcare at modern healthcare facilities. For GI illness, FW preferred to attend the in-factory clinic and RT a private facility over government facilities owing to the quicker service and greater convenience. For RT, who were generally wealthier, the higher cost of private treatment was not a deterrent. CW preferentially chose a government healthcare facility for their GI problems. For obstetric problems, including delivery, government facilities were utilized by RT and CW, but most FW returned to their home country. After adjusting for confounding, having legal status in the country was associated with overall greater use of government facilities and being female and being married with use of both types of modern healthcare facility. One-year estimated period prevalence of TB-suspicious symptoms was around 6% among FW but around 27% and 30% in RT and CW respectively. However, CW were the least likely to visit a modern healthcare facility for these symptoms. Conclusions Self medication is the predominant mode of healthcare seeking among these migrant workers. When accessing a modern healthcare facility the choice is influenced by occupation and its attendant lifestyle and socioeconomic conditions. Utilization of modern facilities could be improved by reducing the current barriers by more complete registration coverage and better provision of healthcare information, in which local vendors of the same ethnicity could play a useful role. Active surveillance for TB among migrant workers, especially CW, may lead to better TB control. PMID:23031509

Design for Occupational Safety and Health of Workers in Construction in Developing Countries: A Study of Architects in Nigeria.

PubMed

Manu, Patrick; Poghosyan, Anush; Mshelia, Ibrahim Mark; Iwo, Samuel Tekena; Mahamadu, Abdul-Majeed; Dziekonski, Krzysztof

2018-06-14

Design for safety (DfS) of workers is amongst the prominent ways of tackling poor occupational safety and health (OSH) performance in construction. However, in developing countries there is an extremely limited research on DfS. This study thus makes an important contribution to the subject of DfS in developing countries by specifically examining the awareness and practice of DfS amongst architects within the construction sector of Nigeria. A survey of architects, yielding 161 valid responses, was conducted. While there is a high awareness of the concept of DfS, the actual practice is low. Additionally, although there is high interest in DfS training, the engagement in DfS training is low. Significantly, awareness of DfS, training and education related to DfS, and membership of a design professional body have very limited bearing on the practice of DfS by architects. The findings are thus symptomatic of the prevalence of influential DfS implementation barriers within the construction sector. Industry stakeholders should seek to raise the profile of DfS practice within the sector. Furthermore, similar empirical studies in the construction sector of other developing countries would be useful in shedding light on the status of DfS in these countries.

Out of the reach of children? Young people's health-seeking practices and agency in Africa's newly-emerging therapeutic landscapes.

PubMed

Hampshire, Kate R; Porter, Gina; Owusu, Samuel Asiedu; Tanle, Augustine; Abane, Albert

2011-09-01

Despite a dominant view within Western biomedicine that children and medicines should be kept apart, a growing literature suggests that children and adolescents often take active roles in health-seeking. Here, we consider young people's health-seeking practices in Ghana: a country with a rapidly-changing therapeutic landscape, characterised by the recent introduction of a National Health Insurance Scheme, mass advertising of medicines, and increased use of mobile phones. Qualitative and quantitative data are presented from eight field-sites in urban and rural Ghana, including 131 individual interviews, focus groups, plus a questionnaire survey of 1005 8-to-18-year-olds. The data show that many young people in Ghana play a major role in seeking healthcare for themselves and others. Young people's ability to secure effective healthcare is often constrained by their limited access to social, economic and cultural resources and information; however, many interviewees actively generated, developed and consolidated such resources in their quest for healthcare. Health insurance and the growth of telecommunications and advertising present new opportunities and challenges for young people's health-seeking practices. We argue that policy should take young people's medical realities as a starting point for interventions to facilitate safe and effective health-seeking. Copyright © 2011 Elsevier Ltd. All rights reserved.

Cross-national study of attitudes towards seeking professional help: Jordan, United Arab Emirates (UAE) and Arabs in Israel.

PubMed

Al-Krenawi, Alean; Graham, John R; Dean, Yasmin Z; Eltaiba, Nada

2004-06-01

Help-seeking processes provide critical links between the onset of mental health problems and the provision of professional care. But little is known about these processes in the Arab world, and still less in transnational, comparative terms. This is the first study to compare help-seeking processes among Muslim Arab female students in Jordan, the United Arab Emirates and Israel. The present study compares the attitudes of Arab Muslim female students from Israel, Jordan and the United Arab Emirates (UAE) towards mental health treatment. A convenience sample of 262 female Muslim-Arab undergraduate university students from Jordan, United Arab Emirates (UAE) and Arab students in Israel completed a modified Orientation for Seeking Professional Help (OSPH) Questionnaire. Data revealed that nationality was not statistically significant as a variable in a positive attitude towards seeking professional help; year of study, marital status and age were found to be significant predictors of a positive attitude towards seeking help. High proportions of respondents among the nationalities referred to God through prayer during times of psychological distress. The discussion considers implications for professional service delivery and programme development. Future research could extrapolate findings to other Arab countries and to Arab peoples living in the non-Arab world.

Sustainable waste management in Africa through CDM projects.

PubMed

Couth, R; Trois, C

2012-11-01

Only few Clean Development Mechanism (CDM) projects (traditionally focussed on landfill gas combustion) have been registered in Africa if compared to similar developing countries. The waste hierarchy adopted by many African countries clearly shows that waste recycling and composting projects are generally the most sustainable. This paper undertakes a sustainability assessment for practical waste treatment and disposal scenarios for Africa and makes recommendations for consideration. The appraisal in this paper demonstrates that mechanical biological treatment of waste becomes more financially attractive if established through the CDM process. Waste will continue to be dumped in Africa with increasing greenhouse gas emissions produced, unless industrialised countries (Annex 1) fund carbon emission reduction schemes through a replacement to the Kyoto Protocol. Such a replacement should calculate all of the direct and indirect carbon emission savings and seek to promote public-private partnerships through a concerted support of the informal sector. Copyright © 2012 Elsevier Ltd. All rights reserved.

China: current trends in pharmaceutical drug discovery.

PubMed

Luo, Ying

2008-04-01

Pharmaceutical discovery and development is expensive and highly risky, even for multinational corporations. As a developing country with limited financial resources, China has been seeking the most cost-effective means to reach the same level of innovation and productivity as Western countries in the pharmaceutical industry sector. After more than 50 years of building up talent and experience, the time for China to become a powerhouse in pharmaceutical innovation is finally approaching. Returnee scientists to China are one of the reasons for the wave of new discovery and commercialization occurring within the country. The consolidation of local Chinese pharmaceutical companies and foreign investment is also providing an agreeable environment for the evolution of a new generation of biotechnology. The opportunity for pharmaceutical innovation is also being expedited by the entry of multinational companies into the Chinese pharmaceutical market, and by the outsourcing of research from these companies to China.

Increased dependence of humans on ecosystem services and biodiversity.

PubMed

Guo, Zhongwei; Zhang, Lin; Li, Yiming

2010-10-01

Humans have altered ecosystems more rapidly and extensively than ever, largely to meet rapidly growing demands for resources along with economic development. These demands have been considered important drivers of ecosystem degradation and biodiversity loss. Are humans becoming less dependent on ecosystem services and biodiversity following economic development? Here, we used roundwood production, hydroelectricity generation and tourism investment in 92 biodiversity hotspot and 60 non-hotspot countries as cases to seek the answer. In 1980-2005, annual growth rates of roundwood production, hydroelectricity generation and tourism investment were higher in hotspot countries (5.2, 9.1 and 7.5%) than in non-hotspot countries (3.4, 5.9 and 5.6%), when GDP grew more rapidly in hotspot countries than non-hotspot countries. Annual growth rates of per capita hydropower and per capita tourism investment were higher in hotspot countries (5.3% and 6.1%) than in non-hotspot countries (3.5% and 4.3%); however, the annual growth rate of per capita roundwood production in hotspot countries (1%) was lower than in non-hotspot countries (1.4%). The dependence of humans on cultural services has increased more rapidly than on regulating services, while the dependence on provisioning services has reduced. This pattern is projected to continue during 2005-2020. Our preliminary results show that economic growth has actually made humans more dependent upon ecosystem services and biodiversity. As a consequence, the policies and implementations of both economic development and ecosystems/biodiversity conservation should be formulated and carried out in the context of the increased dependence of humans on ecosystem services along with economic development.

Prevalence of Abortion and Contraceptive Practice among Women Seeking Repeat Induced Abortion in Western Nigeria

PubMed Central

Lamina, Mustafa Adelaja

2015-01-01

Background. Induced abortion contributes significantly to maternal mortality in developing countries yet women still seek repeat induced abortion in spite of availability of contraceptive services. The aim of this study is to determine the rate of abortion and contraceptive use among women seeking repeat induced abortion in Western Nigeria. Method. A prospective cross-sectional study utilizing self-administered questionnaires was administered to women seeking abortion in private hospitals/clinics in four geopolitical areas of Ogun State, Western Nigeria, from January 1 to December 31 2012. Data were analyzed using SPSS 17.0. Results. The age range for those seeking repeat induced abortion was 15 to 51 years while the median age was 25 years. Of 2934 women seeking an abortion, 23% reported having had one or more previous abortions. Of those who had had more than one abortion, the level of awareness of contraceptives was 91.7% while only 21.5% used a contraceptive at their first intercourse after the procedure; 78.5% of the pregnancies were associated with non-contraceptive use while 17.5% were associated with contraceptive failure. The major reason for non-contraceptive use was fear of side effects. Conclusion. The rate of women seeking repeat abortions is high in Nigeria. The rate of contraceptive use is low while contraceptive failure rate is high. PMID:26078881

Interaction of reward seeking and self-regulation in the prediction of risk taking: A cross-national test of the dual systems model.

PubMed

Duell, Natasha; Steinberg, Laurence; Chein, Jason; Al-Hassan, Suha M; Bacchini, Dario; Lei, Chang; Chaudhary, Nandita; Di Giunta, Laura; Dodge, Kenneth A; Fanti, Kostas A; Lansford, Jennifer E; Malone, Patrick S; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T; Sorbring, Emma; Tapanya, Sombat; Uribe Tirado, Liliana Maria; Alampay, Liane Peña

2016-10-01

In the present analysis, we test the dual systems model of adolescent risk taking in a cross-national sample of over 5,200 individuals aged 10 through 30 (M = 17.05 years, SD = 5.91) from 11 countries. We examine whether reward seeking and self-regulation make independent, additive, or interactive contributions to risk taking, and ask whether these relations differ as a function of age and culture. To compare across cultures, we conduct 2 sets of analyses: 1 comparing individuals from Asian and Western countries, and 1 comparing individuals from low- and high-GDP countries. Results indicate that reward seeking and self-regulation have largely independent associations with risk taking and that the influences of each variable on risk taking are not unique to adolescence, but that their link to risk taking varies across cultures. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Setting the stage for equity-sensitive monitoring of the maternal and child health Millennium Development Goals.

PubMed Central

Wirth, Meg E.; Balk, Deborah; Delamonica, Enrique; Storeygard, Adam; Sacks, Emma; Minujin, Alberto

2006-01-01

OBJECTIVE: This analysis seeks to set the stage for equity-sensitive monitoring of the health-related Millennium Development Goals (MDGs). METHODS: We use data from international household-level surveys (Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS)) to demonstrate that establishing an equity baseline is necessary and feasible, even in low-income and data-poor countries. We assess data from six countries using 11 health indicators and six social stratifiers. Simple bivariate stratification is complemented by simultaneous stratification to expose the compound effect of multiple forms of vulnerability. FINDINGS: The data reveal that inequities are complex and interactive: inferences cannot be drawn about the nature or extent of inequities in health outcomes from a single stratifier or indicator. CONCLUSION: The MDGs and other development initiatives must become more comprehensive and explicit in their analysis and tracking of inequities. The design of policies to narrow health gaps must take into account country-specific inequities. PMID:16878225

Emergence of biopharmaceutical innovators in China, India, Brazil, and South Africa as global competitors and collaborators.

PubMed

Rezaie, Rahim; McGahan, Anita M; Frew, Sarah E; Daar, Abdallah S; Singer, Peter A

2012-06-06

Biopharmaceutical innovation has had a profound health and economic impact globally. Developed countries have traditionally been the source of most innovations as well as the destination for the resulting economic and health benefits. As a result, most prior research on this sector has focused on developed countries. This paper seeks to fill the gap in research on emerging markets by analyzing factors that influence innovative activity in the indigenous biopharmaceutical sectors of China, India, Brazil, and South Africa. Using qualitative research methodologies, this paper a) shows how biopharmaceutical innovation is taking place within the entrepreneurial sectors of these emerging markets, b) identifies common challenges that indigenous entrepreneurs face, c) highlights the key role played by the state, and d) reveals that the transition to innovation by companies in the emerging markets is characterized by increased global integration. It suggests that biopharmaceutical innovators in emerging markets are capitalizing on opportunities to participate in the drug development value chain and thus developing capabilities and relationships for competing globally both with and against established companies headquartered in developed countries.

Emergence of biopharmaceutical innovators in China, India, Brazil, and South Africa as global competitors and collaborators

PubMed Central

2012-01-01

Biopharmaceutical innovation has had a profound health and economic impact globally. Developed countries have traditionally been the source of most innovations as well as the destination for the resulting economic and health benefits. As a result, most prior research on this sector has focused on developed countries. This paper seeks to fill the gap in research on emerging markets by analyzing factors that influence innovative activity in the indigenous biopharmaceutical sectors of China, India, Brazil, and South Africa. Using qualitative research methodologies, this paper a) shows how biopharmaceutical innovation is taking place within the entrepreneurial sectors of these emerging markets, b) identifies common challenges that indigenous entrepreneurs face, c) highlights the key role played by the state, and d) reveals that the transition to innovation by companies in the emerging markets is characterized by increased global integration. It suggests that biopharmaceutical innovators in emerging markets are capitalizing on opportunities to participate in the drug development value chain and thus developing capabilities and relationships for competing globally both with and against established companies headquartered in developed countries. PMID:22672351

Self-help and help-seeking for communication disability in Ghana: implications for the development of communication disability rehabilitation services.

PubMed

Wylie, Karen; McAllister, Lindy; Davidson, Bronwyn; Marshall, Julie; Amponsah, Clement; Bampoe, Josephine Ohenewa

2017-12-29

In low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. As rehabilitation services for communication disability develop, and the profession of speech-language pathology grows, it is important to consider how services can most appropriately respond to the needs and preferences of the community. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community. A qualitative descriptive survey was used to explore likely self-help and help-seeking behaviours for communication disability, in Accra, Ghana. The survey required participants to describe responses to hypothetical scenarios related to communication disability. A mix of theoretical sampling and convenience sampling was used. Qualitative content analysis was used to analyse data and develop categories and subcategories of reported self-help behaviours and sources of help and advice for communication disability. One hundred and thirty-six participants completed the survey. Results indicated that community members would be likely to engage in a variety self-help strategies in response to communication disability. These included working directly with a person with a communication disability to attempt to remediate a communication impairment, altering physical and communication environments, changing attitudes or care practices, educating themselves about the communication disability, providing resources, and responding in spiritual ways. Participants indicated that they would seek help for communication disability across a range of sectors - including the Western healthcare, religious, and traditional sectors. Understanding existing community actions to self-help and help-seek may allow emerging communication rehabilitation services, including the profession of speech-language pathology, to build on existing community practices in resource-limited contexts such as Ghana.

Empirical support for global integrated assessment modeling: Productivity trends and technological change in developing countries' agriculture and electric power sectors

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

Sathaye, Jayant A.

2000-04-01

Integrated assessment (IA) modeling of climate policy is increasingly global in nature, with models incorporating regional disaggregation. The existing empirical basis for IA modeling, however, largely arises from research on industrialized economies. Given the growing importance of developing countries in determining long-term global energy and carbon emissions trends, filling this gap with improved statistical information on developing countries' energy and carbon-emissions characteristics is an important priority for enhancing IA modeling. Earlier research at LBNL on this topic has focused on assembling and analyzing statistical data on productivity trends and technological change in the energy-intensive manufacturing sectors of five developing countries,more » India, Brazil, Mexico, Indonesia, and South Korea. The proposed work will extend this analysis to the agriculture and electric power sectors in India, South Korea, and two other developing countries. They will also examine the impact of alternative model specifications on estimates of productivity growth and technological change for each of the three sectors, and estimate the contribution of various capital inputs--imported vs. indigenous, rigid vs. malleable-- in contributing to productivity growth and technological change. The project has already produced a data resource on the manufacturing sector which is being shared with IA modelers. This will be extended to the agriculture and electric power sectors, which would also be made accessible to IA modeling groups seeking to enhance the empirical descriptions of developing country characteristics. The project will entail basic statistical and econometric analysis of productivity and energy trends in these developing country sectors, with parameter estimates also made available to modeling groups. The parameter estimates will be developed using alternative model specifications that could be directly utilized by the existing IAMs for the manufacturing, agriculture, and electric power sectors.« less

A Review of Literature to Understand the Complexity of Equity, Ethics and Management for Achieving Public Health Goals in India

PubMed Central

Garg, Pankaj; Nagpal, Jitender

2014-01-01

In the context of inadequate public spending on health care in India (0.9% of the GDP); government liberalized its policies in the form of subsidized lands and tax incentives, resulting in the mushrooming of private hospitals and clinics in India. Paradoxically, a robust framework was not developed for the regulation of these health care providers, resulting in disorganized health sector, inadequate financing models, and lack of prioritization of services, as well as a sub-optimal achievement of the Millennium Development Goals (MDG). We systematically reviewed the evidence base regarding regulation of private hospitals, applicability of private-public mix, state of health insurance and effective policy development for India, while seeking lessons on regulation of private health systems, from South African (a developing country) and Australian (a developed country) health care systems. PMID:24701465

Greening government procurement in developing countries: building capacity in China.

PubMed

Geng, Yong; Doberstein, Brent

2008-09-01

With increasing environmental issues and depleting resources, the effective application of green government procurement (GGP) is urgently needed and potentially can have greater impacts in the developing world rather than in the developed world. Such an approach can help promote the general goal of sustainable development and address environmental issues through purchasing and facilitating the use of environmentally friendly services and products. This paper addresses this issue by employing a case study on China. We first trace the development of the GGP concept, its spread to Asian countries, and a number of approaches used to expand GGP adoption. We then review current practices in China on GGP, and analyze and identify some of the current barriers and problems in promoting green procurement in the Chinese governmental sector. We finally seek to identify possible appropriate capacity-building solutions, in order to facilitate the application of GGP in China.

Nurses' Information Seeking Behavior for Clinical Practice: A Case Study in a Developing Country.

PubMed

Sarbaz, Masoumeh; Kimiafar, Khalil; Sheikhtaheri, Abbas; Taherzadeh, Zhila; Eslami, Saeid

2016-01-01

We used a valid questionnaire to survey Iranian nurses' seeking information behavior and their confidence on different information sources. The frequently used sources were Internet" and "personal experiences" (54.8% and 48.2% respectively). "English medical journals" (61.9%) and "English textbooks" (41.3%) were the least frequently used sources. Nurses felt high confidence in sources such as "International instructions/guidelines" (58.6%) and "English medical textbooks" (50.4%). The main reasons for selecting sources were easy accessibility, being up to date and reliability. Google, Pubmed and Up to Date were the most used electronic sources. In addition, there were differences in terms of using some of these resources and nurse' age and gender. In developing information sources for nurses, factors such as reliability level, availability, and updatedness of resources should be more emphasized.

Pricing, distribution, and use of antimalarial drugs.

PubMed Central

Foster, S. D.

1991-01-01

Prices of new antimalarial drugs are targeted at the "travellers' market" in developed countries, which makes them unaffordable in malaria-endemic countries where the per capita annual drug expenditures are US$ 5 or less. Antimalarials are distributed through a variety of channels in both public and private sectors, the official malaria control programmes accounting for 25-30% of chloroquine distribution. The unofficial drug sellers in markets, streets, and village shops account for as much as half of antimalarials distributed in many developing countries. Use of antimalarials through the health services is often poor; drug shortages are common and overprescription and overuse of injections are significant problems. Anxiety over drug costs may prevent patients from getting the necessary treatment for malaria, especially because of the seasonal appearance of this disease when people's cash reserves are very low. The high costs may lead them to unofficial sources, which will sell a single tablet instead of a complete course of treatment, and subsequently to increased, often irrational demand for more drugs and more injections. Increasingly people are resorting to self-medication for malaria, which may cause delays in seeking proper treatment in cases of failure, especially in areas where chloroquine resistance has increased rapidly. Self-medication is now widespread, and measures to restrict the illicit sale of drugs have been unsuccessful. The "unofficial" channels thus represent an unacknowledged extension of the health services in many countries; suggestions are advanced to encourage better self-medication by increasing the knowledge base among the population at large (mothers, schoolchildren, market sellers, and shopkeepers), with an emphasis on correct dosing and on the importance of seeking further treatment without delay, if necessary. PMID:1893512

Denial of abortion in legal settings.

PubMed

Gerdts, Caitlin; DePiñeres, Teresa; Hajri, Selma; Harries, Jane; Hossain, Altaf; Puri, Mahesh; Vohra, Divya; Foster, Diana Greene

2015-07-01

Factors such as poverty, stigma, lack of knowledge about the legal status of abortion, and geographical distance from a provider may prevent women from accessing safe abortion services, even where abortion is legal. Data on the consequences of abortion denial outside of the US, however, are scarce. In this article we present data from studies among women seeking legal abortion services in four countries (Colombia, Nepal, South Africa and Tunisia) to assess sociodemographic characteristics of legal abortion seekers, as well as the frequency and reasons that women are denied abortion care. The proportion of women denied abortion services and the reasons for which they were denied varied widely by country. In Colombia, 2% of women surveyed did not receive the abortions they were seeking; in South Africa, 45% of women did not receive abortions on the day they were seeking abortion services. In both Tunisia and Nepal, 26% of women were denied their wanted abortions. The denial of legal abortion services may have serious consequences for women's health and wellbeing. Additional evidence on the risk factors for presenting later in pregnancy, predictors of seeking unsafe illegal abortion, and the health consequences of illegal abortion and childbirth after an unwanted pregnancy is needed. Such data would assist the development of programmes and policies aimed at increasing access to and utilisation of safe abortion services where abortion is legal, and harm reduction models for women who are unable to access legal abortion services. 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.

Health Care and Distributive Justice.

DTIC Science & Technology

1993-04-01

granting Medicare funding to all patients with kidney failure who need hemodialysis or renal transplantation. Essentially, the government granted...example, more people are allowed to die of chronic renal failure than in any other comparable European country.ŝ Prior to 1973 and government funding...continued failure of the federal government to develop comprehensive health care policy reform led Oregon to seek a solution. The two basic, and

Internationalization as a Challenge for Geographical Education in Poland: Experience of a New Postgraduate Study "Cultural Industries in the Development Policies of Cities and Regions"

ERIC Educational Resources Information Center

Churski, Pawel; Motek, Pawel; Stryjakiewicz, Tadeusz; Cybal-Michalska, Agnieszka

2017-01-01

For many years internationalization has not been a strong point of geographical education in post-socialist countries, including Poland. Therefore, all attempts at intensifying it are a real challenge and good practices deserve dissemination. This paper seeks to present the organizational and programme assumptions of a new field of postgraduate…

Education at a Glance 2008: OECD Indicators

ERIC Educational Resources Information Center

OECD Publishing (NJ1), 2008

2008-01-01

Across OECD countries, governments are seeking policies to make education more effective while searching for additional resources to meet the increasing demand for education. The 2008 edition of "Education at a Glance: OECD Indicators" enables countries to see themselves in the light of other countries' performance. It provides a rich,…

Education at a Glance 2010: OECD Indicators

ERIC Educational Resources Information Center

OECD Publishing (NJ1), 2010

2010-01-01

Across OECD countries, governments are seeking policies to make education more effective while searching for additional resources to meet the increasing demand for education. The 2010 edition of "Education at a Glance: OECD Indicators" enables countries to see themselves in the light of other countries' performance. It provides a rich, comparable…

Education at a Glance 2009: OECD Indicators

ERIC Educational Resources Information Center

OECD Publishing (NJ1), 2009

2009-01-01

Across OECD countries, governments are seeking policies to make education more effective while searching for additional resources to meet the increasing demand for education. The 2009 edition of "Education at a Glance: OECD Indicators" enables countries to see themselves in the light of other countries' performance. It provides a rich,…

Pre-travel health advice-seeking behavior among US international travelers departing from Boston Logan International Airport.

PubMed

LaRocque, Regina C; Rao, Sowmya R; Tsibris, Athe; Lawton, Thomas; Barry, M Anita; Marano, Nina; Brunette, Gary; Yanni, Emad; Ryan, Edward T

2010-01-01

Globally mobile populations are at higher risk of acquiring geographically restricted infections and may play a role in the international spread of infectious diseases. Despite this, data about sources of health information used by international travelers are limited. We surveyed 1,254 travelers embarking from Boston Logan International Airport regarding sources of health information. We focused our analysis on travelers to low or low-middle income (LLMI) countries, as defined by the World Bank 2009 World Development Report. A total of 476 survey respondents were traveling to LLMI countries. Compared with travelers to upper-middle or high income (UMHI) countries, travelers to LLMI countries were younger, more likely to be foreign-born, and more frequently reported visiting family as the purpose of their trip. Prior to their trips, 46% of these travelers did not pursue health information of any type. In a multivariate analysis, being foreign-born, traveling alone, traveling for less than 14 days, and traveling for vacation each predicted a higher odds of not pursuing health information among travelers to LLMI countries. The most commonly cited reason for not pursuing health information was a lack of concern about health problems related to the trip. Among travelers to LLMI countries who did pursue health information, the internet was the most common source, followed by primary care practitioners. Less than a third of travelers to LLMI countries who sought health information visited a travel medicine specialist. In our study, 46% of travelers to LLMI countries did not seek health advice prior to their trip, largely due to a lack of concern about health issues related to travel. Among travelers who sought medical advice, the internet and primary care providers were the most common sources of information. These results suggest the need for health outreach and education programs targeted at travelers and primary care practitioners. © 2010 International Society of Travel Medicine.

The Engineering 4 Health Challenge - an interdisciplinary and intercultural initiative to foster student engagement in B.C. and improve health care for children in under-serviced communities.

PubMed

Price, Morgan; Weber-Jahnke, Jens H

2009-01-01

This paper describes the Engineering 4 Health (E4H) Challenge, an interdisciplinary and intercultural initiative that, on the one hand, seeks to improve health education of children in under-serviced communities and, on the other, seeks to attract students in British Columbia to professions in engineering and health. The E4H Challenge engages high school and university students in BC to cooperatively design and develop health information and communication technology (ICT) to educate children living in under-serviced communities. The E4H Challenge works with the One Laptop Per Child (OLPC) program to integrate applications for health awareness into the school programs of communities in developing countries. Although applications developed by the E4H Challenge use the low-cost, innovative XO laptop (the "$100 laptop" developed by the OLPC foundation) the software can also be used with other inexpensive hardware.

Rethinking burns for low & middle-income countries: Differing patterns of burn epidemiology, care seeking behavior, and outcomes across four countries.

PubMed

Davé, Dattesh R; Nagarjan, Neeraja; Canner, Joseph K; Kushner, Adam L; Stewart, Barclay T

2018-02-20

Low-and middle-income (LMIC) countries account for 90% of all reported burns, nevertheless there is a paucity of providers to treat burns. Current studies on burns in LMICs have not evaluated the gap between care seeking and receiving. This study explores this gap across socioeconomically similar populations in a multi-country population based assessment to inform burn care strategies. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) instrument is a cross sectional national, cluster random sampling survey administered in Nepal, Rwanda, Sierra Leone, and Uganda from 2011 to 2014. The survey identifies burn etiology, demographics, timing, disability, and barriers to receiving care. Among 13,763 individuals surveyed, 896 burns were identified. Rwanda had the highest proportion of individuals seeking and receiving care (91.6% vs 88.5%) while Sierra Leone reported the fewest (79.3% vs 70.3%). Rwanda reported the largest disability while Nepal reported the highest proportion with no disability (47.5% vs 76.2%). Lack of money, healthcare providers, and rural living reduce the odds of receiving care by 68% and 85% respectively. Despite similar country socioeconomic characteristics there was significant variability in burn demographics, timing, and disability. Nevertheless, being geographically and economically disadvantaged predict lack of access to burn care. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

[Economic factors and gender differences in the prevalence of smoking among adults].

PubMed

Paes, Nelson Leitão

2016-01-01

This article presents a study that seeks to identify the relevant economic variables in the prevalence of smoking in a group of 37 countries. The chosen methodology was to estimate multiple linear regression using the least square approach. The econometric exercise is performed by gender, seeking to examine whether there are different motivations for cigarette smoking among the adult population of men and women. The results show that although taxation is a common element in the decision of both sexes, the decision to smoke among women is also sensitive to price and other social and cultural factors. These factors were based on the fact that women who live in countries that are part of the Organization for Economic Cooperation and Development reveal a significantly higher prevalence of cigarette consumption. The evidence presented in this study, therefore, reinforces the perception that taxation is in fact a crucial tool in the control of smoking, but in the specific case of women, higher prices and the promotion of greater equality with men, are also important.

Effect of culture on acceptance of telemedicine in Middle Eastern countries: case study of Jordan and Syria.

PubMed

Alajlani, Mohannad; Clarke, Malcolm

2013-04-01

We investigated issues that affect the use and adoption of telemedicine in Middle Eastern countries, taking the Hashemite Kingdom of Jordan and the Syrian Arab Republic as case studies. Our study is based on interviews with key stakeholders (including doctors, technicians, engineers, and decision makers) and questionnaires administered to key stakeholders (including patients), ensuring opinion was gained from people from a full range of backgrounds and roles in the healthcare system. We found doctor and patient resistance was a major issue preventing the adoption of telemedicine in both countries, followed by poor infrastructure, lack of funding, and lack of information technology training. Our research identifies that culture is a greater issue than technical matters for the adoption of telemedicine in Middle Eastern countries. Based on our preliminary results we developed a guideline framework for each country that might be applied to telemedicine projects at the pre-implementation phase. The proposed guideline framework was validated through a return visit to the stakeholders and seeking further opinion.

Lymphoedema management: an international intersect between developed and developing countries. Similarities, differences and challenges.

PubMed

Stout, Nicole L; Brantus, Pierre; Moffatt, Christine

2012-01-01

Lymphoedema is a chronic swelling condition that contributes to disability, dysfunction and lost quality of life. Significant disparities exist worldwide regarding the availability of resources necessary to identify, treat and manage lymphoedema. This disparity transcends socio-economic status and is a common problem in both developed and developing countries. The overall impact of lymphoedema as a public health problem, however, is underestimated, principally due to the lack of epidemiologic data. These problems pose barriers to optimal identification and management of this disabling, lifelong condition. In 1997, the World Health Organization (50.29) resolved that lymphatic filariasis should be eliminated as a public health problem. A component of this strategy focuses on disability management for those suffering from lymphatic filariasis-related morbidity. This initiative has enhanced lymphoedema awareness in developing countries. However, significant deficits persist in health care providers' knowledge, educational initiatives and basic disease identification and treatment. In developed countries, lymphoedema continues to be an underrecognised condition and assumed to be only cancer-related. Health care resources allocated to treat and manage the disease are insufficient for basic and ongoing care, resulting in disease progression and disability. The International Lymphoedema Framework project, established in 2002, seeks to establish a consensus for best practices in the management of lymphoedema worldwide to reduce this disability burden. A basic global construct for lymphoedema management is needed to decrease morbidity and promote optimal disease management across all cultural and socio-economic boundaries. Many countries are unaware of the importance of lymphoedema management and have not defined a national strategy with respect to this problem. The objective of this article is to define similarities and differences in strategies for lymphoedema management between developed and developing countries and advocate for a cohesive and concerted approach to disease management.

The Impact of Social Capital and Social Networks on Tourism Technology Adoption for Destination Marketing and Promotion: A Case of Convention and Visitors Bureaus

ERIC Educational Resources Information Center

Lee, Byeong Cheol

2011-01-01

Tourism is a growing and significant component of the world economy and competition for tourism revenues is intense. For countries or regions seeking community development through tourism, communication strategies are an essential element of success. The Internet plays an increasingly large role in how we communicate in the 21st century and with…

Toward an Asbestos Ban in the United States.

PubMed

Lemen, Richard A; Landrigan, Philip J

2017-10-26

Many developed countries have banned the use of asbestos, but not the United States. There have, however, been multiple efforts in the US to establish strict exposure standards, to limit asbestos use, and to seek compensation through the courts for asbestos-injured workers' In consequence of these efforts, asbestos use has declined dramatically, despite the absence of a legally mandated ban. This manuscript presents a historical review of these efforts.

Culture: A Bridge to Understanding. Projects of the Federal Republic of Germany for Preserving the Cultural Assets of the Third World. Special Report No. 8-1988 (engl.).

ERIC Educational Resources Information Center

Schwarzwald, Sigrid

1988-01-01

By participating in the cultivation and preservation of existing cultural assets in developing nations, and by promoting the cultural, literary, and artistic manifestations within those countries, the West German government seeks to establish the essential prerequisites required for a thriving dialogue with those nations, and can aid in their…

Setting Engineering Students up for Success in the 21st Century: Integrating Gamification and Crowdsourcing into a CDIO-Based Web Design Course

ERIC Educational Resources Information Center

Song, Donglei; Tavares, Adriano; Pinto, Sandro; Xu, Hao

2017-01-01

Over the past few decades, many researchers have tested course designs that may better engage students in developing countries, accommodate for Millennials' desires to learn and teach at will, and teach students the skills they need for their first jobs. The vision of this paper for a web design course seeks to address these issues for engineering…

Are civil-law notaries rent-seeking monopolists or essential market intermediaries? Endogenous development of a property rights institution in Mexico.

PubMed

Monkkonen, Paavo

2016-01-01

As the fourth contribution in the 'Land' section, this paper forms a research 'diptych' with the next paper by Levy. Whereas she focuses on the notarial institution in mid-nineteenth century Mexico, this contribution examines it in a contemporary context. The notary is one of the chief components of property rights protection in civil-law systems, performing various public functions such as writing deeds for real estate property. Yet notaries are considered an 'inefficient' institution by many, due to the perception of rent-seeking behavior enabled by their near-monopoly over validating property rights claims. This study examines notaries in Mexico to unpack the apparent contradiction in the role of notaries in economic development. I use a combination of interviews with notaries and clients, and data on notarial practice and bureaucratic outcomes across the country, to examine notaries' social function. The theoretical lens of endogenous development and institutional functionalism reveals an alternate explanation for their seemingly high-cost services, as well as their role in economic development. Mexican notaries have a dual social function: public representative and private service provider. They perform diverse and essential activities, which in other countries are performed by multiple actors such as real estate agents, escrow offices and title insurance companies. Thus, what is perceived as inefficiency by some can be interpreted as an efficient response to the context in which they operate, and their semi-privatized nature can overcome problems found in other bureaucratic arrangements.

The impact of drug policy liberalisation on willingness to seek help for problem drug use: A comparison of 20 countries.

PubMed

Benfer, Isabella; Zahnow, Renee; Barratt, Monica J; Maier, Larissa; Winstock, Adam; Ferris, Jason

2018-06-01

While the impact of changing drug policies on rates of drug use has been investigated, research into how help-seeking behaviour changes as drug policies become more public-health focused is limited. This paper investigates reported changes in confidence to utilise drug services following hypothetical changes in national drug policy among a sample of individuals who report recent illicit drug use. We predict that liberalising national drug policy will increase the propensity for people who take illegal drugs to utilise health services. The data were drawn from a sample of self-reported responses to the 2014 Global Drug Survey. Respondents were asked if they would be more confident seeking help if each of the following policy changes were made in their country; a) drugs were legalised; b) penalties for possession of small amounts of drugs were reduced to a fine only; c) drugs were legally available through governments outlets. Multiple correspondence analysis and multinomial logistic regression with post-estimation linear hypothesis testing were conducted. Individuals residing in countries with relatively liberal drug policy regimes report their help-seeking behaviour is unlikely to change given the hypothetical policy amendments. Individuals from countries with prohibition-based drug policies reported a far greater propensity for changing their help-seeking behaviour in the event of hypothetical policy amendments, citing reduced fear of criminal sanctions as the major reason. Age and sex differences were also found. The current study demonstrates the capacity for national drug policy reform to influence drug use risk by facilitating or impeding health service engagement among individuals who use illicit substances. We suggest national drug policy requires careful consideration of both prevention goals and the needs of individuals already engaged in illicit substance use; more liberal drug policies may actually encourage the adoption of harm reduction strategies such as health service engagement. Copyright © 2018 Elsevier B.V. All rights reserved.

Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews

PubMed Central

Atwine, Fortunate; Hultsjö, Sally; Albin, Björn; Hjelm, Katarina

2015-01-01

Introduction Health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The aim of the study was to explore health-care seeking behaviour among persons with type 2 diabetes to understand reasons for using therapies offered by traditional healers. Methods Descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39–72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups. Results Reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends. Conclusion The pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care. PMID:26090034

Macroergonomic aspects in the design of development programs in IDCs.

PubMed

Coelho, Denis A; Ferrara, Patricia R; Couvinhas, Ana F; Lima, Tânia M; Walter, Jake K

2012-01-01

This paper revisits three reports on ergonomic aspects of development initiatives taking place in Industrially Developing Countries (IDCs). These include a macro-ergonomics intervention in a habitation community in Cape Verde (aimed at designing solutions contributing to sustainable development), the evolution of poultry growers' control strategies as an integrative broiler operation is introduced in Mozambique, and a set of macro-ergonomic considerations related to the Agro Forestry Village Project in Mozambique. The paper seeks to set the reviewed development endeavors against the backdrop of the goals of ergonomics interventions. This reflection may inform development agents in future processes of design and implementation of integrated community and work systems transformation.

Policy Development for Environmental Licensing and Biodiversity Offsets in Latin America

PubMed Central

Villarroya, Ana; Barros, Ana Cristina; Kiesecker, Joseph

2014-01-01

Attempts to meet biodiversity goals through application of the mitigation hierarchy have gained wide traction globally with increased development of public policy, lending standards, and corporate practices. With interest in biodiversity offsets increasing in Latin America, we seek to strengthen the basis for policy development through a review of major environmental licensing policy frameworks in Argentina, Brazil, Chile, Colombia, Mexico, Peru and Venezuela. Here we focused our review on an examination of national level policies to evaluate to which degree current provisions promote positive environmental outcomes. All the surveyed countries have national-level Environmental Impact Assessment laws or regulations that cover the habitats present in their territories. Although most countries enable the use of offsets only Brazil, Colombia, Mexico and Peru explicitly require their implementation. Our review has shown that while advancing quite detailed offset policies, most countries do not seem to have strong requirements regarding impact avoidance. Despite this deficiency most countries have a strong foundation from which to develop policy for biodiversity offsets, but several issues require further guidance, including how best to: (1) ensure conformance with the mitigation hierarchy; (2) identify the most environmentally preferable offsets within a landscape context; (3) determine appropriate mitigation replacement ratios; and (4) ensure appropriate time and effort is given to monitor offset performance. PMID:25191758

Reuse of samples: ethical issues encountered by two institutional ethics review committees in Kenya.

PubMed

Langat, Simon K

2005-10-01

There is growing concern about the reuse and exploitation of biological materials (human tissues) for use in research worldwide. Most discussions about samples have taken place in developed countries, where genetic manipulation techniques have greatly advanced in recent years. There is very little discussion in developing countries, although collaborative research with institutions from developed countries is on the increase. The study sought to identify and describe ethical issues arising in the storage, reuse and exportation of samples in a developing country. Research protocols presented to two Ethics Review Committees in Kenya during a period of two years were reviewed. A record was made of the protocol title, sample collected, request for storage, reuse or exportation and whether or not subject consent was sought. The findings indicated that about 25% out of the 388 protocols sought permission for reuse and only half of those actually informed subjects of the contemplated re-use. Less than 20% requested storage and again, about half of them sought consent from subjects. There is an indication that investigators do not see the need to seek consent for storage, reuse and exportation of samples. It is proposed that these issues should be addressed through policy interventions at both the national and global levels.

Policy development for environmental licensing and biodiversity offsets in Latin America.

PubMed

Villarroya, Ana; Barros, Ana Cristina; Kiesecker, Joseph

2014-01-01

Attempts to meet biodiversity goals through application of the mitigation hierarchy have gained wide traction globally with increased development of public policy, lending standards, and corporate practices. With interest in biodiversity offsets increasing in Latin America, we seek to strengthen the basis for policy development through a review of major environmental licensing policy frameworks in Argentina, Brazil, Chile, Colombia, Mexico, Peru and Venezuela. Here we focused our review on an examination of national level policies to evaluate to which degree current provisions promote positive environmental outcomes. All the surveyed countries have national-level Environmental Impact Assessment laws or regulations that cover the habitats present in their territories. Although most countries enable the use of offsets only Brazil, Colombia, Mexico and Peru explicitly require their implementation. Our review has shown that while advancing quite detailed offset policies, most countries do not seem to have strong requirements regarding impact avoidance. Despite this deficiency most countries have a strong foundation from which to develop policy for biodiversity offsets, but several issues require further guidance, including how best to: (1) ensure conformance with the mitigation hierarchy; (2) identify the most environmentally preferable offsets within a landscape context; (3) determine appropriate mitigation replacement ratios; and (4) ensure appropriate time and effort is given to monitor offset performance.

Medical tourism.

PubMed

Leggat, Peter

2015-01-01

Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. This article provides an outline of the current research around medical tourism, especially its impact on Australians. Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad.

Building technological capability within satellite programs in developing countries

NASA Astrophysics Data System (ADS)

Wood, Danielle; Weigel, Annalisa

2011-12-01

This paper explores the process of building technological capability in government-led satellite programs within developing countries. The key message is that these satellite programs can learn useful lessons from literature in the international development community. These lessons are relevant to emerging satellite programs that leverage international partnerships in order to establish local capability to design, build and operate satellites. Countries with such programs include Algeria, Nigeria, Turkey, Malaysia and the United Arab Emirates. The paper first provides background knowledge about space activity in developing countries, and then explores the nuances of the lessons coming from the international development literature. Developing countries are concerned with satellite technology because satellites provide useful services in the areas of earth observation, communication, navigation and science. Most developing countries access satellite services through indirect means such as sharing data with foreign organizations. More countries, however, are seeking opportunities to develop satellite technology locally. There are objective, technically driven motivations for developing countries to invest in satellite technology, despite rich debate on this topic. The paper provides a framework to understand technical motivations for investment in satellite services, hardware, expertise and infrastructure in both short and long term. If a country decides to pursue such investments they face a common set of strategic decisions at the levels of their satellite program, their national context and their international relationships. Analysis of past projects shows that countries have chosen diverse strategies to address these strategic decisions and grow in technological capability. What is similar about the historical examples is that many countries choose to leverage international partnerships as part of their growth process. There are also historical examples from outside the space arena in which organizations have pursued technological capability. Scholars have analyzed these examples and developed insightful frameworks. The paper draws key concepts from this literature about the nature of development, technology, knowledge and organizational learning. These concepts are relevant to learning in new satellite programs, but the ideas must be applied cautiously because of the nature of satellite technology. The paper draws three major lessons from the international development literature regarding absorptive capacity, tacit knowledge and organizational learning; it synthesizes these lessons into a cohesive, original framework. The closing section proposes future work on a detailed study of technological learning in specific government satellite programs.

Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries.

PubMed

Evans-Lacko, S; Brohan, E; Mojtabai, R; Thornicroft, G

2012-08-01

Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems is needed. This study links two large, international datasets to explore the association between public stigma in 14 European countries (Eurobarometer survey) and individual reports of self-stigma, perceived discrimination and empowerment among persons with mental illness (n=1835) residing in those countries [the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) study]. Individuals with mental illness living in countries with less stigmatizing attitudes, higher rates of help-seeking and treatment utilization and better perceived access to information had lower rates of self-stigma and perceived discrimination and those living in countries where the public felt more comfortable talking to people with mental illness had less self-stigma and felt more empowered. Targeting the general public through mass anti-stigma interventions may lead to a virtuous cycle by disrupting the negative feedback engendered by public stigma, thereby reducing self-stigma among people with mental health problems. A combined approach involving knowledge, attitudes and behaviour is needed; mass interventions that facilitate disclosure and positive social contact may be the most effective. Improving availability of information about mental health issues and facilitating access to care and help-seeking also show promise with regard to stigma.

The Education of Minority Groups. An Enquiry into Problems and Practices of Fifteen Countries.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France). Centre for Educational Research and Innovation.

The essays in this volume seek to elucidate the policies and processes whereby groups of students in 15 (mainly industrialized) countries are designated as special, and differential treatment is legitimated, organized, and financed. Essays and authors are as follows: "An Overview of Experience in Fifteen Countries" (W. Donovan, A.…

Background of Individual Education Plans (IEPs) Policy in Some Countries: A Review

ERIC Educational Resources Information Center

Alkahtani, Mohammed Ali; Kheirallah, Sahar Abdelfattah

2016-01-01

This paper seeks to provide a cogent outline of the current policies that six separate countries have on Individual Education Plans (IEPs), identifying the key features in each system. The chosen countries are Australia (Queen Island), Canada (British Columbia), New Zealand, the United Kingdom, the United States of America, and Saudi Arabia. The…

School Choice Policy: Seeking to Balance Educational Efficiency and Equity. A Comparative Analysis of 20 European Countries

ERIC Educational Resources Information Center

Lauri, Triin; Põder, Kaire

2013-01-01

In recent years, the degree of choice in education systems has increased in most countries. Still, the variation of choice policies across countries is substantial. The authors ask under what combinations of conditions (i.e. institutional features of education systems) choice policy succeeds in balancing educational efficiency and equity. Using…

Aggression in Dating Relationships Compared by Country of Origin

ERIC Educational Resources Information Center

Seligowski, Antonia; West, Doe

2009-01-01

Aims: The purpose of this study was to analyze prevalence levels of aggression in dating relationships and to compare this by country of origin. The study also seeks more understanding of the violence experienced by men in these countries. Method: A convenience sample was used; study participants were 194 females and 168 males ranging in age from…

Posttraumatic Stress Disorder and Barriers to Care in Eastern Cape Province, South Africa.

PubMed

Topper, Kegan; van Rooyen, Kempie; Grobler, Christoffel; van Rooyen, Dalena; Andersson, Lena M C

2015-08-01

A range of barriers to seeking mental health care in low- and middle-income countries has been investigated. Little, however, is known of the barriers to care and help-seeking behavior among people with posttraumatic stress disorder (PTSD) in low- and middle-income countries. This was a population-based study including 977 people aged 18-40 years from the Eastern Cape Province in South Africa. Current PTSD was assessed by using a diagnostic questionnaire (Mini International Psychiatric Interview). An additional questionnaire captured socioeconomic and health-related data. The prevalence of current PTSD was 10.8%. Only 48.1% of people with current PTSD accessed health care services. Younger people aged 18 to 29 years were less likely to seek health care, OR = 0.36, 95% CI [0.15, 0.85]. People earning a salary or wage, OR = 2.91, 95% CI [1.26, 6.71]; and those with tuberculosis, OR = 11.63, 95% CI [1.42, 95.56], were more likely to seek health care. A range of barriers to seeking care were identified, the most striking being stigma and a lack of knowledge regarding the nature and treatment of mental illness. People with current PTSD may seek help for other health concerns and brief screening means those affected may be readily identified. Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company.

15 CFR 768.7 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... assessment, it will seek evidence relevant to the assessment, including an analysis of the military needs of a selected country or countries, technical analysis, and intelligence information from the.... (c) Analysis. BIS will conduct its analysis by evaluating whether the reasonable and reliable...

Patient-Held Maternal and/or Child Health Records: Meeting the Information Needs of Patients and Healthcare Providers in Developing Countries?

PubMed Central

Turner, Kathleen E.; Fuller, Sherrilynne

2011-01-01

Though improvements in infant and maternal mortality rates have occurred over time, women and children still die every hour from preventable causes. Various regional, social and economic factors are involved in the ability of women and children to receive adequate care and prevention services. Patient-held maternal and/or child health records have been used for a number of years in many countries to help track health risks, vaccinations and other preventative health measures performed. Though these records are primarily designed to record patient histories and healthcare information and guide healthcare workers providing care, because the records are patient-held, they also allow families a greater ability to track their own health and prevention strategies. A literature search was performed to answer these questions: (1) What are maternal information needs regarding pregnancy, post-natal and infant healthcare, especially in developing countries? (2) What is known about maternal information seeking behavior in developing countries? (3) What is the history and current state of maternal and/or child patient-held healthcare records, do they provide for the information needs of the healthcare provider and what are the effects and outcomes of patient-held records in general and for maternal and/or child health in particular? Specific information needs of pregnant women and mothers are rarely studied. The small numbers of maternal information behavior results available indicate that mothers, in general, prefer to receive health information directly from their healthcare provider as opposed to from other sources (written, etc.) Overall, in developing countries, patient-held maternal and/or child healthcare records have a mostly positive effect for both patient and care provider. Mothers and children with records tend to have better outcomes in healthcare and preventative measures. Further research into the information behaviors of pregnant women and mothers to determine the extent of reliance on interpersonal information seeking is recommended before expending significant resources on enhanced patient-held maternal and/or child healthcare records including storage on mobile devices. In particular, research is needed to explore the utility of providing targeted health messages to mothers regarding their own health and that of their children; this might best be accomplished through mobile technologies. PMID:23569604

Increasing loyalty to breastfeeding: investigating a product development strategy.

PubMed

Parkinson, Joy; Russell-Bennett, Rebekah; Previte, Josephine

2012-01-01

This article demonstrates how social marketing insights were used to influence women's loyalty to breastfeeding. The article reports on a social marketing campaign undertaken by the Australian Breastfeeding Association and a government health department, which used a product development strategy in order to increase breastfeeding loyalty. Seeking new approaches to support breastfeeding behaviors is critical and timely, because while initiation rates of breastfeeding are high in developed countries such as the United Kingdom, Australia, Canada, and the United States, duration rates are significantly lower. Results indicate that a product- focused strategy influences pregnant women's loyalty to exclusively breastfeeding.

Sustainable Energy in Remote Indonesian Grids. Accelerating Project Development

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

Hirsch, Brian; Burman, Kari; Davidson, Carolyn

2015-06-30

Sustainable Energy for Remote Indonesian Grids (SERIG) is a U.S. Department of Energy (DOE) funded initiative to support Indonesia’s efforts to develop clean energy and increase access to electricity in remote locations throughout the country. With DOE support, the SERIG implementation team consists of the National Renewable Energy Laboratory (NREL) and Winrock International’s Jakarta, Indonesia office. Through technical assistance that includes techno-economic feasibility evaluation for selected projects, government-to-government coordination, infrastructure assessment, stakeholder outreach, and policy analysis, SERIG seeks to provide opportunities for individual project development and a collective framework for national replication office.

Toward an Asbestos Ban in the United States

PubMed Central

Lemen, Richard A.; Landrigan, Philip J.

2017-01-01

Many developed countries have banned the use of asbestos, but not the United States. There have, however, been multiple efforts in the US to establish strict exposure standards, to limit asbestos use, and to seek compensation through the courts for asbestos-injured workers’. In consequence of these efforts, asbestos use has declined dramatically, despite the absence of a legally mandated ban. This manuscript presents a historical review of these efforts. PMID:29072598

JPRS Report, China, Qiushi Seeking Truth, No. 23, 1 December 1990.

DTIC Science & Technology

1991-02-08

doubt that we that the building of spiritual civilization-including the must persist in taking economic construction as the building of ideology and...development of a planned commodity economy, to areas of economic , political, cultural, and social lives, provide better material conditions and a broader...prob- who "have ideals, morality, culture, and discipline." We lems. Our country has built an economic system which must do work in this respect

Translations on Telecommunications Policy, Research and Development, Number 8

DTIC Science & Technology

1977-07-28

Telecommunications Sector Advocated Technology Exchange With Italy To Be Discussed CUBA Microwave Relay Network To Improve TV Reception (Ramon Brizuela; JUVENTUD ...Aired (Ricardo Tabares; JUVENTUD REBELDE, 11 May 77) .... 27, *r Briefs Television Transmitters 29 NEAR EAST AND NORTH AFRICA JJTER-ARAB AFFAIRS...TV RECEPTION Havana JUVENTUD REBELDE in Spanish 16 May 77 p 2 /Article by Ramon Brizuela_7 £Text_J Our country is eagerly seeking to modernize its

[Meeting the Abuja and Millennium Development Goals: the state more than ever].

PubMed

Boidin, B

2013-01-01

In the 1980s and 1990s, healthcare policies in poor countries were largely based on the privatization of the healthcare supply. Over the past decade, this trend has led to the expansion of private initiatives in both the nonprofit and profit-seeking sectors. Assessments of these initiatives show mixed results and sometimes pernicious effects. It is accordingly necessary to review and redesign policies to enable public entities and States to once again become leaders in the development of integrated and socially inclusive health policies.

Update on microbicide research and development-seeking new HIV prevention tools for women

PubMed Central

2011-01-01

Women and girls are especially vulnerable to HIV infection in sub-Saharan Africa, and in some of those countries, prevalence among young women can be up to 3 times higher than among men of the same age. Effective HIV prevention options for women are clearly needed in this setting. Several ARV-based vaginal microbicides are currently in development for prevention of HIV transmission to women and are discussed here. The concept of pre-exposure prophylaxis for the prevention of HIV transmission to women is introduced. PMID:21345763

Defense.gov Special Report: Travels With Gates - January 2011

Science.gov Websites

officials will take the military-to-military relationship between the two countries to the next level. Story traveling to China, where he will seek to expand and deepen the military-to-military relationship between weapons to Taiwan. Story | Transcript More Headlines Gates Seeks Sustained Military Relationship with

An International Study in Competency Education: Postcards from Abroad. CompetencyWorks Issue Brief

ERIC Educational Resources Information Center

Bristow, Sara Frank; Patrick, Susan

2014-01-01

"An International Study in Competency Education: Postcards from Abroad" seeks to highlight components of competency education in international practice, to inform US policymakers and decision makers seeking to implement high-quality competency pathways at the state or local level. Other countries are studying our innovations, and we are…

Forest Protection and Reforestation in Costa Rica: Evaluation of a Clean Development Mechanism Prototype.

PubMed

Subak

2000-09-01

/ Costa Rica has recently established a program that provides funds for reforestation and forest protection on private lands, partly through the sale of carbon certificates to industrialized countries. Countries purchasing these carbon offsets hope one day to receive credit against their own commitments to limit emissions of greenhouse gases. Costa Rica has used the proceeds of the sale of carbon offsets to Norway to help finance this forest incentive program, called the Private Forestry Project, which pays thousands of participants to reforest or protect forest on their lands. The Private Forestry Project is accompanied by a monitoring program conducted by Costa Rican forest engineers that seeks to determine net carbon storage accomplished on these lands each year. The Private Forestry Project, which is officially registered as an Activity Implemented Jointly, is a possible model for bundled projects funded by the Clean Development Mechanism (CDM) established by the 1997 Kyoto Protocol to the UN Framework Convention on Climate Change. It also serves as an interesting example for the CDM because it was designed by a developing country host-not by an industrialized country investor. Accordingly, it reflects the particular "sustainable development" objectives of the host country or at least the host planners. Early experience in implementing the Private Forestry Project is evaluated in light of the main objectives of the CDM and its precursor-Activities Implemented Jointly. It is concluded that the project appears to meet the criteria of global cost-effectiveness and financing from non-ODA sources. The sustainable development implications of the project are specific to the region and would not necessarily match the ideals of all investing and developing countries. The project may be seen to achieve additional greenhouse gas abatement when compared against some (although not all) baselines.

Combating Global Antibiotic Resistance: Emerging One Health Concerns in Lower- and Middle-Income Countries.

PubMed

Nadimpalli, Maya; Delarocque-Astagneau, Elisabeth; Love, David C; Price, Lance B; Huynh, Bich-Tram; Collard, Jean-Marc; Lay, Kruy Sun; Borand, Laurence; Ndir, Awa; Walsh, Timothy R; Guillemot, Didier

2018-03-05

Antibiotic misuse in lower- and middle-income countries (LMICs) contributes to the development of antibiotic resistance that can disseminate globally. Strategies specific to LMICs that seek to reduce antibiotic misuse by humans, but simultaneously improve antibiotic access, have been proposed. However, most approaches to date have not considered the growing impact of animal and environmental reservoirs of antibiotic resistance, which threaten to exacerbate the antibiotic resistance crisis in LMICs. In particular, current strategies do not prioritize the impacts of increased antibiotic use for terrestrial food-animal and aquaculture production, inadequate food safety, and widespread environmental pollution. Here, we propose new approaches that address emerging, One Health challenges.

International Emergency Psychiatry Challenges: Disaster Medicine, War, Human Trafficking, Displaced Persons.

PubMed

Jaung, Michael; Jani, Suni; Banu, Sophia; Mackey, Joy M

2017-09-01

Mental health disorders are a major cause of morbidity and a growing burden in low-income and middle-income countries; but there is little existing literature on the detailed epidemiology, diagnosis, and treatment in low-resource settings. Special situations with vulnerable populations, such as those created by international humanitarian emergencies, refugees or internally displaced people, and victims of human trafficking, are increasing in prevalence. These victims are often resettled in developed countries and come to the emergency department seeking care. To better care for these populations, knowledge of specialized psychosocial and cultural considerations should inform the comprehensive psychiatric assessment and treatment plan. Copyright © 2017 Elsevier Inc. All rights reserved.

77 FR 25961 - Subsidy Programs Provided by Countries Exporting Softwood Lumber and Softwood Lumber Products to...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

... DEPARTMENT OF COMMERCE International Trade Administration Subsidy Programs Provided by Countries...: Import Administration, International Trade Administration, Department of Commerce. SUMMARY: The Department of Commerce (Department) seeks public comment on any subsidies, including stumpage subsidies...

76 FR 67148 - Subsidy Programs Provided by Countries Exporting Softwood Lumber and Softwood Lumber Products to...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

... DEPARTMENT OF COMMERCE International Trade Administration Subsidy Programs Provided by Countries...: Import Administration, International Trade Administration, Department of Commerce. SUMMARY: The Department of Commerce (Department) seeks public comment on any subsidies, including stumpage subsidies...

78 FR 24724 - Subsidy Programs Provided by Countries Exporting Softwood Lumber and Softwood Lumber Products to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... DEPARTMENT OF COMMERCE International Trade Administration Subsidy Programs Provided by Countries...: Import Administration, International Trade Administration, Department of Commerce. SUMMARY: The Department of Commerce (Department) seeks public comment on any subsidies, including stumpage subsidies...

Association between caregivers' knowledge and care seeking behaviour for children with symptoms of pneumonia in six sub-Saharan African Countries.

PubMed

Noordam, Aaltje Camielle; Sharkey, Alyssa B; Hinssen, Paddy; Dinant, GeertJan; Cals, Jochen W L

2017-02-02

Pneumonia is the main cause of child mortality world-wide and most of these deaths occur in sub-Saharan Africa (SSA). Treatment with effective antibiotics is crucial to prevent these deaths; nevertheless only 2 out of 5 children with symptoms of pneumonia are taken to an appropriate care provider in SSA. While various factors associated with care seeking have been identified, the relationship between caregivers' knowledge of pneumonia symptoms and actual care seeking for their child with symptoms of pneumonia is not well researched. Based on data from Multiple Indicator Cluster Surveys, we assessed the association between caregivers' knowledge of symptoms related to pneumonia - namely fast or difficulty breathing - and care seeking behaviour for these symptoms. We analysed data of 4,163 children with symptoms of pneumonia and their caregivers. A Chi-square tests and multivariable logistic regression was performed to assess the association between care seeking and knowledge of at least one symptom (i.e., fast or difficulty breathing). Across all 6 countries only around 30% of caregivers were aware of at least one of the two symptoms of pneumonia (i.e., fast or difficulty breathing). Our study shows that in the Democratic Republic of the Congo and Nigeria there was a positive association between knowledge and care seeking (P ≤ 0.01), even after adjusting for key variables (including wealth, residence, education). We found no association between caregivers' knowledge of pneumonia symptoms and actual care seeking for their child with symptoms of pneumonia in Central African Republic, Chad, Malawi, and Sierra Leone. These findings reveal an urgent need to increase community awareness of pneumonia symptoms, while simultaneously designing context specific strategies to address the fundamental challenges associated with timely care seeking.

The Trans Pacific Partnership Agreement, intellectual property and medicines: Differential outcomes for developed and developing countries.

PubMed

Gleeson, Deborah; Lexchin, Joel; Lopert, Ruth; Kilic, Burcu

2018-04-01

The final text of the Trans Pacific Partnership Agreement (TPP), agreed between the 12 negotiating countries in 2016, included a suite of intellectual property provisions intended to expand and extend pharmaceutical company exclusivities on medicines. It drew wide criticism for including such provisions in an agreement that involved developing countries (Vietnam, Peru, Malaysia, Mexico, Chile and Brunei Darussalam) because of the effect on delaying the introduction of low-cost generics. While developing nations negotiated transition periods for implementing some obligations, all parties would have eventually been expected to meet the same standards had the TPP come into force. While the TPP has stalled following US withdrawal, there are moves by some of the remaining countries to reinvigorate the agreement without the United States. The proponents may seek to retain as much as possible of the original text in the hope that the United States will re-join the accord in future. This article presents a comparative analysis of the impact the final 2016 TPP intellectual property chapter could be expected to have (if implemented in its current form) on the intellectual property laws and regulatory regimes for medicines in the TPP countries. Drawing on the published literature, it traces the likely impact on access to medicines. It focuses particularly on the differential impact on regulatory frameworks for developed and developing nations (in terms of whether or not legislative action would have been required to implement the agreement). The article also explores the political and economic dynamics that contributed to these differential outcomes.

The Trans Pacific Partnership Agreement, intellectual property and medicines: Differential outcomes for developed and developing countries

PubMed Central

Gleeson, Deborah; Lexchin, Joel; Lopert, Ruth; Kilic, Burcu

2017-01-01

The final text of the Trans Pacific Partnership Agreement (TPP), agreed between the 12 negotiating countries in 2016, included a suite of intellectual property provisions intended to expand and extend pharmaceutical company exclusivities on medicines. It drew wide criticism for including such provisions in an agreement that involved developing countries (Vietnam, Peru, Malaysia, Mexico, Chile and Brunei Darussalam) because of the effect on delaying the introduction of low-cost generics. While developing nations negotiated transition periods for implementing some obligations, all parties would have eventually been expected to meet the same standards had the TPP come into force. While the TPP has stalled following US withdrawal, there are moves by some of the remaining countries to reinvigorate the agreement without the United States. The proponents may seek to retain as much as possible of the original text in the hope that the United States will re-join the accord in future. This article presents a comparative analysis of the impact the final 2016 TPP intellectual property chapter could be expected to have (if implemented in its current form) on the intellectual property laws and regulatory regimes for medicines in the TPP countries. Drawing on the published literature, it traces the likely impact on access to medicines. It focuses particularly on the differential impact on regulatory frameworks for developed and developing nations (in terms of whether or not legislative action would have been required to implement the agreement). The article also explores the political and economic dynamics that contributed to these differential outcomes. PMID:29706802

Community dialogues for child health: results from a qualitative process evaluation in three countries.

PubMed

Martin, Sandrine; Leitão, Jordana; Muhangi, Denis; Nuwa, Anthony; Magul, Dieterio; Counihan, Helen

2017-06-05

Across the developing world, countries are increasingly adopting the integrated community case management of childhood illnesses (iCCM) strategy in efforts to reduce child mortality. This intervention's effectiveness is dependent on community adoption and changes in care-seeking practices. We assessed the implementation process of a theory-driven community dialogue (CD) intervention specifically designed to strengthen the support and uptake of the newly introduced iCCM services and related behaviours in three African countries. A qualitative process evaluation methodology was chosen and used secondary project data and primary data collected in two districts of each of the three countries, in purposefully sampled communities. The final data set included 67 focus group discussions and 57 key informant interviews, totalling 642 respondents, including caregivers, CD facilitators community leaders, and trainers. Thematic analysis of the data followed the 'Framework Approach' utilising both a deduction and induction process. Results show that CDs contribute to triggering community uptake of and support for iCCM services through filling health information gaps and building cooperation within communities. We found it to be an effective approach for addressing social norms around child care practices. This approach was embraced by communities for its flexibility and value in planning individual and collective change. Regular CDs can contribute to the formation of new habits, particularly in relation to seeking timely care in case of child sickness. This study also confirms the value of process evaluation to unwrap the mechanisms of community mobilisation approaches in context and provides key insights for improving the CD approach.

A Spatiotemporal Analysis of Brazilian Science from the Perspective of Researchers' Career Trajectories.

PubMed

Furtado, Caio Alves; Davis, Clodoveu A; Gonçalves, Marcos André; de Almeida, Jussara Marques

2015-01-01

The growth of Brazilian scientific production in recent years is remarkable, which motivates an investigation on the factors, inside and outside the country, that helped shape this wealthy research environment. This article provides a thorough analysis of the education of researchers that constitute the main Brazilian research groups, using data on about 6,000 researchers involved in the country's National Institutes of Science and Technology (INCT) initiative. Data on the steps taken by each researcher in her education, from the bachelor's degree to doctorate, including a possible postdoctoral experience, and employment, are extracted from an official curriculum vitae repository. The location and the time at which each career step occurred define spatiotemporal career trajectories. We then analyze such trajectories considering additional data, including the area of knowledge of the INCTs to which each researcher is associated. We found an increasing prevalence of Brazilian institutions in the education of Brazilian scientists, as the number of doctorates earned abroad is decreasing over time. Postdoctoral stages, on the other hand, often take place in Europe or in the United States. Taking an international postdoctoral position after a full education in Brazil suggests a drive towards seeking higher-level exchange and cooperation with foreign groups in a more advanced career stage. Results also show that Brazilian researchers tend to seek employment in regions that are close to the institutions at which they received their bachelor's degrees, suggesting low mobility within the country. This study can be instrumental in defining public policies for correcting distortions, and can help other developing countries that aim to improve their national science systems.

Organic livestock production: an emerging opportunity with new challenges for producers in tropical countries.

PubMed

Chander, M; Subrahmanyeswari, B; Mukherjee, R; Kumar, S

2011-12-01

Agrochemicals, veterinary drugs, antibiotics and improved feeds can increase the food supply while minimising production costs in various livestock production systems around the world. However, these days, quality-conscious consumers are increasingly seeking environmentally safe, chemical-residue-free healthy foods, along with product traceability and a high standard of animal welfare, which organic production methods are said to ensure. Organic production is not only a challenge for producers in developing countries, it offers new export opportunities as well. Organic agriculture is practised by 1.8 million producers in 160 countries, and production of organically grown food continues to increase steadily by 15% per year. Most tropical countries are now exporting organic agricultural products but, apart from organic beef from Brazil and Argentina, organic livestock products are yetto take off. Most trade in organic livestock products is restricted to the European Union and other developed nations. Nevertheless, tropical countries cannot afford to neglect this emerging system of animal production. Organic production is knowledge- and management-intensive. Producers must be well versed in organic production standards, principles and practices, which require a high degree of knowledge and skill. In organic production, it is not simply the final product but the whole production process that must be inspected and approved by the accredited certification bodies. Organic livestock farming is still evolving, and further research is needed to make it sustainable. In this paper, the authors review the prospects of organic animal husbandry and its possible constraints in developing and tropical countries.

Sexual maltreatment of unaccompanied asylum-seeking minors from the Horn of Africa: a mixed method study focusing on vulnerability and prevention.

PubMed

Lay, Margaret; Papadopoulos, Irena

2009-10-01

The study described in this paper sought to identify the social, cultural, and political factors that effect African unaccompanied asylum-seeking minors' (UASM) vulnerability to sexual maltreatment in England. It aimed to illuminate how child protection measures could be strengthened for this highly marginalized group. A mixed method approach was used. Former UASM from Ethiopia, Eritrea and Somalia who had been sexually maltreated in the UK were interviewed in-depth. Prior to the interviews they all completed a questionnaire which captured their biographical details as well as sensitive but factual information. Of the 53 (N=53) former UASM who participated in the study only 2 were males. Most arrived in the UK aged 15-17. A range of sexual maltreatment, from sexual harassment to rape was reported. Three quarters experienced more than 1 incident. Most initial incidents happened in the first 12 months of their arrival in the UK. Two perpetrators were female carers. Many participants reported being groomed and sexually maltreated by people from their own country. Many described being seriously sexually maltreated, particularly by groups of young males living in the same accommodation or nearby, some reportedly also asylum seekers. Participants that had been warned of the dangers of sexual maltreatment were more likely to both disclose and to seek professional help. Professionals should assume that UASM will suffer sexual maltreatment in their host country if not protected adequately, which they are unlikely to disclose. They are likely to need more protection from outside sources and help to develop their personal resources than many have received in the past. Preventative measures include provision of safer environments, ideally single sex housing; more monitoring and supervision; more opportunities to develop trustworthy relationships and have emotional needs met; greater opportunities to develop language skills/access to interpretation; early information regarding the social system, culture, and sexual maltreatment; and improved professional awareness and competence in dealing with minors from other cultures.

Contending ideologies and politico-economic philosophies underlying energy policy in the United States

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

Bucknell, H. III

1976-01-01

The energy problem besetting this country comprises economic, technological, and physical (geologic) factors--but the solutions to this problem will be found, for better or worse, in the political arena. In seeking these solutions, increasing conflict can be anticipated between those of a conservative bent favoring ''free enterprise and limited government'' and those of a liberal persuasion arguing for ''big government and public ownership'' in areas directly affecting the public welfare. The financial capability in this country to develop new energy resources on a massive scale through the private enterprise system alone is concluded to be, at best, marginal. The delaymore » in developing conservation programs and new energy resources is portrayed as being ultimately dangerous to the very nature of our political system. (67 references) (auth)« less

Motivations for enterprise system adoption in transition economies: insights from Poland

NASA Astrophysics Data System (ADS)

Soja, Piotr; Weistroffer, Heinz Roland

2016-06-01

Enterprise system (ES) adoption can bring many benefits, but may also put tremendous strain on an organisation or business, sometimes with disastrous outcomes. The specific motivations and expectations that lead to ES adoption may impact the success or failure of these endeavours, and understanding these motivations may be useful in predicting the success of ES projects. Most of the published research on ES adoption motivation has been in the context of highly developed countries. The social, cultural, economic and political conditions in developing, emerging and transition economies make for a different business environment, and insights obtained from developed countries may not always transfer to these settings. This study seeks to identify and help understand the motivations for ES adoption specifically in transition economies, as these economies play a significant role in the global market, but have not been receiving adequate research attention. Drawing on the experience of 129 ES adopters in Poland, a transition economy, this study categorises motivations into coherent groups of issues and evaluates the influence of discovered motivations on ES adoption success. Further, motivations revealed by this study are compared with motivations reported by prior research conducted in developed countries.

Power lifting: people meeting the population challenge.

PubMed

Dillon, L

1994-12-01

Whereas population pressures are usually associated with developing countries, developed countries like the US also suffer from population-associated problems. For example, in some US cities the infant mortality rate is worse than in the developing world. US policy-makers have found it useful to apply some of the programs used successfully in the developing world to problems at home. Efforts to increase the availability of health care services and education have led to the creation of the Healthy Start program in Baltimore, Maryland, which uses community residents to motivate their peers and provides counseling on family planning, education, and employment. In Oregon, an AIDS-prevention program, which makes condoms more accessible to teenagers, has been transplanted from Zaire. Chattanooga, Tennessee, has used techniques from Brazil to design public transportation systems and improve air quality. In communities across the country, activists are working to instill power in local residents as they seek ways to improve the environment and promote economic health. Modeled on an initiative in Bangladesh, community-run loan programs allow the development of microenterprises which help people develop self-employment opportunities. When women take part in these activities and become successfully employed, their children are given what is usually their first example of parental employment and a reason to hope for a better future.

Production of antiretroviral drugs in middle- and low-income countries.

PubMed

Pinheiro, Eloan dos Santos; Brüning, Karin; Macedo, M Fernanda; Siani, Antonio C

2014-01-01

This review outlines the main issues concerning the production of antiretroviral (ARV) drugs in middle- and low-income countries and the relevant political, legal and technical requirements for supporting such production. The requirements for efficient local production, including the manufacture of generic and branded products and public demand, have been considered from economic, market and socio-political perspectives. A steady and consistent government policy is crucial to success. Additional crucial factors in establishing local production are adequate infrastructure, qualified human resources in technical and managerial areas, and production-distribution logistics systems. The creation or strengthening of a national drug regulatory agency is a basic requirement. Production of ARVs relies on the structure of the international market for active pharmaceutical ingredients (APIs), which are highly monopolized for inclusion in branded or patented drugs, or are concentrated in a few Asian generic companies. Countries seeking to begin local production must develop strategies to overcome the various barriers. For instance, sub-Saharan African countries may benefit from developing multilateral health agreements with neighbouring countries. Such agreements are recommended and should be complemented by technology transfers, especially for the manufacture of APIs. Achieving a production level that is sustainable in the long term is crucial to maintaining patients' access to ARVs.

The Movie "The Secret Life of Words:" Implications for Counselors

ERIC Educational Resources Information Center

Cook, Katrina

2008-01-01

Torture still occurs at an alarming rate in the world today. Because many torture victims suffer silently in isolation instead of seeking help for their symptoms of posttraumatic stress, it is impossible to know how many lives have been impacted. However, as more and more torture victims seek asylum in countries such as the United States,…

Chinese International Students in Australia: An Insight into Their Help and Information Seeking Manners

ERIC Educational Resources Information Center

Ling, Cao; Tran, Ly Thi

2015-01-01

Understanding the ways that international students seek information and help in the host country is essential for improving academic, social, cultural, and welfare support for this student cohort. However, there is a dearth of literature that documents how international students in the vocational education and training (VET) sector do so. This…

Do remittances promote financial development in Africa?

PubMed

Karikari, Nana Kwasi; Mensah, Sam; Harvey, Simon K

2016-01-01

The paper seeks to establish whether or not remittances promoted financial developments and explore the traceable causality between remittances and financial developments in some countries in Africa. We examine the association between remittances received and how they affect the availability of credit to private sector, bank deposits intermediated by financial institutions and money supply. We also question whether the development in the financial sector causes higher levels or otherwise of remittances received. This paper uses data on remittance flows to 50 developing countries in Africa from 1990 to 2011 to explore the nexus. The study uses fixed effects and random effect estimations as well as Vector Error Correction Model method on the panel data. The study shows that remittances promote certain aspects of financial development to some extent and better financial system foster receipts of remittances. The effect of causality is seen in the short run and not in the long-run. The study alludes to literature that remittances could promote financial development in the short run and the development of the financial sector helps increase the propensity to remit via formal channels.

Are civil-law notaries rent-seeking monopolists or essential market intermediaries? Endogenous development of a property rights institution in Mexico

PubMed Central

Monkkonen, Paavo

2017-01-01

As the fourth contribution in the ‘Land’ section, this paper forms a research ‘diptych’ with the next paper by Levy. Whereas she focuses on the notarial institution in mid-nineteenth century Mexico, this contribution examines it in a contemporary context. The notary is one of the chief components of property rights protection in civil-law systems, performing various public functions such as writing deeds for real estate property. Yet notaries are considered an ‘inefficient’ institution by many, due to the perception of rent-seeking behavior enabled by their near-monopoly over validating property rights claims. This study examines notaries in Mexico to unpack the apparent contradiction in the role of notaries in economic development. I use a combination of interviews with notaries and clients, and data on notarial practice and bureaucratic outcomes across the country, to examine notaries’ social function. The theoretical lens of endogenous development and institutional functionalism reveals an alternate explanation for their seemingly high-cost services, as well as their role in economic development. Mexican notaries have a dual social function: public representative and private service provider. They perform diverse and essential activities, which in other countries are performed by multiple actors such as real estate agents, escrow offices and title insurance companies. Thus, what is perceived as inefficiency by some can be interpreted as an efficient response to the context in which they operate, and their semi-privatized nature can overcome problems found in other bureaucratic arrangements. PMID:28615798

Treatment-seeking patterns for malaria in pharmacies in five sub-Saharan African countries.

PubMed

Ladner, Joël; Davis, Ben; Audureau, Etienne; Saba, Joseph

2017-08-29

Artemisinin-based combination therapy (ACT) is recommended as the first-line anti-malarial treatment strategy in sub-Saharan African countries. WHO policy recommends parasitological confirmation by microscopy or rapid diagnostic test (RDT) in all cases of suspected malaria prior to treatment. Gaps remain in understanding the factors that influence patient treatment-seeking behaviour and anti-malarial drug purchase decisions in the private sector. The objective of this study was to identify patient treatment-seeking behaviour in Ghana, Kenya, Nigeria, Tanzania, and Uganda. Face-to-face patient interviews were conducted at a total of 208 randomly selected retail outlets in five countries. At each outlet, exit interviews were conducted with five patients who indicated they had come seeking anti-malarial treatment. The questionnaire was anonymous and standardized in the five countries and collected data on different factors, including socio-demographic characteristics, history of illness, diagnostic practices (i.e. microscopy or RDT), prescription practices and treatment purchase. The price paid for the treatment was also collected from the outlet vendor. A total of 994 patients were included from the five countries. Location of malaria diagnosis was significantly different in the five countries. A total of 484 blood diagnostic tests were performed, (72.3% with microscopy and 27.7% with RDT). ACTs were purchased by 72.5% of patients who had undergone blood testing and 86.5% of patients without a blood test, regardless of whether the test result was positive or negative (p < 10 -4 ). A total of 531 patients (53.4%) had an anti-malarial drug prescription, of which 82.9% were prescriptions for an ACT. There were significant differences in prescriptions by country. A total of 923 patients (92.9%) purchased anti-malarial drugs in an outlet, including 79.1% of patients purchasing an ACT drug: 98.0% in Ghana, 90.5% in Kenya, 80.4% in Nigeria, 69.2% in Tanzania, and 57.7% in Uganda (p < 10 -4 ). Having a drug prescription was not a significant predictive factor associated with an ACT drug purchase (except in Kenya). The number of ACT drugs purchased with a prescription was greater than the number purchased without a prescription in Kenya, Nigeria and Tanzania. This study highlights differences in drug prescription and purchase patterns in five sub-Saharan African countries. The private sector is playing an increasingly important role in fever case management in sub-Saharan Africa. Understanding the characteristics of private retail outlets and the role they play in providing anti-malaria drugs may support the design of effective malaria interventions.

Duration of untreated psychosis and pathway to care in Riyadh, Saudi Arabia.

PubMed

Al Fayez, Hanan; Lappin, Julia; Murray, Robin; Boydell, Jane

2017-02-01

Recent studies of 'duration of untreated psychosis' (DUP) indicate that some patients remain untreated in the community for some time. Considerable emphasis has been placed on reducing the DUP. However, most studies investigating DUP have been conducted in Western countries, where well-developed primary care systems are available. This study aims to describe DUP and its association with both demographic factors and pathways to care in Riyadh, Saudi Arabia. A retrospective study of 421 new case records of all Saudi schizophrenia patients over a 2-year period in six governmental hospitals in Riyadh, Saudi Arabia. The median DUP was 1.41 years (interquartile range 0.35-2.81 years). The longest time to contact was 9.86 years but 90% had a DUP shorter than 5 years. Older age at onset, single marital status and higher educational level were associated with shorter DUP. Long DUP was associated with help seeking from traditional healers. In Saudi Arabia, it usually takes longer for patients to seek help from psychiatric services after their first psychosis onset than it does in Western countries. The results suggest that the DUP is influenced by both demographic factors and pathways to care. © 2015 Wiley Publishing Asia Pty Ltd.

Maximizing Societal Benefits Associated With Alternative Fuel Subsidies: The Case of Plug-in Hybrid Electric Vehicles

NASA Astrophysics Data System (ADS)

Nazir, Samir M.

Government seeks to improve the welfare of its citizenry and intervenes in marketplaces to maximize benefits when externalities are not captured. By analyzing how welfare changes from area to area across the country in response to the same intervention informs where government should act. This thesis analyzes the case of plug-in hybrid electric vehicles (PHEVs). PHEVs have many societal benefits, including improving national security, economic, environmental, and health advantages. The magnitude and distribution of these benefits depends on where PHEVs are deployed. This thesis develops and applies a methodology to determine if the benefits from PHEV deployment vary across the country and for ranking regions where positive PHEV consequences are likely to be maximized. The metrics in this method are proxies of key variables which predict the level of benefits in a county from the deployment of a PHEV there; they include population, health benefits from reduced ozone concentration, vehicle miles traveled per capita, existence of non-federal policies, and CO 2 intensity of electricity. By shedding light on how benefits from PHEV deployment vary across counties, this thesis seeks to better inform where to enact government interventions to maximize the benefits of this technology.

Profile of the oral healthcare team in countries with emerging economies.

PubMed

Nash, D; Ruotoistenmäki, J; Argentieri, A; Barna, S; Behbehani, J; Berthold, P; Catalanotto, F; Chidzonga, M; Goldblatt, L; Jaafar, N; Kikwilu, E; Konoo, T; Kouzmina, E; Lindh, C; Mathu-Muju, K; Mumghamba, E; Nik Hussein, N; Phantumvanit, P; Runnel, R; Shaw, H; Forna, N; Orliaguet, T; Honkala, E

2008-02-01

Health is a critical dimension of human well-being and flourishing, and oral health is an integral component of health: one is not healthy without oral health. Significant barriers exist to ensuring the world's people receive basic healthcare, including oral healthcare. Amongst these are poverty, ignorance, inadequate financial resources and lack of adequate numbers of educated and trained (oral) healthcare workers. Emerging economies are encouraged to develop a national strategic plan for oral health. International organizations have developed goals for oral health that can be referenced and adapted by emerging economies as they seek to formulate specific objectives for their countries. Demographic data that assess the nature and extent of oral diseases in a country are essential to sound planning and the development of an oral healthcare system that is relevant, effective and economically viable. Prevention should be emphasized and priority consideration be given to oral healthcare for children. The types and numbers of members of the oral healthcare team (workforce) will vary from country to country depending on the system developed. Potential members of the workforce include: generalist dentists, specialist dentists, dental therapists, dental hygienists, denturists, expanded function dental assistants (dental nurses) and community oral health workers/aides. Competences for dentists, and other members of the team, should be developed to ensure quality care and developed economies should cooperate with emerging economies. The development, by more advanced economies, of digital, virtual curricula, which could be used by emerging economies for educating and training members of the oral healthcare team, should be an important initiative. The International Federation of Dental Educators and Associations (IFDEA) should lead in such an effort.

International cooperation and shortage of doctors: an analysis of the interaction between Brazil, Angola and Cuba.

PubMed

Alves, Sandra Mara Campos; Oliveira, Felipe Proenço de; Matos, Mateus Falcão Martins; Santos, Leonor Maria Pacheco; Delduque, Maria Celia

2017-07-01

The shortage of doctors, especially in remote areas, is a critical issue for the development of national health systems and has thus been the focus of a number of international cooperation projects. An exploratory and qualitative study was conducted to examine cooperation between Brazil, Angola and Cuba. A nonsystematic literature review was conducted of selected open access articles and official documents addressing relevant health cooperation initiatives. Previously selected characteristics of actions designed to redress the shortage of doctors were compared. It was concluded that the interactions between the three countries were fruitful and potentially beneficial for the health of the population of these countries. South-South cooperation between these countries showed positive results in the educational and regulatory dimensions and adopted a non-dependence perspective that seeks to strengthen endogenous capacity, which are important factors for evaluating the structural components of health systems.

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.

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

78 FR 65970 - Subsidy Programs Provided by Countries Exporting Softwood Lumber and Softwood Lumber Products to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... DEPARTMENT OF COMMERCE International Trade Administration Subsidy Programs Provided by Countries... Commerce. SUMMARY: The Department of Commerce (Department) seeks public comment on any subsidies, including..., International Trade Administration, U.S. Department of Commerce, 14th Street and Constitution Avenue NW...

The New Geography: The Map, The Satellite, and The Computer

DTIC Science & Technology

2011-03-23

GDP Ratio To Evaluate Country ETFs ,” September 24, 2007, linked from Seeking Alpha Website, http://seekingalpha.com/article/47992-using-trade-to- gdp...ratio-to-evaluate-country- etfs , (accessed February 18, 2011). 51For additional information and charts on oil and energy refer to the U.S. Energy

Comparison of legislation concerning people with disability and heritage environment in Malaysia and developed countries

NASA Astrophysics Data System (ADS)

Marsin, J. M.; Ariffin, S. I.; Shahminan, R. N. R.

2014-02-01

Heritage towns and buildings are invaluable cultural assets of a nation, and are extremely useful in manifesting place identity, and crucial in promoting tourism. These places of cultural significance should be made accessible to everyone including people with mobility or sensory impairments, the elderly, parents with small children and those who are temporarily disabled due to injury or illness. By creating a accessible heritage environment not only can you cater towards the increasing population of disabled people, but you could increase the number of cultural properties as resources of a nation through 'accessible tourism'. However the differences in implementation of barrier-free tourism for historic buildings and places are rather large between developed and developing countries such as Malaysia. This paper serves as preliminary study on accessibility of heritage environment in Malaysia. First, review of some related definitions, perception toward disability, and background studies in disability movement will be discussed to achieve better understanding of the increasing population of disabled people and how it would affect the development of infrastructure in the built environment. Second, it will look into existing legislation concerning heritage conservation and legislation on provision of access for the disabled in Malaysia and other developing countries. Finally, this paper seeks to find gaps between these legislations and conclude with some recommendations.

Essential health care: a framework for its definition and implementation in health districts.

PubMed

Monekosso, G L

1984-10-01

This paper presents a framework for the definition and implementation of essential health care. It is based upon current experiences in developing countries. Its aim is to facilitate the description, in operational terms, of a range of activities for clearly defined targets--individuals, families and communities. It seeks to bring to the attention of responsible citizens and professionals the major areas which they should address in the search for "Health for All by the year 2000". It is hoped that this will facilitate integration of health care into socio-economic development activities; and promote a partnership between people and governments in community health development.

What contributes to disparities in the preterm birth rate in European countries?

PubMed Central

Delnord, Marie; Blondel, Béatrice; Zeitlin, Jennifer

2015-01-01

Purpose of review In countries with comparable levels of development and healthcare systems, preterm birth rates vary markedly – a range from 5 to 10% among live births in Europe. This review seeks to identify the most likely sources of heterogeneity in preterm birth rates, which could explain differences between European countries. Recent findings Multiple risk factors impact on preterm birth. Recent studies reported on measurement issues, population characteristics, reproductive health policies as well as medical practices, including those related to subfertility treatments and indicated deliveries, which affect preterm birth rates and trends in high-income countries. We showed wide variation in population characteristics, including multiple pregnancies, maternal age, BMI, smoking, and percentage of migrants in European countries. Summary Many potentially modifiable population factors (BMI, smoking, and environmental exposures) as well as health system factors (practices related to indicated preterm deliveries) play a role in determining preterm birth risk. More knowledge about how these factors contribute to low and stable preterm birth rates in some countries is needed for shaping future policy. It is also important to clarify the potential contribution of artifactual differences owing to measurement. PMID:25692506

Determinants of Information Behaviour and Information Literacy Related to Healthy Eating among Internet Users in Five European Countries

ERIC Educational Resources Information Center

Niedzwiedzka, Barbara; Mazzocchi, Mario; Aschemann-Witzel, Jessica; Gennaro, Laura; Verbeke, Wim; Traill, W. Bruce

2014-01-01

Introduction: This study investigates how Europeans seek information related to healthy eating, what determines their information seeking and whether any problems are encountered in doing so. Method: A survey was administered through computer-assisted on-line web-interviewing. Respondents were grouped by age and sex (n = 3003, age +16) in Belgium,…

Unaccompanied Asylum-Seeking Refugee Children's Forced Repatriation: Social Workers' and Police Officers' Health and Job Characteristics.

PubMed

Sundqvist, Johanna; Hansson, Jonas; Ghazinour, Mehdi; Ögren, Kenneth; Padyab, Mojgan

2015-04-19

During the past ten years the number of unaccompanied asylum-seeking refugee children has dramatically increased in Sweden. Some of them are permitted to stay in the receiving country, but some are forced back to their country of origin. Social workers and police officers are involved in these forced repatriations, and such complex situations may cause stressful working conditions. This study aimed to bridge the gap in knowledge of the relationship between general mental health and working with unaccompanied asylum-seeking refugee children who are due for forced repatriation. In addition, the role of psychosocial job characteristics in such relationships was investigated. A questionnaire including sociodemographic characteristics, the Swedish Demand-Control-Support Questionnaire, and the 12-item General Mental Health Questionnaire were distributed nationally. Univariate and multivariable regression models were used. Poorer mental health was associated with working with unaccompanied asylum-seeking refugee children among social workers but not among police officers. Psychological job demand was a significant predictor for general mental health among social workers, while psychological job demand, decision latitude, and marital status were predictors among police officers. Findings are discussed with special regard to the context of social work and police professions in Sweden.

Level of modern health care seeking behaviors among mothers having under five children in Dangila town, north West Ethiopia, 2016: a cross sectional study.

PubMed

Dagnew, Amare Belachew; Tewabe, Tilahun; Murugan, Rajalakshmi

2018-05-29

Health seeking behavior is an action taken by an individual who perceive to have a health problem. In most developing countries including Ethiopia the health of the children is strongly dependant on maternal health care behavior. Most childhood morbidities and mortalities are associated with low level of mothers health care seeking behavior. Therefore, the objective of this study was to assess level of modern health care seeking behavior among mothers having under five children in Dangila town, North West Ethiopia. Community based quantitative cross-sectional study was conducted from April 15 to May 15, 2016. Systematic random sampling technique was used to select study participants. A total of273 mothers with children less than five years were included in this study. The data was collected from all five Kebeles using interviewer administered questionnaire. Descriptive and inferential statistics were used to present the data. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with level of modern health care seeking behavior. Prevalence of modern health care seeking behavior was 82.1%. Age of mothers (AOR = 2.4(1.1, 5.3), age of the child (AOR = 6.7(2.8, 22.2), severity of illness (AOR = 5.2(1.2, 22.6) and family number (AOR = 6.4(2.1, 20.2) were predictors of modern health care seeking behavior among mothers. Majority of the mothers preferred to take their children to modern health care when they got illness. Age of children, age of mother, number of family and severity of illness were the determinant factors for modern health care seeking behavior. Therefore, health care services should be strengthened at community level through community integrated management of childhood illness, information, education communication / behavioral change communication strategies to improve mothers health care seeking behaviors.

Clients and carers perception of mental illness and factors that influence help-seeking: Where they go first and why.

PubMed

Chilale, Harris K; Silungwe, Ndumanene Devlin; Gondwe, Saulos; Masulani-Mwale, Charles

2017-08-01

In Northern Malawi, the duration of untreated psychosis (DUP) is longer than that in high-income countries. The reasons for the delay in help-seeking are not known, although studies show multiple reasons. This research was conducted to establish health care help-seeking behaviours and identify barriers that exist between service users and health care providers. The study also intended to establish the beliefs that clients and family members have regarding the causes of mental illness which profoundly shape help-seeking, care giving process and outcomes. The study employed the exploratory phenomenological method, utilizing focus group discussions (FGDs) in the sampled population. The Health Belief Model and Disease Explanatory Models were conveniently chosen a priori by researchers to develop guide questions to explore clients' and carers' perceptions of the illness and their health care help-seeking behaviours. Results show a bio-psycho-social inclination of disease causation and help-seeking behaviour. Causes of mental illness are understood in three categories, namely: physical/biological, psychological and socio-cultural. The majority of participants attributed mental illness to socio-cultural factors, with witchcraft, spirit possession and curses as main determinants. Causal perceptions also influenced help-seeking pathways. Many participants reported consulting traditional healers first, for diagnosis and to know who was responsible. In this study, it has been found that help-seeking is influenced by the understanding of the source of the illness - which has a bio-psychosocial inclination. The socio-cultural explanation of witchcraft and spirit possession is dominant and a determinant of help-seeking behaviour. While participants noted benefits to hospital treatment, barriers and bio-psychosocial in nature were also noted. Guardians and not clients hold the key to choice of treatment modality and therefore a potential ally in all treatment interventions promotive, preventive and curative. There is need for strengthening of a bio-psychosocial intervention model in the treatment of mental illness.

Mental health care for the elderly in low-income countries: a health systems approach

PubMed Central

PRINCE, MARTIN; LIVINGSTON, GILL; KATONA, CORNELIUS

2007-01-01

Future development of services for older people needs to be tailored to suit the health systems context. Low-income countries lack the economic and human capital to contemplate widespread introduction of specialist services. The most cost-effective way to manage people with dementia will be through supporting, educating and advising family caregivers. The next level of care to be prioritized would be respite care, both in day centres and in residential or nursing homes. An important prerequisite to improving care for older persons is to create a climate that fosters such advances. Better awareness is a necessary precondition for appropriate help-seeking, and lack of awareness is a public health problem for which population level interventions are needed. PMID:17342213

Implications of Medical Tourism.

PubMed

Cesario, Sandra K

2018-06-01

Medical tourism is an emerging industry that facilitates travel to another country for people who seek medical, surgical, or dental care that is unavailable or more affordable than in their home countries. Rapid advances in electronic communication and the ease of international travel have fueled the growth of this industry. More than half of medical travelers are women, especially for services related to cosmetic or reproductive conditions. Medical tourism creates both opportunities and challenges for nurses and other health care providers. Consumers' increased access to the global health care market necessitates the development of a structure that shapes the medical tourism industry and addresses evolving ethical, political, and human rights concerns related to this industry. Copyright © 2018 AWHONN. Published by Elsevier Inc. All rights reserved.

Iran seeking help in regaining prerevolution oil and gas flow

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

Tippee, B.

1996-02-19

This paper reviews the goals of the Iranian oil and gas industry to rebuild their oil and gas production facilities by using foreign investment. It discusses the historical consequences of war in the region to diminish the production and postpone the recovery of natural gas which is currently flared. It describes the major projects Iran hopes to develop through international partnerships and includes field development, pipeline construction, gas reinjection, gas treatment facilities, and new offshore operation. The paper also reviews the US policy on Iran and its attempt to apply sanctions towards this country.

Water resources management. World Bank policy paper; Gestion des ressources en eau

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

NONE

1993-12-31

The management framework presented in this study addresses the demand for water in Asia caused by rapid population growth and economic development. It focuses on three key actions to meet the challenge: evaluate how the region manages water resources; identify guidelines for the Bank`s water resource programs; and develop country-specific strategies and promote joint programs. Reforms built into the framework seek to modernize institutions that affect water sources. The authors suggest ways to improve planning and long-term management, streamline economic and financial policy, and upgrade `real-time` management, operation, and maintenance.

Infertility in public health: the case of Norway

PubMed Central

Sundby, J.

2010-01-01

Infertility is a health issue that demonstrates how unequal access to health care is at a global level. In the poorer segments of the world, and in poor parts of wealthy societies, access is often minimal or non-existent. Public and lay attitudes to modern infertility treatment have been heavily debated alongside development of methods. I have looked at the changes in the public discourse in modern media, legislation, politics, and among professionals. The paper seeks to present and discuss some of these changes as they have evolved in one of the countries that have had one of the more strict laws regulating access to treatment, namely Norway. It is a country that nevertheless offers treatment in the public health system. The paper also tries to connect this discussion to the difficulties faced in every attempt to expand infertility services to the developing world. PMID:25013709

An International Study of Research Misconduct Policies

PubMed Central

Resnik, David B.; Rasmussen, Lisa M.; Kissling, Grace E.

2015-01-01

Research misconduct is an international concern. Misconduct policies can play a crucial role in preventing and policing research misconduct, and many institutions have developed their own policies. While institutional policies play a key role in preventing and policing misconduct, national policies are also important to ensure consistent promulgation and enforcement of ethical standards. The purpose of this study was to obtain more information about research misconduct policies across the globe. We found that twenty-two of the top forty research and development funding countries (55%) had a national misconduct policy. Four countries (18.2%) are in the process of developing a policy, and four (18.2%) have a national research ethics code but no misconduct policy. All twenty-two countries (100%) with national policies included fabrication, falsification, and plagiarism in the definition of misconduct, but beyond that there was considerable diversity. Unethical authorship was mentioned in 54.6% of the misconduct definitions, followed by unethical publication practices (36.4%), conflict of interest mismanagement (36.4%), unethical peer review (31.8%), misconduct related to misconduct investigations (27.3%), poor record keeping (27.3%), other deception (27.3%), serious deviations (22.7%), violating confidentiality (22.7%), and human or animal research violations (22.7%). Having a national policy was positively associated with research and development funding ranking and intensiveness. To promote integrity in international research collaborations, countries should seek to harmonize and clarify misconduct definitions and develop procedures for adjudicating conflicts when harmonization does not occur. PMID:25928177

An international study of research misconduct policies.

PubMed

Resnik, David B; Rasmussen, Lisa M; Kissling, Grace E

2015-01-01

Research misconduct is an international concern. Misconduct policies can play a crucial role in preventing and policing research misconduct, and many institutions have developed their own policies. While institutional policies play a key role in preventing and policing misconduct, national policies are also important to ensure consistent promulgation and enforcement of ethical standards. The purpose of this study was to obtain more information about research misconduct policies across the globe. We found that twenty-two of the top forty research and development funding countries (55%) had a national misconduct policy. Four countries (18.2%) are in the process of developing a policy, and four (18.2%) have a national research ethics code but no misconduct policy. All twenty-two countries (100%) with national policies included fabrication, falsification, and plagiarism in the definition of misconduct, but beyond that there was considerable diversity. Unethical authorship was mentioned in 54.6% of the misconduct definitions, followed by unethical publication practices (36.4%), conflict of interest mismanagement (36.4%), unethical peer review (31.8%), misconduct related to misconduct investigations (27.3%), poor record keeping (27.3%), other deception (27.3%), serious deviations (22.7%), violating confidentiality (22.7%), and human or animal research violations (22.7%). Having a national policy was positively associated with research and development funding ranking and intensiveness. To promote integrity in international research collaborations, countries should seek to harmonize and clarify misconduct definitions and develop procedures for adjudicating conflicts when harmonization does not occur.

Mediterranean studies of cardiovascular disease and hyperglycemia: analytical modeling of population socio-economic transitions (MedCHAMPS)--rationale and methods.

PubMed

Maziak, Wasim; Critchley, Julia; Zaman, Shahaduz; Unwin, Nigel; Capewell, Simon; Bennett, Kathleen; Unal, Belgin; Husseini, Abdullatif; Romdhane, Habiba Ben; Phillimore, Peter

2013-08-01

In response to the escalating epidemic of cardiovascular disease (CVD) in the Mediterranean Region (MR), an international collaboration aiming at understanding the burden of CVD and evaluating cost-effective strategies to combat it was recently established. This paper describes the rationale and methods of the project MedCHAMPS to disseminate this successful experience. The framework of MedCHAMPS is exceptional in combining multiple disciplines (e.g. epidemiology, anthropology, economics), countries [Turkey, Syria, occupied Palestinian territory (oPt), Tunisia, UK, Ireland], research methods (situational and policy analysis, quantitative and qualitative studies, statistical modeling), and involving local stakeholders at all levels to assess trends of CVD/diabetes in the society and attributes of the local health care systems to provide optimal policy recommendations to reduce the burden of CVD/diabetes. MedCHAMPS provides policy makers in the MR and beyond needed guidance about the burden of CVD, and best cost-effective ways to combat it. Our approach of building developed-developing countries collaboration also provides a roadmap for other researchers seeking to build research base into CVD epidemiology and prevention in developing countries.

Country perspective on medical tourism: the Malaysian experience.

PubMed

Abd Manaf, Noor Hazilah; Hussin, Husnayati; Jahn Kassim, Puteri Nemie; Alavi, Rokiah; Dahari, Zainurin

2015-01-01

The study seeks to explore the perception of international patients on Malaysia as a medical tourism destination country, as well as overall patient satisfaction, perceived value and future intention for repeat treatment and services. Self-administered questionnaire was the main method of data collection. The survey covered major private hospitals in medical tourists' states in the country, namely, Penang, Melaka, Selangor and Kuala Lumpur. Convenience sampling was used due to the condition of patients as respondents. Indonesian patients formed the largest majority of international patients in the country. Five dimensions of medical tourism in Malaysia was identified, namely, hospital and staff, country factor, combining tourism and health services, cost saving and insurance and unavailability of treatment. Of these, hospital and staff was found to be the most important factor for the patients. Perception of value, overall satisfaction and intention for future treatment was also found to be high. This indicates that Malaysia is on the right footing in this burgeoning industry. Findings from the study will enable policy-makers to better position Malaysia as a medical tourist destination country. Medical tourism is a recent phenomenon and very little empirical research has been carried out at the patient level. This study is one of the first few studies which seek to explore medical tourism from the perspective of the patients themselves.

Detection of Campylobacter in human faecal samples in Fiji.

PubMed

Devi, Aruna; Wilkinson, Jenny; Mahony, Timothy; Vanniasinkam, Thiru

2014-01-01

Data on campylobacteriosis in developed countries are well documented; in contrast, few studies on campylobacteriosis have been conducted in developing countries. This study was undertaken to test for Campylobacter in human faecal samples sent to the two major pathology laboratories in Fiji. A total of 408 diarrhoeal faecal samples were collected from the two major hospital pathology laboratories in Central Fiji (Suva) and Western Fiji (Lautoka) between December 2012 and February 2013 and from June to July 2013. Samples were analysed for the presence of Campylobacter using polymerase chain reaction (PCR) based methods. Campylobacter was detected in 241/408 (59.1%) of samples tested using PCR. Samples from children aged less than five accounted for 21.6% of positive cases. Campylobacter was detected in 59.1% of diarrhoeal samples collected from the two main laboratories in Fiji. A high proportion of children under five years with Campylobacter has been reported in other countries and could be due to parents being more likely to seek medical attention. Further studies are required to confirm the species of Campylobacter that are predominantly associated with gastroenteritis in Fiji.

Global land use change, economic globalization, and the looming land scarcity.

PubMed

Lambin, Eric F; Meyfroidt, Patrick

2011-03-01

A central challenge for sustainability is how to preserve forest ecosystems and the services that they provide us while enhancing food production. This challenge for developing countries confronts the force of economic globalization, which seeks cropland that is shrinking in availability and triggers deforestation. Four mechanisms-the displacement, rebound, cascade, and remittance effects-that are amplified by economic globalization accelerate land conversion. A few developing countries have managed a land use transition over the recent decades that simultaneously increased their forest cover and agricultural production. These countries have relied on various mixes of agricultural intensification, land use zoning, forest protection, increased reliance on imported food and wood products, the creation of off-farm jobs, foreign capital investments, and remittances. Sound policies and innovations can therefore reconcile forest preservation with food production. Globalization can be harnessed to increase land use efficiency rather than leading to uncontrolled land use expansion. To do so, land systems should be understood and modeled as open systems with large flows of goods, people, and capital that connect local land use with global-scale factors.

Global land use change, economic globalization, and the looming land scarcity

PubMed Central

Lambin, Eric F.; Meyfroidt, Patrick

2011-01-01

A central challenge for sustainability is how to preserve forest ecosystems and the services that they provide us while enhancing food production. This challenge for developing countries confronts the force of economic globalization, which seeks cropland that is shrinking in availability and triggers deforestation. Four mechanisms—the displacement, rebound, cascade, and remittance effects—that are amplified by economic globalization accelerate land conversion. A few developing countries have managed a land use transition over the recent decades that simultaneously increased their forest cover and agricultural production. These countries have relied on various mixes of agricultural intensification, land use zoning, forest protection, increased reliance on imported food and wood products, the creation of off-farm jobs, foreign capital investments, and remittances. Sound policies and innovations can therefore reconcile forest preservation with food production. Globalization can be harnessed to increase land use efficiency rather than leading to uncontrolled land use expansion. To do so, land systems should be understood and modeled as open systems with large flows of goods, people, and capital that connect local land use with global-scale factors. PMID:21321211

Enabling the Billion-Ton Bioeconomy

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

Baumes, Harry; Csonka, Steve; Sayre, Richard

2016-08-08

The United States is rich in non-food ‎biomass that can fuel the development of a thriving ‎bioeconomy where renewable and sustainable resources power cars and planes instead of petroleum. The ‎transportation and aviation industry is actively seeking ways to reduce its carbon footprint by powering planes with solid municipal waste, woody biomass, purpose-grown crops, and ‎algae. Watch this short video to learn how biomass is being used to make our country greener, provide new employment opportunities, and reduce our dependence on foreign oil.

A reassessment of the indicators of primary education quality in developing countries: Emerging evidence from Tanzania

NASA Astrophysics Data System (ADS)

Mosha, Herme Joseph

1988-03-01

This article seeks to identify factors affecting the quality of primary education in five regions of Tanzania by extensively reviewing relevant literature and empirical data. Some of the shortcomings emphasised by the author are: frequent staff turnover, declining financial support for primary education, ineffective curricula, shortage of teachers' guides and textbooks, and unfavourable working conditions for teachers in rural areas. Beyond this, the need for freely available material, efficient school management and regular inspections is stressed by the author.

Suboptimal care and maternal mortality among foreign-born women in Sweden: maternal death audit with application of the 'migration three delays' model.

PubMed

Esscher, Annika; Binder-Finnema, Pauline; Bødker, Birgit; Högberg, Ulf; Mulic-Lutvica, Ajlana; Essén, Birgitta

2014-04-12

Several European countries report differences in risk of maternal mortality between immigrants from low- and middle-income countries and host country women. The present study identified suboptimal factors related to care-seeking, accessibility, and quality of care for maternal deaths that occurred in Sweden from 1988-2010. A subset of maternal death records (n = 75) among foreign-born women from low- and middle-income countries and Swedish-born women were audited using structured implicit review. One case of foreign-born maternal death was matched with two native born Swedish cases of maternal death. An assessment protocol was developed that applied both the 'migration three delays' framework and a modified version of the Confidential Enquiry from the United Kingdom. The main outcomes were major and minor suboptimal factors associated with maternal death in this high-income, low-maternal mortality context. Major and minor suboptimal factors were associated with a majority of maternal deaths and significantly more often to foreign-born women (p = 0.01). The main delays to care-seeking were non-compliance among foreign-born women and communication barriers, such as incongruent language and suboptimal interpreter system or usage. Inadequate care occurred more often among the foreign-born (p = 0.04), whereas delays in consultation/referral and miscommunication between health care providers where equally common between the two groups. Suboptimal care factors, major and minor, were present in more than 2/3 of maternal deaths in this high-income setting. Those related to migration were associated to miscommunication, lack of professional interpreters, and limited knowledge about rare diseases and pregnancy complications. Increased insight into a migration perspective is advocated for maternity clinicians who provide care to foreign-born women.

Canada's implementation of the Paragraph 6 Decision: is it sustainable public policy?

PubMed Central

Cohen-Kohler, Jillian C; Esmail, Laura C; Cosio, Andre Perez

2007-01-01

Background Following the Implementation of Paragraph 6 of the Doha Declaration on TRIPS and Public Health, Canada was among the first countries globally to amend its patent law, which resulted in Canada's Access to Medicines Regime (CAMR). CAMR allows the production and export of generic drugs to developing countries without the requisite manufacturing capacity to undertake a domestic compulsory license. CAMR has been the subject of much criticism lodged at its inability to ensure fast access to urgent medicines for least developing and developing countries in need. Only recently did the Canadian government grant Apotex the compulsory licenses required under CAMR to produce and export antiretroviral therapy to Rwanda's population. Methods The objective of this research is to investigate whether the CAMR can feasibly achieve its humanitarian objectives given the political interests embedded in the crafting of the legislation. We used a political economy framework to analyze the effect of varied institutions, political processes, and economic interests on public policy outcomes. In-depth, semi-structured interviews were conducted with nineteen key stakeholders from government, civil society and industry. Qualitative data analysis was performed using open-coding for themes, analyzing by stakeholder group. Results CAMR is removed from the realities of developing countries and the pharmaceutical market. The legislation needs to include commercial incentives to galvanize the generic drug industry to make use of this legislation. CAMR assumes that developing country governments have the requisite knowledge and human resource capacity to make use of the regime, which is not the case. The legislation does not offer sufficient incentives for countries to turn to Canada when needed drugs may be procured cheaply from countries such as India. In the long term, developing and least developing countries seek sustainable solutions to meet the health needs of their population, including developing their own capacity and local industries. Conclusion CAMR is symbolically meaningful but in practice, limited. The Rwanda case will be noteworthy in terms of the future of the legislation. To meet its intended international health objectives, this legislation needs to be better informed of developing country needs and global pharmaceutical market imperatives. Finally, we contend that serious public policy change cannot strike a balance between all vested interests. Above all, any feasible policy that aims to facilitate compulsory licensing must prioritize public health over trade or economic interests. PMID:18062821

Clinicians' assessment of mobile monitoring: a comparative study in Japan and Spain.

PubMed

Okazaki, Shintaro; Castañeda, José Alberto; Sanz, Silvia

2013-01-01

The gradual but steady shift toward telemedicine during the past decades is a clear response to important health problems that most industrialized countries have been facing. The growing elderly population and changing dietary habits have led to an increase in people with chronic diseases and overall health care expenditures. As more consumers use their mobile device as their preferred information and communication technology (ICT) device, mobile health monitoring has been receiving increasing attention in recent years. This study examines clinicians' perception of factors determining mobile health monitoring acceptance in Japan and Spain. The study proposes a causal model consisting of innovation seeking, new ICT attributes (perceived value, time-place flexibility, and compatibility), and usage intention. In addition, cross-country differences are posited for the hypothesized relationships among the proposed constructs. A questionnaire survey was performed to test our research model and hypotheses. The sample consisted of clinicians from various medical specialties. In total, 471 and 497 usable responses were obtained in Japan and Spain, respectively. In both countries, the collected data fit the model well with all the hypothesized paths among the constructs being supported. Furthermore, the moderating effects of psychic distance were observed in most of the paths. Our study demonstrates the importance of new ICT attributes, namely perceived value, time-place flexibility, and compatibility, in the clinicians' adoption of mobile health monitoring. In particular, our results clearly indicated that perceived medical value and ubiquitous nature of the tool are the two main benefits clinicians are likely to perceive (and appreciate) in both countries. This tendency will be stronger for those with a greater propensity to seek innovation in ICT. In terms of cross-country comparison, the strength of the path from innovation seeking to perceived value was greater in Japan than in Spain. Since the number of clinicians per 10,000 residents is substantially fewer in Japan compared with Spain, clinicians with a greater propensity to seek innovation in ICT may have perceived greater value in using mobile health monitoring to improve remote patient care.

Prevalence and predictors of help-seeking for women exposed to spousal violence in India - a cross-sectional study.

PubMed

Leonardsson, Malin; San Sebastian, Miguel

2017-11-03

Spousal violence against women is prevalent in India (29%). Studies from various countries have shown that few women exposed to intimate partner violence or spousal violence seek help, especially in low-income countries. The objective of this study was to estimate the prevalence and predictors of help-seeking among women in India who have experienced various types of spousal violence. Cross-sectional data on 19,125 married, separated, divorced or widowed women in India who had experienced physical or sexual violence at the hands of their husbands were obtained from the India National Family Health Survey III 2005-2006. Bivariate and multivariate logistic regression analyses were carried out. Less than one fourth (23.7%) of married, separated, divorced or widowed women in India who had experienced some form of physical or sexual spousal violence had sought help, but only 1% had sought help from formal institutions. Help-seeking was most prevalent in women who had been exposed to a combination of physical, sexual and emotional abuse (48.8%) and the least prevalent in women who had experienced sexual violence only (1.5%). Experience of severe violence and violence resulting in injury were the strongest predictors of help-seeking. Having education, being Christian or an acknowledged adherent of another minority religion - mainly Buddhism and Sikhism (Islam not included), getting married after the age of 21 and living in the South region were also associated with seeking help. Women in the North and Northeast regions were less likely to seek help, as were women with children and women who thought that a husband could be justified in hitting his wife. Very few Indian women who experience spousal violence seek help. The characteristics of the violence are the strongest predictors of help-seeking, but sociodemographic factors are also influential. We recommend efforts to ensure educational attainment for girls, prevention of child marriages, and that police officers and health care staff should be educated about intimate partner violence and in how to respond to women who seek help. It is important to tackle norms and attitudes surrounding violence against women, as well as attitudes to women who disclose violence.

Around the world, adolescence is a time of heightened sensation seeking and immature self-regulation.

PubMed

Steinberg, Laurence; Icenogle, Grace; Shulman, Elizabeth P; Breiner, Kaitlyn; Chein, Jason; Bacchini, Dario; Chang, Lei; Chaudhary, Nandita; Giunta, Laura Di; Dodge, Kenneth A; Fanti, Kostas A; Lansford, Jennifer E; Malone, Patrick S; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T; Sorbring, Emma; Tapanya, Sombat; Tirado, Liliana Maria Uribe; Alampay, Liane Peña; Al-Hassan, Suha M; Takash, Hanan M S

2018-03-01

The dual systems model of adolescent risk-taking portrays the period as one characterized by a combination of heightened sensation seeking and still-maturing self-regulation, but most tests of this model have been conducted in the United States or Western Europe. In the present study, these propositions are tested in an international sample of more than 5000 individuals between ages 10 and 30 years from 11 countries in Africa, Asia, Europe and the Americas, using a multi-method test battery that includes both self-report and performance-based measures of both constructs. Consistent with the dual systems model, sensation seeking increased between preadolescence and late adolescence, peaked at age 19, and declined thereafter, whereas self-regulation increased steadily from preadolescence into young adulthood, reaching a plateau between ages 23 and 26. Although there were some variations in the magnitude of the observed age trends, the developmental patterns were largely similar across countries. © 2017 John Wiley & Sons Ltd.

Depression literacy and health-seeking attitudes in the Western Pacific region: a mixed-methods study.

PubMed

Ho, Grace W K; Bressington, D; Leung, S F; Lam, K K C; Leung, A Y M; Molassiotis, A; Ligot, J; Ranoco, C; Sophal, C; Valimaki, M

2018-06-02

Depression literacy refers to the ability to recognize depression and make informed decisions about its treatment. To date, relatively little research has been done to examine depression literacy in the Western Pacific region. Given the pervasiveness of depression and the need to enhance mental health care in this region, it is important to gain a better understanding of depression literacy and health-seeking behaviors in this part of the world. This mixed-methods study utilized a convergent parallel design to examine depression literacy and the associated health-seeking attitudes among urban adults from three countries-Cambodia, Philippines, and Fiji. A total of 455 adults completed a quantitative survey on depression knowledge, attitudes, and professional help seeking. Separately, 56 interviewees from 6 focus groups provided qualitative data on their impression and knowledge of depression and mental illness within the context of their local communities. Overall, results showed that depression knowledge was comparatively lower in this region. Controlling for differences across countries, higher knowledge was significantly associated with more positive attitudes towards mental illness (B = - 0.28, p = 0.025) and professional help seeking (B = 0.20, p < 0.001). Financial stability, such as employment, was also a salient factor for help seeking. This study was the first to provide a baseline understanding on depression literacy and highlights the need to increase public knowledge on depression in the Western Pacific. Culturally congruent recommendations on enhancing depression literacy in this region, such as anti-stigma campaigns, use of financial incentives, and family-based approach in health education, are discussed.

How to address the ethics of reproductive travel to developing countries: a comparison of national self-sufficiency and regulated market approaches.

PubMed

Crozier, G K D; Martin, Dominique

2012-04-01

One of the areas of concern raised by cross-border reproductive travel regards the treatment of women who are solicited to provide their ova or surrogacy services to foreign consumers. This is particularly troublesome in the context of developing countries where endemic poverty and low standards for both medical care and informed consent may place these women at risk of exploitation and harm. We explore two contrasting proposals for policy development regarding the industry, both of which seek to promote ethical outcomes and social justice: While one proposal advocates efforts to minimize cross-border demand for female reproductive resources through the pursuit of national self-sufficiency, the other defends cross-border trade as a means for meeting the needs of vulnerable groups. Despite the conflicting objectives of the proposed strategies, the paper identifies common values and points of agreement between the two, including the importance of regulations to safeguard those providing ova or surrogacy services. © 2012 Blackwell Publishing Ltd.

What systems are essential to achieving the sustainable development goals and what will it take to marshal them?

PubMed

Thomas, James C; Silvestre, Eva; Salentine, Shannon; Reynolds, Heidi; Smith, Jason

2016-12-01

The sustainable development goal (SDG) for health is linked to 67 indicators, eight times more than their predecessor, the Millenium Development Goals. In many low- and middle-income countries (LMICs), the information infrastructure is not yet able to collect and use the data needed for the indicators. As they seek to be responsive to the SDG agenda, LMICs must not lose sight of their local data needs; they should be cautious about embracing untested electronic technologies for data collection, analysis, and use; carefully balance the care provision and data collection responsibilities of care providers; and use evidence of what works in strengthening their health information systems (HIS). While attending to these concerns, countries can look for instances in which SDG indicators are in sync with their own HIS goals. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A short review on the effects of aerosols on visibility impairment

NASA Astrophysics Data System (ADS)

Emetere Moses, E.; Akinyemi, ML

2017-05-01

Ozone in the lower planetary boundary layer of the earth atmosphere is dangerous to people and vegetation, since it oxidizes natural tissue. The diminished in visibility is because of dispersing of sun based radiation by high convergences of anthropogenic aerosols. Visibility impairment is most prominent at high relative mugginess when the aerosols swell by the take-up of water to expand the cross sectional area for dispersing; this is the wonder known as haze. Haze has become a major air pollution challenge the aviation industry has to cope with in recent time. In this review, two major problems were spotted to be responsible for air disaster in any region of the world. While some developed countries had almost resolved the challenge of visibility impairment by seeking relevant solutions, most developing countries do not have a recovery plan. Therefore, the resolution of this major challenge may be the leverage for most developing nations to draw out a recovery plan.

Global Conceptualization of the Professional Learning Community Process: Transitioning from Country Perspectives to International Commonalities

ERIC Educational Resources Information Center

Huffman, Jane B.; Olivier, Dianne F.; Wang, Ting; Chen, Peiying; Hairon, Salleh; Pang, Nicholas

2016-01-01

The authors seek to find common PLC structures and actions among global educational systems to enhance understanding and practice. Six international researchers formed the Global Professional Learning Community Network (GloPLCNet), conducted literature reviews of each country's involvement with PLC actions, and noted similarities and common…

The Experiences of Host Country Nationals in International Schools: A Case-Study from Malaysia

ERIC Educational Resources Information Center

Bailey, Lucy

2015-01-01

Although there has been considerable research into expatriate children attending international schools, there has been little investigation into children who attend international schools within their own nation. Seeking to redress this imbalance, this article analyses interview data from a small-scale study of host country nationals attending an…

The Global State of Higher Education and the Rise of Private Finance. Issue Brief

ERIC Educational Resources Information Center

Hahn, Ryan

2007-01-01

In the past two decades, higher education around the globe has undergone a remarkable transformation. Technological innovation coupled with globalization has drastically altered the structure and finance of educational systems of all countries seeking to benefit from the global economy. In the countries of the Organisation for Economic…

Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: results from an international multi-center study exploring DSM-IV and DSM-5 criteria.

PubMed

van de Glind, Geurt; Konstenius, Maija; Koeter, Maarten W J; van Emmerik-van Oortmerssen, Katelijne; Carpentier, Pieter-Jan; Kaye, Sharlene; Degenhardt, Louisa; Skutle, Arvid; Franck, Johan; Bu, Eli-Torild; Moggi, Franz; Dom, Geert; Verspreet, Sofie; Demetrovics, Zsolt; Kapitány-Fövény, Máté; Fatséas, Melina; Auriacombe, Marc; Schillinger, Arild; Møller, Merete; Johnson, Brian; Faraone, Stephen V; Ramos-Quiroga, J Antoni; Casas, Miguel; Allsop, Steve; Carruthers, Susan; Schoevers, Robert A; Wallhed, Sara; Barta, Csaba; Alleman, Peter; Levin, Frances R; van den Brink, Wim

2014-01-01

Available studies vary in their estimated prevalence of attention deficit/hyperactivity disorder (ADHD) in substance use disorder (SUD) patients, ranging from 2 to 83%. A better understanding of the possible reasons for this variability and the effect of the change from DSM-IV to DSM-5 is needed. A two stage international multi-center, cross-sectional study in 10 countries, among patients form inpatient and outpatient addiction treatment centers for alcohol and/or drug use disorder patients. A total of 3558 treatment seeking SUD patients were screened for adult ADHD. A subsample of 1276 subjects, both screen positive and screen negative patients, participated in a structured diagnostic interview. Prevalence of DSM-IV and DSM-5 adult ADHD varied for DSM-IV from 5.4% (CI 95%: 2.4-8.3) for Hungary to 31.3% (CI 95%:25.2-37.5) for Norway and for DSM-5 from 7.6% (CI 95%: 4.1-11.1) for Hungary to 32.6% (CI 95%: 26.4-38.8) for Norway. Using the same assessment procedures in all countries and centers resulted in substantial reduction of the variability in the prevalence of adult ADHD reported in previous studies among SUD patients (2-83%→5.4-31.3%). The remaining variability was partly explained by primary substance of abuse and by country (Nordic versus non-Nordic countries). Prevalence estimates for DSM-5 were slightly higher than for DSM-IV. Given the generally high prevalence of adult ADHD, all treatment seeking SUD patients should be screened and, after a confirmed diagnosis, treated for ADHD since the literature indicates poor prognoses of SUD in treatment seeking SUD patients with ADHD. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: Results from an international multi-center study exploring DSM-IV and DSM-5 criteria☆☆

PubMed Central

van de Glind, Geurt; Konstenius, Maija; Koeter, Maarten W.J.; van Emmerik-van Oortmerssen, Katelijne; Carpentier, Pieter-Jan; Kaye, Sharlene; Degenhardt, Louisa; Skutle, Arvid; Franck, Johan; Bu, Eli-Torild; Moggi, Franz; Dom, Geert; Verspreet, Sofie; Demetrovics, Zsolt; Kapitány-Fövény, Máté; Fatséas, Melina; Auriacombe, Marc; Schillinger, Arild; Møller, Merete; Johnson, Brian; Faraone, Stephen V.; Ramos-Quiroga, J. Antoni; Casas, Miguel; Allsop, Steve; Carruthers, Susan; Schoevers, Robert A.; Wallhed, Sara; Barta, Csaba; Alleman, Peter; Levin, Frances R.; van den Brink, Wim

2014-01-01

Background Available studies vary in their estimated prevalence of attention deficit/hyperactivity disorder (ADHD) in substance use disorder (SUD) patients, ranging from 2 to 83%. A better understanding of the possible reasons for this variability and the effect of the change from DSM-IV to DSM-5 is needed. Methods A two stage international multi-center, cross-sectional study in 10 countries, among patients form inpatient and outpatient addiction treatment centers for alcohol and/or drug use disorder patients. A total of 3558 treatment seeking SUD patients were screened for adult ADHD. A subsample of 1276 subjects, both screen positive and screen negative patients, participated in a structured diagnostic interview. Results Prevalence of DSM-IV and DSM-5 adult ADHD varied for DSM-IV from 5.4% (CI 95%: 2.4–8.3) for Hungary to 31.3% (CI 95%:25.2–37.5) for Norway and for DSM-5 from 7.6% (CI 95%: 4.1–11.1) for Hungary to 32.6% (CI 95%: 26.4–38.8) for Norway. Using the same assessment procedures in all countries and centers resulted in substantial reduction of the variability in the prevalence of adult ADHD reported in previous studies among SUD patients (2–83%→ 5.4–31.3%). The remaining variability was partly explained by primary substance of abuse and by country (Nordic versus non-Nordic countries). Prevalence estimates for DSM-5 were slightly higher than for DSM-IV. Conclusions Given the generally high prevalence of adult ADHD, all treatment seeking SUD patients should be screened and, after a confirmed diagnosis, treated for ADHD since the literature indicates poor prognoses of SUD in treatment seeking SUD patients with ADHD. PMID:24156882

Latin American Network of students in Atmospheric Sciences and Meteorology

NASA Astrophysics Data System (ADS)

Cuellar-Ramirez, P.

2017-12-01

The Latin American Network of Students in Atmospheric Sciences and Meteorology (RedLAtM) is a civil nonprofit organization, organized by students from Mexico and some Latin- American countries. As a growing organization, providing human resources in the field of meteorology at regional level, the RedLAtM seeks to be a Latin American organization who helps the development of education and research in Atmospheric Sciences and Meteorology in order to engage and promote the integration of young people towards a common and imminent future: Facing the still unstudied various weather and climate events occurring in Latin America. The RedLAtM emerges from the analysis and observation/realization of a limited connection between Latin American countries around research in Atmospheric Sciences and Meteorology. The importance of its creation is based in cooperation, linking, research and development in Latin America and Mexico, in other words, to join efforts and stablish a regional scientific integration who leads to technological progress in the area of Atmospheric Sciences and Meteorology. As ultimate goal the RedLAtM pursuit to develop climatic and meteorological services for those countries unable to have their own programs, as well as projects linked with the governments of Latin American countries and private companies for the improvement of prevention strategies, research and decision making. All this conducing to enhance the quality of life of its inhabitants facing problems such as poverty and inequality.

Help-seeking, stigma and attitudes of people with and without a suicidal past. A comparison between a low and a high suicide rate country.

PubMed

Reynders, Alexandre; Kerkhof, Ad J F M; Molenberghs, Geert; Van Audenhove, Chantal

2015-06-01

A significant proportion of suicidal persons do not seek help for their psychological problems. Psychological help-seeking is assumed to be a protective factor for suicide. However, different studies showed that negative attitudes and stigma related to help-seeking are major barriers to psychological help-seeking. These attitudes and stigma are not merely individual characteristics but they are also developed by and within society. The aim of this study is twofold. First, we investigate if persons with a suicidal past differ from people without a suicidal past with respect to help-seeking intentions, attitudes toward help-seeking, stigma and attitudes toward suicide. The second aim is to investigate if these attitudinal factors differ between people living in two regions with similar socio-economic characteristics but deviating suicide rates. We defined high (Flemish Community of Belgium) and low (The Netherlands) suicide regions and drew a representative sample of the general Flemish and Dutch population between 18 and 65 years. Data were gathered by means of a postal questionnaire. Descriptive statistics are presented to compare people with and without suicidal past. Multiple logistic regressions were used to compare Flemish and Dutch participants with a suicidal past. Compared to people without a suicidal past, people with a suicidal past are less likely to seek professional and informal help, perceive more stigma, experience more self-stigma (only men) and shame (only women) when seeking help and have more accepting attitudes toward suicide. In comparison to their Dutch counterparts, Flemish people with a suicidal past have less often positive attitudes toward help-seeking, less intentions to seek professional and informal (only women) help and have less often received help for psychological problems (only men). The main limitations are: the relatively low response rate; suicidal ideation was measured by retrospective self-report; and the research sample includes only participants between 18 and 65 years old. Having a suicidal past is associated with attitudinal and stigmatizing barriers toward help seeking and accepting attitudes toward suicide. Prevention strategies should therefore target people with a suicidal history with special attention for attitudes, self-stigma and feelings of shame related to help-seeking. Copyright © 2015 Elsevier B.V. All rights reserved.

Unrecognized sexually transmitted infections in rural South African women: a hidden epidemic.

PubMed Central

Wilkinson, D.; Abdool Karim, S. S.; Harrison, A.; Lurie, M.; Colvin, M.; Connolly, C.; Sturm, A. W.

1999-01-01

Sexually transmitted infections (STIs) are of major public health concern in developing countries, not least because they facilitate transmission of human immunodeficiency virus (HIV). The present article presents estimates of the prevalence, on any given day, of STIs among women in rural South Africa and the proportion who are asymptomatic, symptomatic but not seeking care, and symptomatic and seeking care. The following data sources from Hlabisa district were used: clinical surveillance for STI syndromes treated in health facilities, microbiological studies among women attending antenatal and family planning clinics, and a community survey. Population census provided denominator data. Adequacy of drug treatment was determined through quality of care surveys. Of 55,974 women aged 15-49 years, a total of 13,943 (24.9%) were infected on any given day with at least one of Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, or Treponema pallidum. Of the women investigated, 6697 (48%) were asymptomatic, 6994 (50%) were symptomatic but not seeking care, 238 (1.7%) were symptomatic and would seek care, and 14 (0.3%) were seeking care on that day. Only 9 of the 14 women (65%) were adequately treated. STIs remained untreated because either women were asymptomatic or the symptoms were not recognized and acted upon. Improved case management alone is therefore unlikely to have a major public health impact. Improving partner treatment and women's awareness of symptoms is essential, while the potential of mass STI treatment needs to be explored. PMID:10063657

Regulatory challenges for GM crops in developing economies: the African experience.

PubMed

Nang'ayo, Francis; Simiyu-Wafukho, Stella; Oikeh, Sylvester O

2014-12-01

Globally, transgenic or genetically modified (GM) crops are considered regulated products that are subject to regulatory oversight during trans-boundary movement, testing and environmental release. In Africa, regulations for transgenic crops are based on the outcomes of the historic Earth Summit Conference held in Rio, Brazil two decades ago, namely, the adoption of the Convention on Biological Diversity (CBD) and the subsequent adoption of the Cartagena Protocol on Biosafety. To exploit the potential benefits of transgenic crops while safeguarding the potential risks on human health and environment, most African countries have signed and ratified the CBD and the Cartagena Protocol on Biosafety. Consequently, these countries are required to take appropriate legal, administrative and other measures to ensure that the handling and utilization of living modified organisms are undertaken in a manner that reduces the risks to humans and the environment. These countries are also expected to provide regulatory oversight on transgenic crops through functional national biosafety frameworks (NBFs). While in principle this approach is ideal, NBFs in most African countries are steeped in a host of policy, legal and operational challenges that appear to be at cross-purposes with the noble efforts of seeking to access, test and deliver promising GM crops for use by resource-limited farmers in Africa. In this paper we discuss the regulatory challenges faced during the development and commercialization of GM crops based on experiences from countries in Sub-Saharan Africa.

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

Students' perceptions and doubts about menstruation in developing countries: a case study from India.

PubMed

Chothe, Vikas; Khubchandani, Jagdish; Seabert, Denise; Asalkar, Mahesh; Rakshe, Sarika; Firke, Arti; Midha, Inuka; Simmons, Robert

2014-05-01

Menstrual education is a vital aspect of adolescent health education. Culture, awareness, and socioeconomic status often exert profound influence on menstrual practices. However, health education programs for young women in developing countries do not often address menstrual hygiene, practices, and disorders. Developing culturally sensitive menstrual health education and hygiene programs for adolescent females has been recommended by professional health organizations like the World Health Organization and UNICEF. These programs cannot be developed without understanding existing myths and perceptions about menstruation in adolescent females of developing countries. Thus, the purpose of this qualitative study from India was to document existing misconceptions regarding menstruation and perceptions about menarche and various menstrual restrictions that have been understudied. Out of the 612 students invited to participate by asking questions, 381 girls participated by asking specific questions about menstruation (response rate = 62%). The respondents consisted of 84 girls from sixth grade, 117 from seventh grade, and 180 from eighth grade. The questions asked were arranged into the following subthemes: anatomy and physiology, menstrual symptoms, menstrual myths and taboos, health and beauty, menstrual abnormalities, seeking medical advice and home remedies; sanitary pads usage and disposal; diet and lifestyle; and sex education. Results of our study indicate that students had substantial doubts about menstruation and were influenced by societal myths and taboos in relation to menstrual practices. Parents, adolescent care providers, and policy makers in developing countries should advocate for comprehensive sexuality education and resources (e.g., low-cost sanitary pads and school facilities) to promote menstrual health and hygiene promotion.

Distributed Generation to Support Development-Focused Climate Action

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

Cox, Sadie; Gagnon, Pieter; Stout, Sherry

2016-09-01

This paper explores the role of distributed generation, with a high renewable energy contribution, in supporting low emission climate-resilient development. The paper presents potential impacts on development (via energy access), greenhouse gas emission mitigation, and climate resilience directly associated with distributed generation, as well as specific actions that may enhance or increase the likelihood of climate and development benefits. This paper also seeks to provide practical and timely insights to support distributed generation policymaking and planning within the context of common climate and development goals as the distributed generation landscape rapidly evolves globally. Country-specific distributed generation policy and program examples,more » as well as analytical tools that can inform efforts internationally, are also highlighted throughout the paper.« less

Developing nanotechnology in Latin America

PubMed Central

Shapira, Philip

2008-01-01

This article investigates the development of nanotechnology in Latin America with a particular focus on Argentina, Brazil, Chile, and Uruguay. Based on data for nanotechnology research publications and patents and suggesting a framework for analyzing the development of R&D networks, we identify three potential strategies of nanotechnology research collaboration. Then, we seek to identify the balance of emphasis upon each of the three strategies by mapping the current research profile of those four countries. In general, we find that they are implementing policies and programs to develop nanotechnologies but differ in their collaboration strategies, institutional involvement, and level of development. On the other hand, we find that they coincide in having a modest industry participation in research and a low level of commercialization of nanotechnologies. PMID:21170134

Psychiatric disorders among adolescents from Lebanon: prevalence, correlates, and treatment gap.

PubMed

Maalouf, Fadi T; Ghandour, Lilian A; Halabi, Fadi; Zeinoun, Pia; Shehab, Al Amira Safa; Tavitian, Lucy

2016-08-01

Adolescence is a critical age for the development of psychiatric disorders. Although Lebanon, a low-to-middle income country, has suffered from decades of war and political instability, the burden of psychiatric disorders among adolescents in Lebanon remains unclear. This study aims to estimate the prevalence of psychiatric disorders among adolescents in the Lebanese capital, Beirut, and to study the correlates and treatment seeking behavior associated with these disorders. Through a multistage cluster sampling design, 510 adolescents, aged 11-17 years were recruited from a household sample in Beirut in 2012. Parents and adolescents completed a battery of self-reported questionnaires and interviews including the Development and Well-being Assessment (DAWBA), the Peer-Relations Questionnaire (PRQ), and a demographic/clinical information questionnaire. Logistic regression models were used to study the correlates of psychiatric disorders. The 30-day prevalence of psychiatric disorders was 26.1 %, with anxiety disorders (13.1 %) and ADHD (10.2 %) being the most prevalent disorders. Only 6 % of those with disorders reported seeking professional help. Parental marital status, not attending school, having a chronic medical condition, having a family history of psychiatric disorders, as well as propensity to bullying and to being victimized by peers emerged as correlates of having psychiatric disorders. A clear treatment gap is evident with a high 30-day prevalence of psychiatric disorders among adolescents in Beirut coupled with a very low percentage seeking treatment. Scaling up mental health services and addressing potential barriers to seeking care would be important to close this gap.

Determinants of women's satisfaction with maternal health care: a review of literature from developing countries.

PubMed

Srivastava, Aradhana; Avan, Bilal I; Rajbangshi, Preety; Bhattacharyya, Sanghita

2015-04-18

Developing countries account for 99 percent of maternal deaths annually. While increasing service availability and maintaining acceptable quality standards, it is important to assess maternal satisfaction with care in order to make it more responsive and culturally acceptable, ultimately leading to enhanced utilization and improved outcomes. At a time when global efforts to reduce maternal mortality have been stepped up, maternal satisfaction and its determinants also need to be addressed by developing country governments. This review seeks to identify determinants of women's satisfaction with maternity care in developing countries. The review followed the methodology of systematic reviews. Public health and social science databases were searched. English articles covering antenatal, intrapartum or postpartum care, for either home or institutional deliveries, reporting maternal satisfaction from developing countries (World Bank list) were included, with no year limit. Out of 154 shortlisted abstracts, 54 were included and 100 excluded. Studies were extracted onto structured formats and analyzed using the narrative synthesis approach. Determinants of maternal satisfaction covered all dimensions of care across structure, process and outcome. Structural elements included good physical environment, cleanliness, and availability of adequate human resources, medicines and supplies. Process determinants included interpersonal behavior, privacy, promptness, cognitive care, perceived provider competency and emotional support. Outcome related determinants were health status of the mother and newborn. Access, cost, socio-economic status and reproductive history also influenced perceived maternal satisfaction. Process of care dominated the determinants of maternal satisfaction in developing countries. Interpersonal behavior was the most widely reported determinant, with the largest body of evidence generated around provider behavior in terms of courtesy and non-abuse. Other aspects of interpersonal behavior included therapeutic communication, staff confidence and competence and encouragement to laboring women. Quality improvement efforts in developing countries could focus on strengthening the process of care. Special attention is needed to improve interpersonal behavior, as evidence from the review points to the importance women attach to being treated respectfully, irrespective of socio-cultural or economic context. Further research on maternal satisfaction is required on home deliveries and relative strength of various determinants in influencing maternal satisfaction.

Health Care Coverage Decision Making in Low- and Middle-Income Countries: Experiences from 25 Coverage Schemes.

PubMed

Gutierrez, Hialy; Shewade, Ashwini; Dai, Minghan; Mendoza-Arana, Pedro; Gómez-Dantés, Octavio; Jain, Nishant; Khonelidze, Irma; Nabyonga-Orem, Juliet; Saleh, Karima; Teerawattananon, Yot; Nishtar, Sania; Hornberger, John

2015-08-01

Lessons learned by countries that have successfully implemented coverage schemes for health services may be valuable for other countries, especially low- and middle-income countries (LMICs), which likewise are seeking to provide/expand coverage. The research team surveyed experts in population health management from LMICs for information on characteristics of health care coverage schemes and factors that influenced decision-making processes. The level of coverage provided by the different schemes varied. Nearly all the health care coverage schemes involved various representatives and stakeholders in their decision-making processes. Maternal and child health, cardiovascular diseases, cancer, and HIV were among the highest priorities guiding coverage development decisions. Evidence used to inform coverage decisions included medical literature, regional and global epidemiology, and coverage policies of other coverage schemes. Funding was the most commonly reported reason for restricting coverage. This exploratory study provides an overview of health care coverage schemes from participating LMICs and contributes to the scarce evidence base on coverage decision making. Sharing knowledge and experiences among LMICs can support efforts to establish systems for accessible, affordable, and equitable health care.

[Recommendations for the management of pancreatic cancer type adenocarcinoma: A consensus statement reached during the 2015 Latin American Symposium on Gastroenterological Oncology].

PubMed

Caglevic, Christian; Gallardo, Jorge; de la Torre, Marcela; Mahave, Mauricio; Müller, Bettina; Solé, Sebastián; Moscoso, Yuri; De La Fuente, Hernán; Roa, Juan Carlos; Hoefler, Sebastián; Butte, Jean M; González M, Pablo; O'Connor, Juan Manuel; Torres, Javiera; Pérez Encalada, Verónica; Alarcón Cano, Daniel; Ubillos, Luis; Rolfo, Christian; Lingua, Alejo; Díaz Romero, Consuelo; Padilla Rosciano, Alejandro; Cuartero, Viviana; Calderillo Ruiz, Germán; Schwartsmann, Gilberto; Kon Jara, Xavier; Andrade G, Andrés; Mas López, Luis; Barajas, Olga; Carballido, Marcela; Lembach, Hanns; Morillas G, Lena; Roca, Enrique; Lobatón, José; Montenegro B, Paola; Yepes, Andrés; Marsiglia, Hugo

2016-10-01

Pancreatic cancer is a malignancy of great impact in developed countries and is having an increasing impact in Latin America. Incidence and mortality rates are similar for this cancer. This is an important reason to offer to the patients the best treatments available. During the Latin American Symposium of Gastroenterology Oncology (SLAGO) held in Viña del Mar, Chile, in April 2015, a multidisciplinary group of specialists in the field met to discuss about this disease. The main conclusions of this meeting, where practitioners from most of Latin American countries participated, are listed in this consensus that seek to serve as a guide for better decision making for patients with pancreatic cancer in Latin America.

International trade in services: a growing trend among highly skilled migrants with special reference to Asia.

PubMed

Garnier, P

1996-01-01

"An essential component of trade in services is cross-border movements of service providers.... On the one hand, there are international movements of skilled transients who emigrate for individual reasons in a long term perspective. On the other hand, there are skilled temporary migrants who perform services abroad without the intention or right to settle or seek employment in the host country. This study aims to clarify these differences using the example provided by the Asian Pacific region. Moreover, this study shows that the dynamics of skilled international migration is largely determined by the circulatory movement of skills of international service providers and has emerged as an essential component of economic development strategy of the countries in the region." excerpt

Restoring the Unwritten Alliance in Brazil -- United States Relations

DTIC Science & Technology

2012-03-23

improve U.S. relations with Brazil will cause its leaders to seek more advantageous relationships elsewhere--to the detriment of the United States...substantially improve U.S. relations with Brazil will cause its leaders to seek more advantageous relationships elsewhere--to the detriment of the...security improvements throughout the country. Additionally, a new oil field has been discovered off the coast of Rio de Janeiro. This discovery has drawn

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

NASA Astrophysics Data System (ADS)

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

2010-04-01

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

Investigating the Primary School Teachers' Perspectives on the Use of Education Platforms in Teaching

ERIC Educational Resources Information Center

Uredi, Lütfi; Akbasli, Sait; Ulum, Hakan

2016-01-01

Technology plays an important role in educational activities in Turkey. This is largely because of the Faith Project, which was recently introduced into the country. The Fatih Project is a project of Turkish government which seeks to integrate computer technology into the country's public education system. Education Informatics Network is one of…

Differences in Agency? How Adolescents from 18 Countries Perceive and Cope with Their Futures

ERIC Educational Resources Information Center

Seiffge-Krenke, Inge; Persike, Malte; Chau, Cecilia; Hendry, Leo B.; Kloepp, Marion; Terzini-Hollar, Michelle; Tam, Vicky; Naranjo, Carmen Rodriguez; Herrera, Dora; Menna, Palma; Rohail, Iffat; Veisson, Marika; Hoareau, Elsa; Luwe, Merja; Loncaric, Darko; Han, Hyeyoun; Regusch, Ludmilla

2012-01-01

This study investigated how N = 5,126 adolescents (mean age of 15 years) from 18 countries perceive and cope with future- and school-related stress. The adolescents completed the Problem Questionnaire (PQ), which assesses stress, and the Coping Across Situations Questionnaire (CASQ), which assesses three coping styles (reflection/support-seeking,…

Inclusive Education in Progress: Policy Evolution in Four European Countries

ERIC Educational Resources Information Center

Smyth, Fiona; Shevlin, Michael; Buchner, Tobias; Biewer, Gottfried; Flynn, Paula; Latimier, Camille; Šiška, Jan; Toboso-Martín, Mario; Rodríguez Díaz, Susana; Ferreira, Miguel A. V.

2014-01-01

This paper seeks to compare the evolution of inclusive education policy in the four countries of an EU-funded research project (QualiTYDES) operating under the shared policy environment of the UN, EU and European Commission. A shared policy cannot of course be assumed to result in common legislative or provisional outcomes at national level. The…

Governance, Management and Accountability: The Experience of the School System in the English-Speaking Caribbean Countries

ERIC Educational Resources Information Center

Hutton, Disraeli M.

2015-01-01

This paper seeks to explore the implementation of three of the critical elements required to improve performance in the education system: governance, accountability and management. The paper examines the education reform processes conducted by five Caribbean countries: Jamaica, Cayman Islands, Guyana, Belize, Trinidad and Tobago, along with those…

Family Inequality, School Inequalities, and Mathematics Achievement in 65 Countries: Microeconomic Mechanisms of Rent Seeking and Diminishing Marginal Returns

ERIC Educational Resources Information Center

Chiu, Ming Ming

2015-01-01

Background/Context: While many studies show that greater economic inequality widens the achievement gap between rich and poor students, recent studies indicate that countries with greater economic inequality have lower overall student achievement. Purpose/Objective/Research Question/Focus of Study: This study explores whether family inequalities…

A Cross-Comparative Survey of Information Seeking and Scanning About Drug-Related Sources and Topics Among U.S. and Israeli College Students.

PubMed

Cheng, Ying; Ahn, Jisoo; Lewis, Nehama; Martinez, Lourdes S

2017-08-01

There is an increasing amount of drug-related information that is easily accessible from media and interpersonal sources. Recent research shows significant positive associations between information acquisition and nonmedical drug use intentions among college students. This study examines information about amphetamines and marijuana that was actively searched ("seeking") as well as information that was encountered during routine media use ("scanning"). Data are drawn from a cross-national comparative survey of college students in the United States (N = 734) and in Israel (N = 800). U.S. participants reported seeking and scanning information about marijuana across a broader range of sources than Israeli participants. Among U.S. and Israeli participants, the most frequently searched marijuana-related topics included the benefits of marijuana, negative effects of marijuana use, and political reasons why marijuana should be legal. Participants from both countries reported the benefits of amphetamines, and the negative effects of amphetamine use as the most frequently searched topics about amphetamines. Participants in both countries identified the internet and friends as the most popular sources of drug-related information and noted that physicians, friends, and the internet were the most trusted sources. Implications for research on information seeking and health communication are discussed.

Unaccompanied Asylum-Seeking Refugee Children’s Forced Repatriation: Social Workers’ and Police Officers’ Health and Job Characteristics

PubMed Central

Sundqvist, Johanna; Hansson, Jonas; Ghazinour, Mehdi; Ögren, Kenneth; Padyab, Mojgan

2015-01-01

During the past ten years the number of unaccompanied asylum-seeking refugee children has dramatically increased in Sweden. Some of them are permitted to stay in the receiving country, but some are forced back to their country of origin. Social workers and police officers are involved in these forced repatriations, and such complex situations may cause stressful working conditions. This study aimed to bridge the gap in knowledge of the relationship between general mental health and working with unaccompanied asylum-seeking refugee children who are due for forced repatriation. In addition, the role of psychosocial job characteristics in such relationships was investigated. A questionnaire including sociodemographic characteristics, the Swedish Demand-Control-Support Questionnaire, and the 12-item General Mental Health Questionnaire were distributed nationally. Univariate and multivariable regression models were used. Poorer mental health was associated with working with unaccompanied asylum-seeking refugee children among social workers but not among police officers. Psychological job demand was a significant predictor for general mental health among social workers, while psychological job demand, decision latitude, and marital status were predictors among police officers. Findings are discussed with special regard to the context of social work and police professions in Sweden. PMID:26153185

Professional role identity in shaping community nurses' reactions to nursing policy.

PubMed

Elliott, Lawrie; Kennedy, Catriona; Raeside, Robert

2015-05-01

To establish the extent to which professional role identity shapes community nurses' reactions before the implementation of a policy that sought to introduce a generic role. Many countries seek to alter community nurse roles to address changes in population health and health workforce. We know little about the influences that might shape nurses' reaction to these policies before their implementation and our theoretical understanding is poorly developed at this point in the policy-making cycle. Self completed cross-sectional survey of 703 community nurses before the introduction of a generic Community Health Nurse role in Scotland. The minority (33%) supported the new role. The professional role identity of those who were supportive differed significantly from those who did not support the policy or were uncertain of it. It is possible that the new policy acted to increase the value of the professional role identity of those who were supportive and conversely devalued the professional role identity of those who were unsupportive or uncertain of it. Professional role identity should be considered by policy makers in any country seeking to introduce policies that aim to radically change the role of community nurses and that this is acknowledged at an early stage in the policy-making cycle. © 2013 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.

Gender dysphoria in adolescence: current perspectives

PubMed Central

Kaltiala-Heino, Riittakerttu; Bergman, Hannah; Työläjärvi, Marja; Frisén, Louise

2018-01-01

Increasing numbers of adolescents are seeking treatment at gender identity services in Western countries. An increasingly accepted treatment model that includes puberty suppression with gonadotropin-releasing hormone analogs starting during the early stages of puberty, cross-sex hormonal treatment starting at ~16 years of age and possibly surgical treatments in legal adulthood, is often indicated for adolescents with childhood gender dysphoria (GD) that intensifies during puberty. However, virtually nothing is known regarding adolescent-onset GD, its progression and factors that influence the completion of the developmental tasks of adolescence among young people with GD and/or transgender identity. Consolidation of identity development is a central developmental goal of adolescence, but we still do not know enough about how gender identity and gender variance actually evolve. Treatment-seeking adolescents with GD present with considerable psychiatric comorbidity. There is little research on how GD and/or transgender identity are associated with completion of developmental tasks of adolescence. PMID:29535563

The Post-Military West: Globalization’s Impact on U.S. Strategic Culture

DTIC Science & Technology

2009-03-01

culture, it is an important condition to monitor, since strategic culture shapes policy-making and influences how a country fights its wars.1 This SRP...of the societies, culture and politics of other countries . Due to this interconnectedness, crises anywhere in the world can affect security everywhere...Third World countries , seeking a way out of poverty, head west to join relatives and friends who emigrated before them. Compared with European immigrants

Promoting space research and applications in developing countries through small satellite missions

NASA Astrophysics Data System (ADS)

Sweeting, M.

The high vantage-point of space offers very direct and tangible benefits to developing countries when carefully focused upon their real and particular communications and Earth observation needs. However, until recently, access to space has been effectively restricted to only those countries prepared to invest enormous sums in complex facilities and expensive satellites and launchers: this has placed individual participation in space beyond the sensible grasp of developing countries. However, during the last decade, highly capable and yet inexpensive small satellites have been developed which provide an opportunity for developing countries realistically to acquire and operate their own independent space assets - customized to their particular national needs. Over the last 22 years, the Surrey Space Centre has pioneered, developed and launched 23 nano-micro-minisatellite missions, and has worked in partnership with 12 developing countries to enable them to take their first independent steps into space. Surrey has developed a comprehensive and in-depth space technology know-how transfer and 'hands-on' training programme that uses a collaborative project comprising the design, construction, launch and operation of a microsatellite to acquire an indigenous space capability and create the nucleus of a national space agency and space industry. Using low cost small satellite projects as a focus, developing countries are able to initiate a long term, affordable and sustainable national space programme specifically tailored to their requirements, that is able to access the benefits derived from Earth observation for land use and national security; improved communications services; catalyzing scientific research and indigenous high-technology supporting industries. Perhaps even more important is the long-term benefit to the country provided by stimulating educational and career opportunities for your scientists and engineers and retaining them inside the country rather the all-too-familiar 'brain-drain' seeking employment overseas. The most successful countries have secured their initial investment in acquiring space know-how by following through with the formation of a national space agency or organization to provide a stable nucleus for supporting long-term space activities. Particularly suited to developing countries, Surrey has co-ordinated the first international constellation of small satellites for Earth Observation - the Disaster Monitoring Constellation (DMC). Four enhanced microsatellites have been launched in 2002 & 2003 built collaboratively by Surrey and Algeria, Nigeria, Turkey and UK which now provide daily images of anywhere in the world for disaster management and monitoring other dynamic phenomena such as land use and urban development. The same model of international partnership will be used in follow-on constellations with different sensors (IR, SAR, hyper-spectral) to meet national needs in a sustainable way. In a similar manner whereby the Personal Computer enabled developing countries access to modern information technologies on an affordable budget, small satellites are enabling these same countries to access space within sensible and sustainable expenditures for the direct benefit of their populations.

Challenges and Opportunities of US and Arab Collaborations in Health Services Research: A Case Study from Qatar

PubMed Central

Hammoud, Maya M.; Elnashar, Maha; Abdelrahim, Huda; Khidir, Amal; Elliott, Heather A.K.; Killawi, Amal; Padela, Aasim I.; Khal, Abdul Latif Al; Bener, Abdulbari; Fetters, Michael D.

2012-01-01

Economic globalization and advances in technology have made it more feasible and even necessary to develop international research collaborations in global public health. Historically, collaborations in global research described in the literature have been mostly “North-South” collaborations in which the more developed “North” country works together with a developing “South” country to conduct research in the latter. This type of collaboration has for the most part, represented unequal partnership and rarely left behind a lasting impact. Recently, the opportunity for a new kind of international research partnership has emerged in which the host country has significant financial resources, but relatively limited expertise in research methodology or techniques and research implementation. This type of collaboration features a relative equalization of power between the international partners. The purpose of this paper is to describe the process of building a successful research collaboration between a team in the United States and a team in Qatar, a rich Arabic nation in Gulf. We present a case study that provides an overview of our own project focused on the development of a culturally and linguistically adapted health care quality instrument for Qatar, discussing many of the benefits and challenges we encountered during each phase of instrument development. We present recommendations for researchers seeking sustainable and equitable partnerships with the Arab World. PMID:23121751

Challenges and opportunities of US and Arab collaborations in health services research: a case study from Qatar.

PubMed

Hammoud, Maya M; Elnashar, Maha; Abdelrahim, Huda; Khidir, Amal; Elliott, Heather A K; Killawi, Amal; Padela, Aasim I; Al Khal, Abdul Latif; Bener, Abdulbari; Fetters, Michael D

2012-09-25

Economic globalization and advances in technology have made it more feasible and even necessary to develop international research collaborations in global public health. Historically, collaborations in global research described in the literature have been mostly "North-South" collaborations in which the more developed "North" country works together with a developing "South" country to conduct research in the latter. This type of collaboration has for the most part, represented unequal partnership and rarely left behind a lasting impact. Recently, the opportunity for a new kind of international research partnership has emerged in which the host country has significant financial resources, but relatively limited expertise in research Methodology or techniques and research implementation.  This type of collaboration features a relative equalization of power between the international partners. The purpose of this paper is to describe the process of building a successful research collaboration between a team in the United States and a team in Qatar, a rich Arabic nation in Gulf. We present a case study that provides an overview of our own project focused on the development of a culturally and linguistically adapted health care quality instrument for Qatar, discussing many of the benefits and challenges we encountered during each phase of instrument development. We present recommendations for researchers seeking sustainable and equitable partnerships with the Arab World.

What is the impact of water sanitation and hygiene in healthcare facilities on care seeking behaviour and patient satisfaction? A systematic review of the evidence from low-income and middle-income countries

PubMed Central

Cumming, Oliver; Hunter, Paul R

2018-01-01

Patient satisfaction with healthcare has clear implications on service use and health outcomes. Barriers to care seeking are complex and multiple and delays in seeking care are associated with significant morbidity and mortality. We sought to assess the relationship between water, sanitation and hygiene (WASH) provision in healthcare facilities (HCF) and patient satisfaction/care seeking behaviour in low-income and middle-income countries. Pubmed and Medline Ovid were searched using a combination of search terms. 984 papers were retrieved and only 21 had a WASH component warranting inclusion. WASH was not identified as a driver of patient satisfaction but poor WASH provision was associated with significant patient dissatisfaction with infrastructure and quality of care. However, this dissatisfaction was not sufficient to stop patients from seeking care in these poorly served facilities. With specific regard to maternal health services, poor WASH provision was the reason for women choosing home delivery, although providers’ attitudes and interpersonal behaviours were the main drivers of patient dissatisfaction with maternal health services. Patient satisfaction was mainly assessed via questionnaires and studies reported a high risk of courtesy bias, potentially leading to an overestimation of patient satisfaction. Patient satisfaction was also found to be significantly affected by expectation, which was strongly influenced by patients’ socioeconomic status and education. This systematic review also highlighted a paucity of research to describe and evaluate interventions to improve WASH conditions in HCF in low-income setting with a high burden of healthcare-associated infections. Our review suggests that improving WASH conditions will decrease patience dissatisfaction, which may increase care seeking behaviour and improve health outcomes but that more rigorous research is needed. PMID:29765776

Health care seeking behaviours in pregnancy in rural Sindh, Pakistan: a qualitative study.

PubMed

Qureshi, Rahat Najam; Sheikh, Sana; Khowaja, Asif Raza; Hoodbhoy, Zahra; Zaidi, Shujaat; Sawchuck, Diane; Vidler, Marianne; Bhutta, Zulfiqar A; von Dadeslzen, Peter

2016-06-08

Pakistan has alarmingly high numbers of maternal mortality along with suboptimal care-seeking behaviour. It is essential to identify the barriers and facilitators that women and families encounter, when deciding to seek maternal care services. This study aimed to understand health-seeking patterns of pregnant women in rural Sindh, Pakistan. A qualitative study was undertaken in rural Sindh, Pakistan as part of a large multi-country study in 2012. Thirty three focus group discussions and 26 in-depth interviews were conducted with mothers [n = 173], male decision-makers [n = 64], Lady Health Workers [n = 64], Lady Health Supervisors [n = 10], Women Medical Officers [n = 9] and Traditional Birth Attendants [n = 7] in the study communities. A set of a priori themes regarding care-seeking during pregnancy and its complications as well as additional themes as they emerged from the data were used for analysis. Qualitative analysis was done using NVivo version 10. Women stated they usually visited health facilities if they experienced pregnancy complications or danger signs, such as heavy bleeding or headache. Findings revealed the importance of husbands and mothers-in-law as decision makers regarding health care utilization. Participants expressed that poor availability of transport, financial constraints and the unavailability of chaperones were important barriers to seeking care. In addition, private facilities were often preferred due to the perceived superior quality of services. Maternal care utilization was influenced by social, economic and cultural factors in rural Pakistani communities. The perceived poor quality care at public hospitals was a significant barrier for many women in accessing health services. If maternal lives are to be saved, policy makers need to develop processes to overcome these barriers and ensure easily accessible high-quality care for women in rural communities. NCT01911494.

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.

Topical Collection: Climate-change research by early-career hydrogeologists

NASA Astrophysics Data System (ADS)

Re, Viviana; Maldaner, Carlos H.; Gurdak, Jason J.; Leblanc, Marc; Resende, Tales Carvalho; Stigter, Tibor Y.

2018-05-01

Scientific outreach, international networking, collaboration and adequate courses are needed in both developed and developing countries to enable early-career hydrogeologists to promote long-term multidisciplinary approaches to cope with climate-change issues and emphasize the importance of groundwater in a global strategy for adaptation. One such collaboration has involved the Early Career Hydrogeologists' Network of the International Association of Hydrogeologists (ECHN-IAH) and the UNESCO International Hydrological Programme's (IHP) Groundwater Resources Assessment under the Pressures of Humanity and Climate Changes (GRAPHIC) project. This collaboration seeks to foster the education and involvement of the future generation of water leaders in the debate over groundwater and climate change.

Beliefs and advice-seeking behaviours for fertility and pregnancy: a cross-sectional study of a global sample.

PubMed

Walker, R; Blumfield, M; Truby, H

2018-04-16

Pregnancy can motivate individuals to adopt lifestyle behaviours that protect the health of their offspring. The aims of the present study were to explore men's and women's beliefs about lifestyle, fertility and pregnancy, as well as where they seek advice. Participants (2185 women and 221 men, six unspecified) from 104 countries completed a questionnaire that explored their beliefs about what was important for a healthy pregnancy and their advice-seeking behaviours. Recruitment was via a Massive Open Online Course entitled 'Food as Medicine', with food, nutrient and health content. Comparisons of categorical data were performed using a chi-squared test (P = 0.05). Eating a variety of fruits and vegetables and not smoking (both 93.7%) were the most frequently and equally ranked in the top-five factors for a healthy pregnancy. Taking prenatal supplements (26.8%) was considered to be less important. Participants in Westernised countries ranked not smoking or drinking alcohol as being significantly more important than those in other countries. Overall, doctors (47.7%) were the most common source of fertility and pregnancy advice. Larger proportions of those aged <40 years used the Internet (<40 years 44.1%, >40 years 18.2% χ 2 = 152.7, P < 0.01) and social media (<40 years 16.1%, >40 years 3.6%; χ 2 = 110.18, P < 0.01) for health information. There is disconnection between beliefs and actions regarding the lifestyle behaviours considered to be important for a healthy pregnancy, particularly nutrition. Pregnancy advice-seeking has evolved, with younger men and women utilising the Internet and social media. Health professionals must consider new communication strategies to deliver evidence-based lifestyle advice, particularly for younger men and women and where access to healthcare is limited. © 2018 The British Dietetic Association Ltd.

Finding the Missing Patients With Tuberculosis: Lessons Learned From Patient-Pathway Analyses in 5 Countries.

PubMed

Hanson, Christy; Osberg, Mike; Brown, Jessie; Durham, George; Chin, Daniel P

2017-11-06

Despite significant progress in diagnosis and treatment of tuberculosis over the past 2 decades, millions of patients with tuberculosis go unreported every year. The patient-pathway analysis (PPA) is designed to assess the alignment between tuberculosis care-seeking patterns and the availability of tuberculosis services. The PPA can help programs understand where they might find the missing patients with tuberculosis. This analysis aggregates and compares the PPAs from case studies in Kenya, Ethiopia, Indonesia, the Philippines, and Pakistan. Across the 5 countries, 24% of patients with tuberculosis initiated care seeking in a facility with tuberculosis diagnostic capacity. Forty-two percent of patients sought care at level 0 facilities, where there was generally no tuberculosis diagnostic capacity; another 42% of patients sought care at level 1 facilities, of which 39% had diagnostic capacity. Sixty-six percent of patients initially sought care in private facilities, which had considerably less tuberculosis diagnostic capacity than public facilities; only 7% of notified cases were from the private sector. The GeneXpert system was available in 14%-41% of level 2 facilities in the 3 countries for which there were data. Tuberculosis treatment capacity tracked closely with the availability of diagnostic capacity. There were substantial subnational differences in care-seeking patterns and service availability. The PPA can be a valuable planning and programming tool to ensure that diagnostic and treatment services are available to patients where they seek care. Patient-centered care will require closing the diagnostic gap and engaging the private sector. Extensive subnational differences in patient pathways to care call for differentiated approaches to patient-centered care. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Finding the Missing Patients With Tuberculosis: Lessons Learned From Patient-Pathway Analyses in 5 Countries

PubMed Central

Hanson, Christy; Osberg, Mike; Brown, Jessie; Durham, George; Chin, Daniel P

2017-01-01

Abstract Background Despite significant progress in diagnosis and treatment of tuberculosis over the past 2 decades, millions of patients with tuberculosis go unreported every year. The patient-pathway analysis (PPA) is designed to assess the alignment between tuberculosis care-seeking patterns and the availability of tuberculosis services. The PPA can help programs understand where they might find the missing patients with tuberculosis. Methods This analysis aggregates and compares the PPAs from case studies in Kenya, Ethiopia, Indonesia, the Philippines, and Pakistan. Results Across the 5 countries, 24% of patients with tuberculosis initiated care seeking in a facility with tuberculosis diagnostic capacity. Forty-two percent of patients sought care at level 0 facilities, where there was generally no tuberculosis diagnostic capacity; another 42% of patients sought care at level 1 facilities, of which 39% had diagnostic capacity. Sixty-six percent of patients initially sought care in private facilities, which had considerably less tuberculosis diagnostic capacity than public facilities; only 7% of notified cases were from the private sector. The GeneXpert system was available in 14%–41% of level 2 facilities in the 3 countries for which there were data. Tuberculosis treatment capacity tracked closely with the availability of diagnostic capacity. There were substantial subnational differences in care-seeking patterns and service availability. Discussion The PPA can be a valuable planning and programming tool to ensure that diagnostic and treatment services are available to patients where they seek care. Patient-centered care will require closing the diagnostic gap and engaging the private sector. Extensive subnational differences in patient pathways to care call for differentiated approaches to patient-centered care. PMID:29117351

A theoretical flaw in the advance market commitment idea.

PubMed

Sonderholm, Jorn

2010-06-01

Infectious and parasitic diseases cause massive health problems in the developing world. Research and development of drugs for diseases that mainly affect poor people in developing countries is limited. The advance market commitment (AMC) idea is an incentivising mechanism for research and development of drugs for neglected diseases. Discussion of the AMC idea is of renewed interest given the launch in June 2009 of the first AMC. This pilot AMC is designed to, among other things, test the idea for potential future applications. This paper is a critique of the AMC idea. It seeks to show that the idea has a hitherto unrecognised theoretical flaw that should make policy-makers and donors hesitant to embrace future applications of the idea.

Contribution of the conferences of the parties and the renewable energy role for the fight against climate change

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

Ghezloun, A., E-mail: a.ghezloun@cder.dz; Oucher, N.; Merabet, H.

The Kyoto Protocol, which entered into force on 16 February 2005, commits developed countries to reduce their emissions of greenhouse gases by 5% in 2012 compared to 1990. Due to the abstention of the United States and the absence of constraint on Southern countries, the protocol establishes obligations only to countries that represent only 33% of global CO{sub 2} emissions. All the diplomatic effort is therefore to seek the commitment of discussion for the period after 2012. The participation of the United States and emerging countries is imperative. The essential point of this second negotiation process is to search inmore » the effort to integrate the United States and the developing countries and, more particularly, emerging economies such as China, India or Brazil, whose current emissions and / or projected should exceed those of developed countries during the first half of the twenty-first century. Real progress has been made in recent years. Indeed, a first universal historic agreement and legally binding was adopted after two weeks of intense negotiations by the Parties from 30 November to 12 December 2015, which aims to limit global warming by the end of this century well below 2 ° C while continuing efforts to not exceed 1.5 ° C. Moreover, the European Union, China and the United States have expressed their willingness to reduce their greenhouse gas. Because, one of the great hopes of the fight against the emission of greenhouse gases is the development of renewable energy, the IPCC (Intergovernmental Panel on Climate Change) report highlights the need to move towards renewable energy sources. The European Union, China and United States also expressed their willingness to increase the share of renewable energy. It is therefore necessary to develop the only inexhaustible energy, renewable energy, to fight against climate change.« less

Contribution of the conferences of the parties and the renewable energy role for the fight against climate change

NASA Astrophysics Data System (ADS)

Ghezloun, A.; Saidane, A.; Oucher, N.; Merabet, H.

2016-07-01

The Kyoto Protocol, which entered into force on 16 February 2005, commits developed countries to reduce their emissions of greenhouse gases by 5% in 2012 compared to 1990. Due to the abstention of the United States and the absence of constraint on Southern countries, the protocol establishes obligations only to countries that represent only 33% of global CO2 emissions. All the diplomatic effort is therefore to seek the commitment of discussion for the period after 2012. The participation of the United States and emerging countries is imperative. The essential point of this second negotiation process is to search in the effort to integrate the United States and the developing countries and, more particularly, emerging economies such as China, India or Brazil, whose current emissions and / or projected should exceed those of developed countries during the first half of the twenty-first century. Real progress has been made in recent years. Indeed, a first universal historic agreement and legally binding was adopted after two weeks of intense negotiations by the Parties from 30 November to 12 December 2015, which aims to limit global warming by the end of this century well below 2 ° C while continuing efforts to not exceed 1.5 ° C. Moreover, the European Union, China and the United States have expressed their willingness to reduce their greenhouse gas. Because, one of the great hopes of the fight against the emission of greenhouse gases is the development of renewable energy, the IPCC (Intergovernmental Panel on Climate Change) report highlights the need to move towards renewable energy sources. The European Union, China and United States also expressed their willingness to increase the share of renewable energy. It is therefore necessary to develop the only inexhaustible energy, renewable energy, to fight against climate change.

A measure of welfare.

PubMed

Harrison, P

1979-10-01

The Overseas Development Council has been seeking to perfect a new kind of measure for assessment of development strategies, for it has long been recognized that the Gross National Product is an inadequate measurement tool. The Physical Quality of Life Index, developed by the ODC over the past 3 years, scores nations on a scale of 0-100. It is calculated by averaging the countries' scores in 3 important fields of welfare -- adult literacy, infant mortality, and life expectancy at age 1. Although the PQLI data are averages also they do seem to be sensitive to the distribution of benefits. Results have been calculated for every country in the world, and they refute the arguments of conservative economists and political leaders who claim that basic human needs can only be met through rapid economic growth. Poor countries can achieve high levels of welfare for their population without waiting for growth in material wealth, and relatively high levels of national income can fail to guarantee that the mass of the population will have their basic needs met. In that their advance tends to slow down as countries approach the upper levels of the PQLI, the Overseas Development Council introduced a new concept -- the disparity reduction ratio -- for measuring changes in welfare. This is the annual rate at which each nation is closing the gap between its current score and the best expected score anywhere for the year 2000. The disparity reduction rate may permit exact targets to be established for progress in meeting basic needs. A worthwhile objective over the next 20 years might be for each country to halve the gap separating them from the best attainable.

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

PubMed

Osamor, Pauline E; Grady, Christine

2016-01-01

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

Global support for new vaccine implementation in middle-income countries.

PubMed

Kaddar, Miloud; Schmitt, Sarah; Makinen, Marty; Milstien, Julie

2013-04-18

Middle-income countries (MICs) as a group are not only characterized by a wide range of gross national income (GNI) per capita (US $1026 to $12,475), but also by diversity in size, geography, governance, and infrastructure. They include the largest and smallest countries of the world-including 16 landlocked developing countries, 27 small island developing states, and 17 least developed countries-and have a significant diversity in burden of vaccine-preventable diseases. Given the growth in the number of MICs and their considerable domestic income disparities, they are now home to the greatest proportion of the world's poor, having more inhabitants below the poverty line than low-income countries (LICs). However, they have little or no access to external funding for the implementation of new vaccines, nor are they benefiting from an enabling global environment. The MICs are thus not sustainably introducing new life-saving vaccines at the same rate as donor-funded LICs or wealthier countries. The global community, through World Health Assembly resolutions and the inclusion of MIC issues in several recent studies and important documents-including the Global Vaccine Action Plan (GVAP) for the Decade of Vaccines-has acknowledged the sub-optimal situations in some MICs and is actively seeking to enhance the situation by expanding support to these countries. This report documents some of the activities already going on in a subset of MICs, including strengthening of national regulatory authorities and national immunization technical advisory groups, and development of comprehensive multi-year plans. However, some additional tools developed for LICs could prove useful to MICs and thus should be adapted for use by them. In addition, new approaches need to be developed to support MIC-specific needs. It is clear that no one solution will address the needs of this diverse group. We suggest tailored interventions in the four categories of evidence and capacity-building, policy and advocacy, financing, and procurement and supply chain. For MICs to have comparable rates of introduction as other wealthier countries and to contribute to the global fight against vaccine-preventable diseases, global partners must implement a coordinated and pragmatic intervention strategy in accord with their competitive advantage. This will require political will, joint planning, and additional modest funding. Copyright © 2012 Elsevier Ltd. All rights reserved.

Community perceptions and practices of treatment seeking for childhood pneumonia: a mixed methods study in a rural district, Ghana.

PubMed

Abbey, Mercy; Chinbuah, Margaret A; Gyapong, Margaret; Bartholomew, L Kay; van den Borne, Bart

2016-08-22

The World Health Organization recommends community case management of malaria and pneumonia for reduction of under-five mortality in developing countries. Caregivers' perception and understanding of the illness influences the care a sick child receives. Studies in Ghana and elsewhere have routinely shown adequate recognition of malaria by caregivers. Similarly, evidence from Asia and some African countries have shown adequate knowledge on pneumonia. However, in Ghana, little has been documented about community awareness, knowledge, perceptions and management of childhood pneumonia particularly in the Dangme West district. Therefore this formative study was conducted to determine community perceptions of pneumonia for the purpose of informing the design and implementation of context specific health communication strategies to promote early and appropriate care seeking behaviour for childhood pneumonia. A mixed method approach was adopted. Data were obtained from structured interviews (N = 501) and eight focus group discussions made up of 56 caregivers of under-fives and eight community Key Informants. Descriptive and inference statistics were used for the quantitative data and grounded theory to guide the analysis of the qualitative data. Two-thirds of the respondents had never heard the name pneumonia. Most respondents did not know about the signs and symptoms of pneumonia. For the few who have heard about pneumonia, causes were largely attributed to coming into contact with cold temperature in various forms. Management practices mostly were self-treatment with home remedies and allopathic care. The low awareness and inadequate recognition of pneumonia implies that affected children may not receive prompt and appropriate treatment as their caregivers may misdiagnose the illness. Adequate measures need to be taken to create the needed awareness to improve care seeking behaviour.

Enabling the Billion-Ton Bioeconomy

ScienceCinema

Baumes, Harry; Csonka, Steve; Sayre, Richard; Steen, Eric; Kenney, Kevin; Labbe, Nicole

2018-01-16

The United States is rich in non-food ‎biomass that can fuel the development of a thriving ‎bioeconomy where renewable and sustainable resources power cars and planes instead of petroleum. The ‎transportation and aviation industry is actively seeking ways to reduce its carbon footprint by powering planes with solid municipal waste, woody biomass, purpose-grown crops, and ‎algae. Watch this short video to learn how biomass is being used to make our country greener, provide new employment opportunities, and reduce our dependence on foreign oil.

Overcoming phase 1 delays: the critical component of obstetric fistula prevention programs in resource-poor countries

PubMed Central

2012-01-01

Background An obstetric fistula is a traumatic childbirth injury that occurs when labor is obstructed and delivery is delayed. Prolonged obstructed labor leads to the destruction of the tissues that normally separate the bladder from the vagina and creates a passageway (fistula) through which urine leaks continuously. Women with a fistula become social outcasts. Universal high-quality maternity care has eliminated the obstetric fistula in wealthy countries, but millions of women in resource-poor nations still experience prolonged labor and tens of thousands of new fistula sufferers are added to the millions of pre-existing cases each year. This article discusses fistula prevention in developing countries, focusing on the factors which delay treatment of prolonged labor. Discussion Obstetric fistulas can be prevented through contraception, avoiding obstructed labor, or improving outcomes for women who develop obstructed labor. Contraception is of little use to women who are already pregnant and there is no reliable screening test to predict obstruction in advance of labor. Improving the outcome of obstructed labor depends on prompt diagnosis and timely intervention (usually by cesarean section). Because obstetric fistulas are caused by tissue compression, the time interval from obstruction to delivery is critical. This time interval is often extended by delays in deciding to seek care, delays in arriving at a hospital, and delays in accessing treatment after arrival. Communities can reasonably demand that governments and healthcare institutions improve the second (transportation) and third (treatment) phases of delay. Initial delays in seeking hospital care are caused by failure to recognize that labor is prolonged, confusion concerning what should be done (often the result of competing therapeutic pathways), lack of women’s agency, unfamiliarity with and fear of hospitals and the treatments they offer (especially surgery), and economic constraints on access to care. Summary Women in resource-poor countries will use institutional obstetric care when the services provided are valued more than the competing choices offered by a pluralistic medical system. The key to obstetric fistula prevention is competent obstetrical care delivered respectfully, promptly, and at affordable cost. The utilization of these services is driven largely by trust. PMID:22809234

Understanding the modifiable health systems barriers to hypertension management in Malaysia: a multi-method health systems appraisal approach.

PubMed

Risso-Gill, Isabelle; Balabanova, Dina; Majid, Fadhlina; Ng, Kien Keat; Yusoff, Khalid; Mustapha, Feisul; Kuhlbrandt, Charlotte; Nieuwlaat, Robby; Schwalm, J-D; McCready, Tara; Teo, Koon K; Yusuf, Salim; McKee, Martin

2015-07-03

The growing burden of non-communicable diseases in middle-income countries demands models of care that are appropriate to local contexts and acceptable to patients in order to be effective. We describe a multi-method health system appraisal to inform the design of an intervention that will be used in a cluster randomized controlled trial to improve hypertension control in Malaysia. A health systems appraisal was undertaken in the capital, Kuala Lumpur, and poorer-resourced rural sites in Peninsular Malaysia and Sabah. Building on two systematic reviews of barriers to hypertension control, a conceptual framework was developed that guided analysis of survey data, documentary review and semi-structured interviews with key informants, health professionals and patients. The analysis followed the patients as they move through the health system, exploring the main modifiable system-level barriers to effective hypertension management, and seeking to explain obstacles to improved access and health outcomes. The study highlighted the need for the proposed intervention to take account of how Malaysian patients seek treatment in both the public and private sectors, and from western and various traditional practitioners, with many patients choosing to seek care across different services. Patients typically choose private care if they can afford to, while others attend heavily subsidised public clinics. Public hypertension clinics are often overwhelmed by numbers of patients attending, so health workers have little time to engage effectively with patients. Treatment adherence is poor, with a widespread belief, stemming from concepts of traditional medicine, that hypertension is a transient disturbance rather than a permanent asymptomatic condition. Drug supplies can be erratic in rural areas. Hypertension awareness and education material are limited, and what exist are poorly developed and ineffective. Despite having a relatively well funded health system offering good access to care, Malaysia's health system still has significant barriers to effective hypertension management. The study uncovered major patient-related barriers to the detection and control of hypertension which will have an impact on the design and implementation of any hypertension intervention. Appropriate models of care must take account of the patient modifiable health systems barriers if they are to have any realistic chance of success; these findings are relevant to many countries seeking to effectively control hypertension despite resource constraints.

Interaction of Reward Seeking and Self-Regulation in the Prediction of Risk Taking: A Cross-National Test of the Dual Systems Model

ERIC Educational Resources Information Center

Duell, Natasha; Steinberg, Laurence; Chein, Jason; Al-Hassan, Suha M.; Bacchini, Dario; Lei, Chang; Chaudhary, Nandita; Di Giunta, Laura; Dodge, Kenneth A.; Fanti, Kostas A.; Lansford, Jennifer E.; Malone, Patrick S.; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T.; Sorbring, Emma; Tapanya, Sombat; Uribe Tirado, Liliana Maria; Alampay, Liane Peña

2016-01-01

In the present analysis, we test the dual systems model of adolescent risk taking in a cross-national sample of over 5,200 individuals aged 10 through 30 (M = 17.05 years, SD = 5.91) from 11 countries. We examine whether reward seeking and self-regulation make independent, additive, or interactive contributions to risk taking, and ask whether…

International comparisons of waiting times in health care--limitations and prospects.

PubMed

Viberg, Nina; Forsberg, Birger C; Borowitz, Michael; Molin, Roger

2013-09-01

Long waiting times for health care is an important health policy issue in many countries, and many have introduced some form of national waiting time guarantees. International comparison of waiting times are critical for countries to improve policy and for patients to be able to make informed choices, especially in Europe, where patients have the right to seek care in other countries if there is undue delay. The objective of this study was to describe how countries measure waiting times and to assess whether waiting times can be compared internationally. Twenty-three OECD countries were included. Information was collected through scientific articles, official and unofficial documents and web pages. Fifteen of the 23 countries monitor and publish national waiting time statistics and have some form of waiting time guarantees. There are significant differences in how waiting times are measured: whether they measure the "ongoing" or "completed" waiting period what kind of care the patient is waiting for; the parameters used; and where in the patient journey the measurement begins. Current national waiting time statistics are of limited use for comparing health care availability among the various countries due to the differences in measurements and data collection. Different methodological issues must be taken into account when making such cross-country comparisons. Within the given context of national sovereignty of health systems it would be desirable if countries could collaborate in order to facilitate international comparisons. Such comparisons would be of benefit to all involved in the process of continuous improvement of health services. They would also benefit patients who seek cross-border alternatives for their care. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Lines of evidence for environmentally driven human migration

NASA Astrophysics Data System (ADS)

Davis, K. F.; D'Odorico, P.

2012-12-01

International human migration is an important mechanism that affects, and is affected by, various human and natural systems. With the number of people living outside their countries of origin currently estimated at 214 million people and projected to potentially reach more than 400 million people by mid-century, the topic of international human movements presents possible advantages and pitfalls for both sending and receiving countries on multiple fronts (e.g. economic, environmental, political and cultural). Understanding how human migration interacts with human and natural systems is therefore essential in realizing a sustainable and balanced future. While the study of international migration has historically been motivated largely by economic and political interests, the issue of environmentally induced migration has become increasingly important in light of a rapidly changing climate in conjunction with increasing population pressure on many important resources. Particularly in terms of theoretical and conceptual discussions, environmentally induced human migration has been receiving increased attention in the literature. To date, few studies - many of which focus on internal (intra-national) or regional migration - have attempted to quantify the interactions of human migration and the environment, with little attention paid to the global scale as a result of varying regional factors and lack of sufficient data. Recently available global bilateral migration datasets have been developed that allow for a more comprehensive understanding of human movements between all countries. With these datasets, we seek to elucidate environmental drivers of human migration over the past half-century using a multi-pronged approach. First, using a recently developed universal radiation model, we examine human movements based solely on global population distribution. Next, by comparison of migration movements with selected economic, environmental and human welfare indicators, we determine additional factors that may help explain migration at global, regional, continental and community-based (i.e. maximized module) scales. Lastly, we explore the relationship between migration and natural disasters (e.g. drought, flooding) to identify instances in which the environment is a proximate cause of human displacement and in turn use this information to determine if a subsequent cascade of human movements appears in neighboring countries as a result of the elevated inflow of migrants from the initial country of interest. In this way, we seek to gain a fuller picture of the environmental factors driving the dynamics of modern human migration.

South Asian co-operation in population education. Materials jointly developed for common use by South Asian population education programmes.

PubMed

1992-01-01

Southern Asian population education programs have developed common materials on population and family life education. Countries involved were Bangladesh, India, Nepal, Pakistan, and Sri Lanka. The development of materials occurred as a byproduct of workshop conducted in Nepal from December 3-7, 1990 and December 2-10, 1991 in Sri Lanka. The 1st meeting was organized by UNESCO's Population Education Advisory team, and 6 curriculum topics were identified. Pretesting of materials was conducted between meetings. The final product was a set of 10 posters and 2 comic strips on the quality of life developed by India for elementary level use; a family life and sex education syllabus developed by Sri Lanka for secondary school use; 5 modules with teacher's guides and sample lessons for secondary school use; 5 modules and a teacher's guide on transmission of values on population education by Pakistan; 25 flip charts on maternal and child health for illiterates developed by Nepal; and a field guide on environmental protection for nonformal field workers developed by Bangladesh. Materials were designed through brainstorming sessions, designing of materials by experts, review by other groups, and retesting on target audiences. Revision followed pretesting. The plan for assuring use of materials was to have UNESCO print prototypes and then participants would seek financial support for country supplies. A suggestion was made to leave ample space for insertion of local language captions. Another suggestion was that the cartoon strip "Girls are Pearls" be printed on students' exercise books for all member countries. Member countries should also have available selected materials translated into English and distributed. UNESCO should continue to play the role of facilitator of information and expertise exchange among member countries. Another mutually cooperative activity was the Group Training Course on Population Education for the South Asian subregion held in December 1991.

Russian expats seek research reforms

NASA Astrophysics Data System (ADS)

Banks, Michael

2009-11-01

Over 170 Russian researchers working abroad have signed a letter addressed to the Russian president, Dmitry Medvedev, and prime minister Vladimir Putin raising concerns about "the catastrophic state of basic science" in the country. The letter, which appeared last month in the Moscow business paper Vedomosti, warns Russian leaders that unless urgent measures are implemented by the government, then science in the country may collapse.

Preparing Preservice Teachers to Meet the Needs of Hmong Refugee Students

ERIC Educational Resources Information Center

McCall, Ava L.; Vang, Bee

2012-01-01

The United States is home to more than two million refugees since 1975, with over half arriving as children. Refugees are semi-voluntary immigrants fleeing persecution in their home countries and seeking a country willing to resettle them. They may have experienced war, separation from or loss of family, and loss of home and basic needs. One…

Energy Security Strategies: An Analysis of Tanzania and Mozambique

DTIC Science & Technology

2016-06-01

prioritizes domestic consumption or export of energy resources. The strategy a government chooses affects the overall energy security of that country...This thesis seeks to explain why countries pursue energy strategies that focus on domestic consumption of indigenous energy resources instead of...energy strategy that either prioritizes domestic consumption or export of energy resources. The strategy a government chooses affects the overall

Whiplash Syndrome Reloaded: Digital Echoes of Whiplash Syndrome in the European Internet Search Engine Context

PubMed Central

2017-01-01

Background In many Western countries, after a motor vehicle collision, those involved seek health care for the assessment of injuries and for insurance documentation purposes. In contrast, in many less wealthy countries, there may be limited access to care and no insurance or compensation system. Objective The purpose of this infodemiology study was to investigate the global pattern of evolving Internet usage in countries with and without insurance and the corresponding compensation systems for whiplash injury. Methods We used the Internet search engine analytics via Google Trends to study the health information-seeking behavior concerning whiplash injury at national population levels in Europe. Results We found that the search for “whiplash” is strikingly and consistently often associated with the search for “compensation” in countries or cultures with a tort system. Frequent or traumatic painful injuries; diseases or disorders such as arthritis, headache, radius, and hip fracture; depressive disorders; and fibromyalgia were not associated similarly with searches on “compensation.” Conclusions In this study, we present evidence from the evolving viewpoint of naturalistic Internet search engine analytics that the expectations for receiving compensation may influence Internet search behavior in relation to whiplash injury. PMID:28347974

Syndromic treatment of gonococcal and chlamydial infections in women seeking primary care for the genital discharge syndrome: decision-making.

PubMed Central

Behets, F. M.; Miller, W. C.; Cohen, M. S.

2001-01-01

The syndromic treatment of gonococcal and chlamydial infections in women seeking primary care in clinics where resources are scarce, as recommended by WHO and implemented in many developing countries, necessitates a balance to be struck between overtreatment and undertreatment. The present paper identifies factors that are relevant to the selection of specific strategies for syndromic treatment in the above circumstances. Among them are the general aspects of decision-making and caveats concerning the rational decision-making approach. The positive and negative implications are outlined of providing or withholding treatment following a specific algorithm with a given accuracy to detect infection, i.e. sensitivity, specificity and predictive values. Other decision-making considerations that are identified are related to implementation and include the stability of risk factors with regard to time, space and the implementer, acceptability by stakeholders, and environmental constraints. There is a need to consider empirically developed treatment algorithms as a basis for policy discourse, to be evaluated together with the evidence, alternatives and arguments by the stakeholders. PMID:11731816

Cross-national comparison of Middle Eastern university students: help-seeking behaviors, attitudes toward helping professionals, and cultural beliefs about mental health problems.

PubMed

Al-Krenawi, Alean; Graham, John R; Al-Bedah, Eman A; Kadri, Hafni Mahmud; Sehwail, Mahmud A

2009-02-01

This study is the first to use identical data collection processes and instruments in Egypt, Kuwait, Palestine, and Israeli Arab communities regarding help-seeking behaviors and attitudes towards perceived cultural beliefs about mental health problems. Data is based on a survey sample of 716, undergraduate students in the 4 countries, 61% female and 39% male. Results indicate that respondents within the various countries, based on nationality, gender and level of education, vary in terms of recognition of personal need, beliefs about mental health problems (i.e. stigmatization), and the use of traditional healing methods versus modern approaches to psychiatric therapy. The conclusion discusses differences between our respondents' expectations and prevailing mental health service provision and delivery.

International taxation of multinational enterprises in developed countries

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

Adams, J.D.R.; Whalley, J.

1977-01-01

The authors, specialists in law and economics, respectively, adopt an interdisciplinary approach to the international taxation of multinational corporations in developed countries, with particular emphasis on the EEC and the United States, integrating both legal and economic aspects of the subject. Since the international nature of the activities of multinational companies brings them within the scope of the domestic tax provisions of different countries, the authors outline the principles behind the domestic tax treatment of companies, and then assess the economic impact of this treatment. They subsequently examine the international taxation of multinationals, paying special attention to the OECD modelmore » treaty which seeks to remove the problem of international double taxation; reactions of governments to each other's fiscal policies are also examined, with special attention being paid to tax havens. Finally, they look at the EEC proposals for the harmonization of corporate tax systems within the Community and postulate how these proposals would operate if put into effect. There are numerous examples throughout the book of international taxation at work, and these together with the clear text provide a readily comprehensible account of a subject that can seem highly complicated to the uninitiated.« less

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

Couth, R.; Trois, C., E-mail: troisc@ukzn.ac.za

Highlights: Black-Right-Pointing-Pointer This is a compendium on GHG reductions via improved waste strategies in Africa. Black-Right-Pointing-Pointer This note provides a strategic framework for Local Authorities in Africa. Black-Right-Pointing-Pointer Assists LAs to select Zero Waste scenarios and achieve sustained GHG reduction. - Abstract: Only few Clean Development Mechanism (CDM) projects (traditionally focussed on landfill gas combustion) have been registered in Africa if compared to similar developing countries. The waste hierarchy adopted by many African countries clearly shows that waste recycling and composting projects are generally the most sustainable. This paper undertakes a sustainability assessment for practical waste treatment and disposal scenariosmore » for Africa and makes recommendations for consideration. The appraisal in this paper demonstrates that mechanical biological treatment of waste becomes more financially attractive if established through the CDM process. Waste will continue to be dumped in Africa with increasing greenhouse gas emissions produced, unless industrialised countries (Annex 1) fund carbon emission reduction schemes through a replacement to the Kyoto Protocol. Such a replacement should calculate all of the direct and indirect carbon emission savings and seek to promote public-private partnerships through a concerted support of the informal sector.« less

Improving the quality of health care: using international collaboration to inform guideline programmes by founding the Guidelines International Network (G-I-N)*

PubMed Central

Ollenschlager, G; Marshall, C; Qureshi, S; Rosenbrand, K; Burgers, J; Makela, M; Slutsky, J; t for

2004-01-01



 Clinical practice guidelines are regarded as powerful tools to achieve effective health care. Although many countries have built up experience in the development, appraisal, and implementation of guidelines, until recently there has been no established forum for collaboration at an international level. As a result, in different countries seeking similar goals and using similar strategies, efforts have been unnecessarily duplicated and opportunities for harmonisation lost because of the lack of a supporting organisational framework. This triggered a proposal in 2001 for an international guidelines network built on existing partnerships. A baseline survey confirmed a strong demand for such an entity. A multinational group of guideline experts initiated the development of a non-profit organisation aimed at promotion of systematic guideline development and implementation. The Guidelines International Network (G-I-N) was founded in November 2002. One year later the Network released the International Guideline Library, a searchable database which now contains more than 2000 guideline resources including published guidelines, guidelines under development, "guidelines for guidelines", training materials, and patient information tools. By June 2004, 52 organisations from 27 countries had joined the network including institutions from Oceania, North America, and Europe, and WHO. This paper describes the process that led to the foundation of the G-I-N, its characteristics, prime activities, and ideas on future projects and collaboration. PMID:15576708

Identifying barriers from home to the appropriate hospital through near-miss audits in developing countries.

PubMed

Filippi, Véronique; Richard, Fabienne; Lange, Isabelle; Ouattara, Fatoumata

2009-06-01

Near-miss cases often arrive in critical condition in referral hospitals in developing countries. Understanding the reasons why women arrive at these hospitals in a moribund state is crucial to the reduction of the incidence and case fatality of severe obstetric complications. This paper discusses how near-miss audits can empower the hospital teams to document and help reduce barriers to obstetric care in the most useful way and makes practical suggestions on interviews, analytical framework, ethical issues and staff motivation. Review of the evidence shows that case reviews and confidential enquiries appear particularly suitable to the understanding of delays. Criterion-based audits can also achieve this by establishing criteria for referral. However, hospital staff have limited intervention tools at their disposal to address barriers to emergency care at the community level. It is therefore important to involve the district management team and representatives of the community in auditing the health care seeking and treatment of women with near-miss complications.

Social inequalities in self-reported refraining from health care due to financial reasons in Sweden: health care on equal terms?

PubMed

Molarius, Anu; Simonsson, Bo; Lindén-Boström, Margareta; Kalander-Blomqvist, Marina; Feldman, Inna; Eriksson, Hans G

2014-11-29

The main goal of the health care system in Sweden is good health and health care on equal terms for the entire population. This study investigated the existence of social inequalities in refraining from health care due to financial reasons in Sweden. The study is based on 38,536 persons who responded to a survey questionnaire sent to a random sample of men and women aged 18-84 years in 2008 (response rate 59%). The proportion of persons who during the past three months due to financial reasons limited or refrained from seeking health care, purchasing medicine or seeking dental care is reported. The groups were defined by gender, age, country of origin, educational level and employment status. The prevalence of longstanding illness was used to describe morbidity in these groups. Differences between groups were tested with chi-squared statistics and multivariate logistic regression models. In total, 3% reported that they had limited or refrained from seeking health care, 4% from purchasing medicine and 10% from seeking dental care. To refrain from seeking health care was much more common among the unemployed (12%) and those on disability pension (10%) than among employees (2%). It was also more common among young adults and persons born outside the Nordic countries. Similar differences also apply to purchasing medicine and dental care. The odds for refraining from seeking health care, purchasing medicine or seeking dental care due to financial reasons were 2-3 times higher among persons with longstanding illness than among persons with no longstanding illness. There are social inequalities in self-reported refraining from health care due to financial reasons in Sweden even though the absolute levels vary between different types of care. Often those in most need refrain from seeking health care which contradicts the national goal of the health care system. The results suggest that the fare systems of health care and dental care should be revised because they contribute to inequalities in health care.

Experiences of registered nurses from a refugee background: A scoping review.

PubMed

Ng Chok, Harrison; Mannix, Judy; Dickson, Cathy; Wilkes, Lesley

2018-04-01

This scoping review presents an exploration of international literature on the factors that impact refugees' personal and professional experiences during their journey to being registered nurses in a new host country. Governments of host countries receiving refugees seek to develop strategies that facilitate the successful resettlement, employment and enculturation of refugees that arrive as skilled professionals. There is a scarcity of studies focussing on issues faced by refugees that are RNs or those pursuing nursing registration and employment in a new host country. This study is relevant for resettlement services, nursing registration authorities and education providers and informs the international nursing workforce. Scoping review. Databases such as MEDLINE, EMBASE, Cochrane Library, CINAHL; Google Scholar; PubMed; Scopus and Web of Science were searched for qualitative studies published up to and including 2017. Articles that did not specify explicitly the participants as registered nurses and/or refugees were excluded. All eligible articles were analysed for collective findings, and impact factors were extracted, synthesised and illustrated diagrammatically. This review explored six eligible articles and six impact factors were identified. The challenging impacts were as follows: loss of control; shock in a new environment and bleak employment prospects. Equally three impact factors: reconciling new reality; establishing a new identity and hope for the future, facilitate positive experiences for nurses in their successful transition into society and the nursing workplace. This scoping review reports the small number of international studies on the experiences of refugees seeking to become registered and employed as registered nurses. The six impact factors identified influence the lives of the nurse participants socio-economically in and out of the workplace. Policymakers, managers and educators providing resettlement, registration and employment services could develop strategies that enhance integration and transition experiences of refugees aspiring to be registered nurses. © 2018 John Wiley & Sons Ltd.

Quality and quantity of infertility care in Bangladesh.

PubMed

Fatima, P; Ishrat, S; Rahman, D; Banu, J; Deeba, F; Begum, N; Anwary, S A; Hossain, H B

2015-01-01

Infertility is an important health issue which has been neglected in the developing countries. First test-tube babies (triplet) in Bangladesh were born on 30th May, 2001. Although there is no tertiary level infertility center in the public sector, several private centers have come up with the facilities. The objective of the study was to find i) the quality and quantity of infertility care in Bangladesh and ii) the cause of infertility in the attending patients iii) the treatment seeking behaviors iv) and the reasons for not taking treatment among the attending patients. There are now 10 tertiary level Infertility centers in Bangladesh. The information was collected in a preformed datasheet about the facilities and the profile of the patients and the treatment seeking behavior of the attending patients. Out of the ten centers two centers refused to respond and did not disclose their data. Around 16700 new patients are enrolled in a year in the responsive clinics. Five percent (5%) of the patients underwent ART, 7% of the patients gave only one visit, 84% of the patients completed their evaluation, 76% of the patients took treatment. Causes of infertility in the patients taking treatment were male factor in 36.4%, bilateral tubal block in 20.2%, PCOS and anovulation in 31.7%, endometriosis in 19.6%, unexplained in 10.95, combined in 3.5%, ovarian failure in 1.4%, testicular failure in 0.33%, congenital anomaly in 0.3%. The main reason for not taking treatment was financial constrainment. The quality and quantity of infertility care is dependent on the available resources and on the use of the resources by the patients. In developing countries the resources are merging and confined to specified areas which cannot meet the demand of their population. The study gives us the idea of the need and the demand of the services in the country.

Volunteers in plastic surgery guidelines for providing surgical care for children in the less developed world: part II. Ethical considerations.

PubMed

Schneider, William J; Migliori, Mark R; Gosain, Arun K; Gregory, George; Flick, Randall

2011-09-01

Many international volunteer groups provide free reconstructive plastic surgery for the poor and underserved in developing countries. An essential issue in providing this care is that it meets consistent guidelines for both quality and safety-a topic that has been addressed previously. An equally important consideration is how to provide that care in an ethical manner. No literature presently addresses the various issues involved in making those decisions. With these ethical considerations in mind, the Volunteers in Plastic Surgery Committee of the American Society of Plastic Surgeons/Plastic Surgery Foundation undertook a project to create a comprehensive set of guidelines for volunteer groups planning to provide this type of reconstructive plastic surgery in developing countries. The committee worked in conjunction with the Society for Pediatric Anesthesia on this project. The Board of the American Society of Plastic Surgeons/Plastic Surgery Foundation has approved the ethical guidelines created for the delivery of care in developing countries. The guidelines address the variety of ethical decisions that may be faced by a team working in an underdeveloped country. These guidelines make it possible for a humanitarian effort to anticipate the types of ethical decisions that are often encountered and be prepared to deal with them appropriately. Any group seeking to undertake an international mission trip in plastic surgery should be able to go to one source to find a detailed discussion of the perceived needs in providing ethical humanitarian care. This document was created to satisfy that need and is a companion to our original guidelines addressing safety and quality.

Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis

PubMed Central

Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

2017-01-01

Objective Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. Setting The study focused on all 72 health districts of Zambia. Methods We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Results Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. Conclusions With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. PMID:28057650

Are We Doing Enough to Stem the Tide of Acquired MDR-TB in Countries with High TB Burden? Results of a Mixed Method Study in Chongqing, China

PubMed Central

Li, Ying; Ehiri, John; Oren, Eyal; Hu, Daiyu; Luo, Xingneng; Liu, Ying; Li, Daikun; Wang, Qingya

2014-01-01

Multi-drug resistant tuberculosis (MDR-TB) represents a threat to health and development in countries with high TB burden. China’s MDR-TB prevalence rate of 6.8% is the highest in the world. Interventions to remove barriers against effective TB control, and prevention of MDR-TB are urgently needed in the country. This paper reports a cross-sectional questionnaire survey of 513 pulmonary TB (PTB) patients, and qualitative interviews of 10 healthcare workers (HCWs), and 15 PTB patients. The objective was to assess barriers against effective control of PTB and prevention of MDR-TB by elucidating the perspectives of patients and healthcare providers. Results showed that more than half of the patients experienced patient delay of over 12.5 days. A similar proportion also experienced detection delay of over 30 days, and delay in initiating treatment of over 31 days. Consulting a non-TB health facility ≥3 times before seeking care at TB dispensary was a risk factor for both detection delay [AOR (95% CI): 1.89(1.07, 3.34) and delay in initiating treatment[AOR (95% CI): 1.88 (1.06, 3.36). Results revealed poor implementation of Directly Observed Therapy (DOT), whereby treatment of 34.3% patients was never monitored by HCWs. Only 31.8% patients had ever accessed TB health education before their TB diagnosis. Qualitative data consistently disclosed long patient delay, and indicated that patient’s poor TB knowledge and socioeconomic barriers were primary reasons for patient delay. Seeking care and being treated at a non-TB hospital was an important reason for detection delay. Patient’s long work hours and low income increased risk for treatment non-adherence. Evidence-based measures to improve TB health seeking behavior, reduce patient and detection delays, improve the quality of DOT, address financial and system barriers, and increase access to TB health promotion are urgently needed to address the burgeoning prevalence of MDR-TB in China. PMID:24505476

International stem cell tourism and the need for effective regulation. Part II: Developing sound oversight measures and effective patient support.

PubMed

Cohen, Cynthia B; Cohen, Peter J

2010-09-01

Part I of this article, published in the March 2010 issue of the Kennedy Institute of Ethics Journal, traces and addresses the provision of unproven stem cell treatments in Russia and India, examines the concept of innovative treatment, and concludes that stronger regulations are needed to protect the health and informed choices of patients. The current paper, Part II, proposes that the regulatory frameworks for the development of safe and efficacious treatments in effect in the United States and the United Kingdom provide examples of strong oversight measures from which countries seeking to obtain international credibility for their biotechnological competence could draw when developing regulations for stem cell treatments. Major sources of information available to persons who consider receiving such unproven treatments are explored in order to understand and address their concerns. The paper concludes with proposed measures to inform those considering the pursuit of unproven stem cell treatments abroad more accurately about their efficacy and safety and provide them with improved medical and social support in their home countries.

South East Asia, Differing Socioeconomic Factors, Differing Access to Radiotherapy: The Philippines, a Microcosm.

PubMed

Calaguas, Miriam Joy C; Gubat, Johannes A

2017-04-01

The accessibility of radiotherapy in Southeast Asia, a region characterized by diversity in both economy and culture, differ widely among its member countries. In most countries, access is not universal and is generally limited by radiotherapy resources and the health-seeking behavior of patients. This in turn relates to the current health policy in place, the practice of radiation oncology, and cultural factors such as religion and family dynamics. Although it is clear that radiotherapy access parallel economic development, it is also affected by different social factors that work to facilitate or impede its improvement. These factors are herein described in relation to the Philippine situation, where there is wide economic disparity, multiple subcultures, and logistical impediments to improving radiotherapy access, reminiscent of the Southeast Asian region. In the face of increasing cancer burden, it becomes increasingly important to improve services and develop new and efficient approaches taking different cultural factors into consideration. Through regional and international cooperation, solutions to the common and complex problem of inequity in radiotherapy access may be developed. Copyright © 2017. Published by Elsevier Inc.

Healthcare-seeking preferences of patients with sexually transmitted infection attending a tertiary care center in South Kerala.

PubMed

Jayapalan, Sabeena

2016-01-01

Sexually transmitted infections (STIs) are a major public health problem in developing countries. These diseases are associated with increased risk of transmission of human immunodeficiency virus as well as adverse outcomes on pregnancy and reproductive health. Sexual behavior and healthcare-seeking behavior are identified as the true risk factors of STIs. Hospital-based cross-sectional study design was adopted. Eighty-five STI patients were studied regarding the inappropriate treatment-seeking behavior, the nature of the first point of contact with the health care, the appropriateness of treatment and the concerns of the patient regarding the services rendered by government health-care facilities. Among the 85 patients studied, 55.3% were males and 44.7% were females. Inappropriate treatment-seeking behavior was seen in 29.8% of males and 36.8% of females. About 59.6% of males and 81.6% of females sought appropriate treatment from modern medicine practitioners before attending our institution. Only 7.1% of males and 3.2% of females received appropriate treatment. The government sector was the choice of treatment for 46.4% males and 93.5% females and this difference was statistically significant ( P = 0.00081). Lack of free medicines, issues of confidentiality, and privacy were the major service-related issues in the public sector. Appropriate treatment at the first point of contact with the health system is an important measure to prevent further transmission and development of complications. Health providers from both private and public sector should be given frequent periodic training regarding syndromic management of STIs and the training should stress on the need for risk reduction and condom promotion messages along with medical management. Program planners should take necessary steps to ensure adequate and continuous supply of free drugs and tackle issues of confidentiality and privacy.

Mapping health research capacity in 17 countries of the former Soviet Union and south-eastern Europe: an exploratory study.

PubMed

Santoro, Alessio; Glonti, Ketevan; Bertollini, Roberto; Ricciardi, Walter; McKee, Martin

2016-04-01

Policies to improve health status, tackle disease and ensure equitable access to healthcare should be informed by evidence derived from high-quality research. However, health research capacity is unevenly distributed across countries, as revealed by mapping exercises that have been undertaken to provide a basis for concerted action to strengthen capacity. This study systematically describes capacity to undertake health research in the countries of the former Soviet Union and south-eastern Europe and identifies the elements required to create a national health research system. The mapping exercise comprised two elements: a survey of key informants in the respective countries and a bibliometric analysis of scientific publications in the field of public health. Our results confirm that health research remains a low priority in some countries of the WHO European Region. In these countries, most of the literature was produced by researchers outside the country, often to inform international donors. This study provides important information for countries seeking to initiate action to strengthen their research capacity. There is a need for a comprehensive strategy with sustained investment in training and career development of researchers. There is also a need to create new funding systems to provide financial support to those undertaking policy-relevant research. International collaboration and investment in mechanisms to bridge the gap between research and policy are urgently required. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

A Qualitative Study of the Work Environments of Mexican Nurses

PubMed Central

Squires, Allison; Juarez, Adrian

2012-01-01

Background Studies of the nursing work environment are increasingly common in developed countries, but few exist in developing countries. Because of resource differences between the two contexts, researchers need to clarify what aspects of the work environments are similar and different. Objectives To study the perspectives of Mexican nurses about their work environments to determine similarities and differences to results from developed world studies. Design A secondary, directed content analysis of qualitative data from 46 Spanish language interviews using workplace-oriented themes Setting Purposively selected Mexican states from four regions of the country that reflect the country’s socioeconomic differences. Participants Practicing Mexican nurses with at least one year of clinical experience and currently working in nursing. Participants were recruited through convenience and snowball sampling techniques. Methods Initial data collection occurred in 2006 and 2008 during a broader study about professionalization processes that occurred in Mexican nursing between 1980 and 2005. The secondary, directed content analysis focused on an in-depth exploration of a central theme that emerged from the two original studies: The Workplace. The directed content analysis used themes from the global nursing work environment literature to structure the analysis: Professional relationships, organizational administrative practices, and quality of care and services. Results The three themes from the global literature were relevant for the Mexican context and a new one emerged related to hiring practices. By category, the same factors that created positive or negative perceptions of the work environment matched findings from other international studies conducted in developed countries. The descriptors of the category, however, had different conceptual meanings that illustrate the health system challenges in Mexico. Conclusions Findings from this study suggest that studies that seek to measure nursing work environments will most likely apply in Mexico and other Latin American or middle-income countries. Instruments designed to measure the work environment of nurses in these countries may prove relevant in those contexts, but require careful adaptation and systematic translations to ensure it. PMID:22386989

Anti-bacterial Treatments Using Peptide-Based Inhibitors of the STAT3-IL10 Pathway | NCI Technology Transfer Center | TTC

Cancer.gov

Tuberculosis (TB) is an infectious disease that typically affects the lungs. Current therapies include a panel of antibiotics given over a range of 6-9 months. As a result of the expense of treatment, the extended timeframe needed for effective treatment, and the scarcity of medicines in some developing countries, patient compliance with TB treatment is very low and results in multi-drug resistant TB (MDR-TB). There remains a need for a faster, more effective treatment for TB. NCI researchers seek licensing and/or co-development of peptide inhibitors of STAT3 and IL-10 developed to treat bacterial infections such as tuberculosis. See aslo: NIH inventions E-164-2007 and E-167-2010

Financial security for women -- Fem Consult congress.

PubMed

1996-01-01

The nongovernmental organization "Fem Consult," which seeks to strengthen the socioeconomic position of women by applying a gender perspective to programs and projects in developing countries, celebrated its 10th anniversary in 1996 by holding a conference in the Netherlands on financial security for women in the developing world. During the conference, the President of the WWF (Working Women's Forum) described her agency's 17 years of experience in lending to impoverished rural and urban women in India. By extending microcredit assistance through a network of cooperatives, the WWF has been the catalyst for lasting improvements in the economic and social status of impoverished women. Representatives of the Grameen Bank, Women's World Banking, the Ecumenical Development Cooperative Society, and other organizations also addressed the conference.

Communication strategy for implementing community IMCI.

PubMed

Ford, Neil; Williams, Abimbola; Renshaw, Melanie; Nkum, John

2005-01-01

In resource-poor developing countries, significant improvements in child survival, growth, and development can be made by: (a) shifting from sectoral programmes (for example, in nutrition or immunization) to holistic strategies such as the Integrated Management of Childhood Illnesses (IMCI) and (b) improving household and community care and health-seeking practices as a priority, while concurrently strengthening health systems and the skills of health professionals. This article focuses on household and community learning, and proposes a communication strategy for implementing community IMCI (c-IMCI) that is based on human rights principles such as inclusion, participation, and self-determination. Rather than attempt to change the care practices and health-seeking behaviour of individuals through the design and delivery of messages alone, it proposes an approach that is based on community engagement and discussion to create the social conditions in which individual change is possible. The strategy advocates for the integration of sectoral programmes rather than the development of new holistic programmes, so that integrated programmes are created from "multiple entry points". As integration occurs, the participatory communication processes that are used in sectoral programmes can be enriched and combined, improving the capacity of governments and agencies to engage community members effectively in a process of learning and action related to child health and development.

Adult Participation in Higher Education and the "Knowledge Economy": A Cross-National Analysis of Patterns of Delayed Participation in Higher Education across 15 European Countries

ERIC Educational Resources Information Center

Souto-Otero, Manuel; Whitworth, Adam

2017-01-01

"Delayed participation" in higher education (HE) is an increasingly important feature of modern HE systems in many countries. Despite this, surprisingly little empirical research has been undertaken seeking to better understand levels of delayed adult participation in HE across Europe. The present article responds to this gap by…

Cross-Cultural Validation of Teachers' Sense of Efficacy Scale in Three Asian Countries: Test of Measurement Invariance

ERIC Educational Resources Information Center

Ruan, Jiening; Nie, Youyan; Hong, Ji; Monobe, Gumiko; Zheng, Guomin; Kambara, Hitomi; You, Sula

2015-01-01

The purpose of this study is to validate the widely adopted Teachers' Sense of Efficacy Scale (TSES) for the East Asian context. The researchers seek to find out whether TSES holds validity and reliability and is appropriate for use to measure teacher efficacy in China, Korea, and Japan. 489 teachers from the three countries participated in the…

When Students Repeat Grades or Are Transferred out of School: What Does It Mean for Education Systems? PISA in Focus. No. 6

ERIC Educational Resources Information Center

OECD Publishing (NJ1), 2011

2011-01-01

School systems handle the challenges of diverse student populations in different ways. Some countries have non-selective and comprehensive school systems that seek to provide all students with similar opportunities, leaving it to individual schools and teachers to meet the particular needs of every student. Other countries group students, whether…

Official Positions for FRAX® clinical regarding international differences from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®.

PubMed

Cauley, Jane A; El-Hajj Fuleihan, Ghada; Arabi, Asma; Fujiwara, Saeko; Ragi-Eis, Sergio; Calderon, Andrew; Chionh, Siok Bee; Chen, Zhao; Curtis, Jeffrey R; Danielson, Michelle E; Hanley, David A; Kroger, Heikki; Kung, Annie W C; Lesnyak, Olga; Nieves, Jeri; Pluskiewicz, Wojciech; El Rassi, Rola; Silverman, Stuart; Schott, Anne-Marie; Rizzoli, Rene; Luckey, Marjorie

2011-01-01

Osteoporosis is a serious worldwide epidemic. Increased risk of fractures is the hallmark of the disease and is associated with increased morbidity, mortality and economic burden. FRAX® is a web-based tool developed by the Sheffield WHO Collaborating Center team, that integrates clinical risk factors, femoral neck BMD, country specific mortality and fracture data and calculates the 10 year fracture probability in order to help health care professionals identify patients who need treatment. However, only 31 countries have a FRAX® calculator at the time paper was accepted for publication. In the absence of a FRAX® model for a particular country, it has been suggested to use a surrogate country for which the epidemiology of osteoporosis most closely approximates the index country. More specific recommendations for clinicians in these countries are not available. In North America, concerns have also been raised regarding the assumptions used to construct the US ethnic specific FRAX® calculators with respect to the correction factors applied to derive fracture probabilities in Blacks, Asians and Hispanics in comparison to Whites. In addition, questions were raised about calculating fracture risk in other ethnic groups e.g., Native Americans and First Canadians. In order to provide additional guidance to clinicians, a FRAX® International Task Force was formed to address specific questions raised by physicians in countries without FRAX® calculators and seeking to integrate FRAX® into their clinical practice. The main questions that the task force tried to answer were the following: The Task Force members conducted appropriate literature reviews and developed preliminary statements that were discussed and graded by a panel of experts at the ISCD-IOF joint conference. The statements approved by the panel of experts are discussed in the current paper. Copyright © 2011. Published by Elsevier Inc.

Egyptian future physicians are packing to leave but may be willing to return.

PubMed

Fouad, Yousef A; Fahmy, Yara M; Abdel Hady, Sarah M; Elsabagh, Abdelrahman E

2015-05-01

The migration of physicians from the developing to the developed world remains a controversial topic with many proposed negative effects. Although Egypt remains a major supplier of international medical graduates, no exploration of the root causes of the issue or the required policy changes was attempted before. An online questionnaire was used to survey 940 Egyptian undergraduates enrolled at the Faculty of Medicine, Ain Shams University exploring their intentions of mobility following graduation and the factors impacting such intentions. Of the responding students, 85.7% (n=806) intended to leave the country for training following graduation, mostly seeking better research opportunities (mean 4.74) and working conditions (mean 4.64). Of those, 81.8% (659) reported their plan to eventually return after training, although at different intervals, principally driven by the feeling of belonging and desire to serve their country (mean 4.01). Due attention should be given to such an unnoticed country's issue with the adoption of evidence-based policy changes to minimize its negative effects. The affinity of the students to eventually return (driven by the desire to serve the country) could prove a valuable point to consider in policy-making. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Opposition to gender-sensitive development. Learning to answer back.

PubMed

Longwe, S H

1995-02-01

Opposition to gender-sensitive development policies can arise within the very development agencies charged with implementing the policies. Agencies may maintain that policies on equality for women are unnecessary because development is concerned with improving welfare in general. This can be refuted by referring to the literature which points out that failure to address the specific needs of women means their exclusion from the development process. Agencies may argue that women's equality is a political rather than a developmental issue. This is countered by the fact that the "Forward-Looking Strategies" define women's development, equality, and empowerment as intertwined processes. Agencies may say that promoting women's equality constitutes undue interference in a country's internal affairs. This is wrong because aid programs should not be supported in countries which do not support women's rights. Agencies may claim that they must work within the existing laws and policies of a developing country. This is partly correct, but the point must be limited because policies and laws may be "given," but they are not fixed. An agency may state that they have no business seeking or promoting change in existing social and customary practices. This is wrong where such practices stand in the way of development and because any development project is by definition a social and economic intervention. Agencies may consider their policy on women an inappropriate imposition of Western ideas. This is wrong because international conventions place a concern for women's rights on a level with a concern for human rights. Finally, agencies may maintain that women in developing countries do not desire equality with men. While it may be true that women accept their subordinate position, this does not offset issues of human rights and equal development. Oppressed women may be very silent; given the opportunity, they generally have a great deal to say.

"My child has a sleep problem": a cross-cultural comparison of parental definitions.

PubMed

Sadeh, Avi; Mindell, Jodi; Rivera, Luis

2011-05-01

Sleep problems are highly prevalent in early childhood. In many cases, parents seek professional help when they suspect their child suffers from a sleep problem. The aim of this study was to explore sleep, demographic and cultural factors associated with parental definition of child sleep problem in a large-scale, cross cultural study. Parents (or caregivers) of 29,287 infants and toddlers (aged 0-3 years) from 17 countries completed a questionnaire on their child's sleep patterns, sleep setting, and demographic variables. The results indicated that, in comparison to parents from predominantly Caucasian (PC) countries, parents from predominantly Asian (PA) countries were significantly more likely to identify a sleep problem in their children (26% vs 52% overall; 2% vs 17% "severe" sleep problem). Furthermore, whereas infant sleep variables were strong predictors of a sleep problem definition in PC countries, they were significantly less predictive in PA countries where demographic variables played a significant role. These results highlight the need to further explore the role of demographic and cultural variables in determining parental perception of a sleep problem, a perception that relates to help seeking professional treatment for infant sleep problems. Our findings also emphasize the need to educate parents about infant and toddler sleep and to provide parents information and screening tools to help them identify sleep problems in a more evidence-based approach. Copyright © 2011 Elsevier B.V. All rights reserved.

The introduction of new vaccines into developing countries. III. The role of intellectual property.

PubMed

Mahoney, Richard T; Pablos-Mendez, Ariel; Ramachandran, S

2004-01-26

The development of new vaccines that address the particular needs of developing countries has been proceeding slowly. A number of new public sector vaccine research and development initiatives have been launched to address this problem. These new initiatives find that they often wish to collaborate with the private sector and, in collaborating with the private sector, they must address issues of intellectual property (IP) management. It has not been well understood why IP management is important and how such management by public sector groups can best be conducted. IP management has become very important because vaccine research and development is driven by the regulatory process. The regulatory process has increased the cost of vaccine development to very high levels especially for the highly sophisticated new vaccines currently under development. Thus, investors seek IP protection for the required large investments. Conversely, we assert this concept as a new insight, IP rights are essential for mobilizing the significant funds necessary to meet regulatory requirements. Thus, IP rights are of value not only for investors but also for the public at large. In the absence of public sector mechanisms to carry out the functions that the private sector currently conducts, the public sector needs to increase its sophistication in IP management and needs to identify and implement strategies that will help the public sector to achieve its public health goals, especially for the poor and, among these individuals, the poor in developing countries. This paper suggests some strategies that might be used by the public sector to help achieve its public health goals, especially for the poor.

Reduced carbon intensity in highly developed countries: environmental kuznets curves for carbon dioxide

NASA Astrophysics Data System (ADS)

Kornhuber, Kai; Rybski, Diego; Costa, Luis; Reusser, Dominik E.; Kropp, Jürgen P.

2014-05-01

The Environmental Kuznets Curves (EKC) postulates that pollution increases with the income per capita up to a maximum, above which it decreases with the further increase in income per capita, i.e. following an inverse U-shape in the pollution vs. income per capita. It is commonly believed that EKC occurs for "local" pollutants such as nitrogen oxide and sulfur dioxide, but does not hold for CO2 emissions. This is attributed to the fact that while "local" pollutants cause a visible environmental damage on the local/regional scale (which authorities/governments seek to avoid), the consequences of CO2 emission have no immediate attributable local/regional consequences. We review EKC for CO2 exploring its relation between CO2 per capita and the Human Development Index (HDI) between 1990 and 2010 obtained from the World Bank database. We find evidence for a reduction in CO2 emissions per capita in highly developed countries. We propose a model according to which the emissions per capita of a country are composed of a component related to the actual state of development and a component related to the change of development. The model leads to four distinct cases of which two have EKC shape and two imply saturation. This outcome is in line with previously suggested qualitative relations. Our analysis indicates that the EKC shaped cases better describes the empirical values. We explore the less extreme version corresponding to the so-called conventional EKC and study the maximum of the fitted curve, providing a threshold-value for the HDI and a typical maximum value for the emissions per capita. We find that approx. 5 countries have crossed the CO2-HDI maximum, corresponding to approx. 1.5% of the world population.

The impact of the financial crisis on human resources for health policies in three southern-Europe countries.

PubMed

Correia, Tiago; Dussault, Gilles; Pontes, Carla

2015-12-01

The public health sector has been the target of austerity measures since the global financial crisis started in 2008, while health workforce costs have been a source of rapid savings in most European Union countries. This article aims to explore how health workforce policies have evolved in three southern European countries under external constraints imposed by emergency financial programmes agreed with the International Monetary Fund, Central European Bank and European Commission. The selected countries, Greece, Portugal and Cyprus, show similarities with regard to corporatist systems of social protection and comprehensive welfare mechanisms only recently institutionalized. Based on document analysis of the Memoranda of Understanding agreed with the Troika, our results reveal broadly similar policy responses to the crisis but also important differences. In Cyprus, General Practitioners have a key position in reducing public expenditure through gatekeeping and control of users' access, while Portugal and Greece seeks to achieve cost containment by constraining the decision-making powers of professionals. All three countries lack innovation as well as monitoring and assessment of the effects of the financial crisis in relation to the health workforce. Consequently, there is a need for health policy development to use human resources more efficiently in healthcare. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Drug supply indicators: Pitfalls and possibilities for improvements to assist comparative analysis.

PubMed

Singleton, Nicola; Cunningham, Andrew; Groshkova, Teodora; Royuela, Luis; Sedefov, Roumen

2018-06-01

Interventions to tackle the supply of drugs are seen as standard components of illicit drug policies. Therefore drug market-related administrative data, such as seizures, price, purity and drug-related offending, are used in most countries for policy monitoring and assessment of the drug situation. International agencies, such as the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the UN Office of Drugs and Crime, also monitor and report on the drug situation cross-nationally and therefore seek to collect and make available key data in a uniform manner from the countries they cover. However, these data are not primarily collected for this purpose, which makes interpretation and comparative analysis difficult. Examples of limitations of these data sources include: the extent to which they reflect operational priorities rather than market changes; question marks over the robustness of and consistency in data collection methods, and issues around the timeliness of data availability. Such problems are compounded by cultural, social and contextual differences between countries. Making sense of such data is therefore challenging and extreme care needs to be taken using it. Nevertheless, these data provide an important window on a hidden area, so improving the quality of the data collected and expanding its scope should be a priority for those seeking to understand or monitor drug markets and supply reduction. In addition to highlighting some of the potential pitfalls in using supply indicators for comparative analysis, this paper presents a selection of options for improvements based on the current EMCDDA programme of work to improve their supply-related monitoring and analysis. The conceptual framework developed to steer this work may have wider application. Adopting this approach has the potential to provide a richer picture of drug markets, at both national and international levels, and make it easier to compare data between countries. Copyright © 2018 Elsevier B.V. All rights reserved.

Suboptimal care and maternal mortality among foreign-born women in Sweden: maternal death audit with application of the ‘migration three delays’ model

PubMed Central

2014-01-01

Background Several European countries report differences in risk of maternal mortality between immigrants from low- and middle-income countries and host country women. The present study identified suboptimal factors related to care-seeking, accessibility, and quality of care for maternal deaths that occurred in Sweden from 1988–2010. Methods A subset of maternal death records (n = 75) among foreign-born women from low- and middle-income countries and Swedish-born women were audited using structured implicit review. One case of foreign-born maternal death was matched with two native born Swedish cases of maternal death. An assessment protocol was developed that applied both the ‘migration three delays’ framework and a modified version of the Confidential Enquiry from the United Kingdom. The main outcomes were major and minor suboptimal factors associated with maternal death in this high-income, low-maternal mortality context. Results Major and minor suboptimal factors were associated with a majority of maternal deaths and significantly more often to foreign-born women (p = 0.01). The main delays to care-seeking were non-compliance among foreign-born women and communication barriers, such as incongruent language and suboptimal interpreter system or usage. Inadequate care occurred more often among the foreign-born (p = 0.04), whereas delays in consultation/referral and miscommunication between health care providers where equally common between the two groups. Conclusions Suboptimal care factors, major and minor, were present in more than 2/3 of maternal deaths in this high-income setting. Those related to migration were associated to miscommunication, lack of professional interpreters, and limited knowledge about rare diseases and pregnancy complications. Increased insight into a migration perspective is advocated for maternity clinicians who provide care to foreign-born women. PMID:24725307

Defense.gov Special Report: Travels with Mullen - December 2010

Science.gov Websites

Department of Defense Submit Search December 2010 Top Stories Chairman Seeks to Restore Military Relationship two countries' stalled military-to-military relationship. Story Mullen Calls Cooperation Best Response

Comparative Medical Ethnobotany of the Senegalese Community Living in Turin (Northwestern Italy) and in Adeane (Southern Senegal)

PubMed Central

Ellena, Rachele; Quave, Cassandra L.; Pieroni, Andrea

2012-01-01

A medico-ethnobotanical survey was conducted among the Senegalese migrant communities of Turin (Piedmont, NW Italy) and their peers living in Adeane (Casamance, Southern Senegal), both among healers and laypeople. Through 27 in-depth interviews, 71 medicinal plant taxa were recorded and identified in Adeane and 41 in Turin, for a total of 315 different folk remedies recorded in Senegal and 62 in Turin. The large majority of the medicinal plants recorded among Senegalese migrants in Turin were also used in their country of origin. These findings demonstrate the resilience of home remedies among migrants and consequently the role they should have in shaping public health policies devoted to migrant groups in Western Countries, which seek to seriously take into account culturally sensitive approaches, that is, emic health-seeking strategies. PMID:22761638

The Sensation Seeking Scale (SSS-V) and Its Use in Latin American Adolescents: Alcohol Consumption Pattern as an External Criterion for Its Validation.

PubMed

Schmidt, Vanina; Molina, María Fernanda; Raimundi, María Julia

2017-11-01

Sensation Seeking is a trait defined by the seeking of varied, novel, complex, and intense situations and experiences, and the willingness to take physical, social, and financial risks for the sake of such experience. The Sensation Seeking Scale (SSS-V) is the most widely used measure to assess this construct. In previous studies a variety of psychometric limitations were found when using the SSS-V with Latin American population. The purpose of this study is to present additional psychometric properties for its use with Latin American adolescents. It was applied to a 506 adolescent sample (from 12 to 20 years). The result is a scale of 22 items that cover four factors. It seems that sensation seeking among Latin American adolescents can be described in terms of four factors, but with some slightly content differences from what is usually found in adult samples from other countries. Future lines of research are proposed.

The Sensation Seeking Scale (SSS-V) and Its Use in Latin American Adolescents: Alcohol Consumption Pattern as an External Criterion for Its Validation

PubMed Central

Schmidt, Vanina; Molina, María Fernanda; Raimundi, María Julia

2017-01-01

Sensation Seeking is a trait defined by the seeking of varied, novel, complex, and intense situations and experiences, and the willingness to take physical, social, and financial risks for the sake of such experience. The Sensation Seeking Scale (SSS-V) is the most widely used measure to assess this construct. In previous studies a variety of psychometric limitations were found when using the SSS-V with Latin American population. The purpose of this study is to present additional psychometric properties for its use with Latin American adolescents. It was applied to a 506 adolescent sample (from 12 to 20 years). The result is a scale of 22 items that cover four factors. It seems that sensation seeking among Latin American adolescents can be described in terms of four factors, but with some slightly content differences from what is usually found in adult samples from other countries. Future lines of research are proposed. PMID:29358988

The incidence of high medical expenses by health status in seven developed countries.

PubMed

Baird, Katherine Elizabeth

2016-01-01

Health care policy seeks to ensure that citizens are protected from the financial risk associated with needing health care. Yet rising health care costs in many countries are leading to a greater reliance on out-of-pocket (OOP) measures. This paper uses 2010 household survey data from seven countries to measure and compare the burden OOP expenses place on individuals. It compares countries based on the extent to which citizens with health problems devote a large share of their income to OOP expenses. The paper finds that in all countries but France, and to a lesser extent Slovenia, citizens with health problems face considerably higher medical costs than do those without. As many as one-quarter of less healthy citizens in the US, Poland, Russia and Israel devote a large share of their income to OOP expenses. The paper also finds a strong cross-national correlation between the degree to which citizens face high OOP expenses, and the disparities in OOP expenses between those with and without health problems. The levels of high OOP spending uncovered, and their inequitable impact on those with health problems in the seven countries, underscore the potential for OOP measures to undermine core objectives of health care systems, including those of equitable financing, equal access, and improved health among the population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Does a Mobile Phone Depression-Screening App Motivate Mobile Phone Users With High Depressive Symptoms to Seek a Health Care Professional's Help?

PubMed

BinDhim, Nasser F; Alanazi, Eman M; Aljadhey, Hisham; Basyouni, Mada H; Kowalski, Stefan R; Pont, Lisa G; Shaman, Ahmed M; Trevena, Lyndal; Alhawassi, Tariq M

2016-06-27

The objective of disease screening is to encourage high-risk subjects to seek health care diagnosis and treatment. Mobile phone apps can effectively screen mental health conditions, including depression. However, it is not known how effective such screening methods are in motivating users to discuss the obtained results of such apps with health care professionals. Does a mobile phone depression-screening app motivate users with high depressive symptoms to seek health care professional advice? This study aimed to address this question. This was a single-cohort, prospective, observational study of a free mobile phone depression app developed in English and released on Apple's App Store. Apple App Store users (aged 18 or above) in 5 countries, that is, Australia, Canada, New Zealand (NZ), the United Kingdom (UK), and the United States (US), were recruited directly via the app's download page. The participants then completed the Patient Health Questionnaire (PHQ-9), and their depression screening score was displayed to them. If their score was 11 or above and they had never been diagnosed with depression before, they were advised to take their results to their health care professional. They were to follow up after 1 month. A group of 2538 participants from the 5 countries completed PHQ-9 depression screening with the app. Of them, 322 participants were found to have high depressive symptoms and had never been diagnosed with depression, and received advice to discuss their results with health care professionals. About 74% of those completed the follow-up; approximately 38% of these self-reported consulting their health care professionals about their depression score. Only positive attitude toward depression as a real disease was associated with increased follow-up response rate (odds ratio (OR) 3.2, CI 1.38-8.29). A mobile phone depression-screening app motivated some users to seek a depression diagnosis. However, further study should investigate how other app users use the screening results provided by such apps.

Addressing Women's Non-Maternal Healthcare Financing in Developing Countries: What Can We Learn from the Experiences of Rural Indian Women?

PubMed Central

Gopalan, Saji S.; Durairaj, Varatharajan

2012-01-01

Background and Objectives This paper focuses on the inadequate attention on women's non-maternal healthcare in low- and middle-income countries. The study assessed the purchase of and financial access to non-maternal healthcare. It also scoped for mainstreaming household financial resources in this regard to suggest for alternatives. Methods A household survey through multi-stage stratified sampling in the state of Orissa interviewed rural women above 15 years who were neither pregnant nor had any pregnancy-related outcome six weeks preceding the survey. The questions explored on the processes, determinants and outcomes of health seeking for non-maternal ailments. The outcome measures were healthcare access, cost of care and financial access. The independent variables for bivariate and multivariate analyses were contextual factors, health seeking and financing pattern. Results The survey obtained a response rate of 98.64% and among 800 women, 43.8% had no schooling and 51% were above 60 years. Each woman reported at least one episode of non-maternal ailment; financial constraints prevented 68% from receiving timely and complete care. Distress coping measures (e.g. borrowings) dominated the financing source (67.9%) followed by community–based measures (32.1%). Only 6% had financial risk-protection; financial risk of not obtaining care doubled for women aged over 60 years (OR 2.00, 95% CI 0.84–4.80), seeking outpatient consultation (OR 2.01, 95% CI 0.89–4.81), facing unfavourable household response (OR 2.04, 95% CI 1.09–3.83), and lacking other financial alternatives (OR 2.13, 95% CI 1.11–4.07). When it comes to timely mobilization of funds and healthcare seeking, 90% (714) of the households preferred maternal care to non-maternal healthcare. Conclusion The existing financing options enable sub-optimal purchase of women's non-maternal healthcare. Though dominant, household economy extends inadequate attention in this regard owing to its unfavourable approach towards non-maternal healthcare and limited financial capacity and support from other financial resources. PMID:22272262

Hope from Abroad in the International Medical Travel of Yemeni Patients.

PubMed

Kangas, Beth

2007-12-01

Studies of care-seeking behaviour have generally focused only on the medical facilities that are available within a country's national boundaries. However, a growing number of patients worldwide are pursuing medical services outside of their own countries. The burgeoning literature on 'medical tourism' tends to offer the perspectives of the treatment destinations, not the experiences of patients. This paper examines the international medical travel of patients from the capital-poor country of Yemen. Families in Yemen often sacrifice greatly to seek the advanced, trustworthy technological medicine that is unavailable locally. The paper draws on interviews conducted with 71 Yemeni medical travellers in India and Jordan, as well as a survey of 205 doctors in Yemen about their disclosure practices regarding terminally ill patients. While perhaps an attractive option in today's global world, the use of medical services abroad affects local perceptions: it perpetuates a lack of trust in local capabilities, invites criticism of the government for not providing care to its citizens and fosters the hope that a cure exists somewhere in the world.

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

PubMed

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

2012-02-01

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

Mobilizing Science, Evidence and Technology for the Sendai Framework

NASA Astrophysics Data System (ADS)

Calkins, J. A.

2015-12-01

In March 2015, UN member states adopted the Sendai Framework for Disaster Risk Reduction: 2015-2030. The Sendai Framework recognises the cross-cutting nature of DRR policy and calls on a range of stakeholders to help governments. The Sendai Framework sets the aim of achieving "the substantial reduction of disaster risk and losses in lives, livelihoods and health and in the economic, physical, social, cultural and environmental assets of persons, businesses, communities and countries" (para 16). The international science community is acknowledged as a key stakeholder in supporting countries to implement the Sendai Framework. With this call to action and the gravity of disaster risk escalating around the globe, it is now vital that scientific knowledge and research resources are shared and become accessible in a form that can directly support coordinated application. Recent work is presented on the DRR gaps voiced by governments and scientists across a range of science and technology related needs, including through the drafting process for the Sendai Framework. Across regions and development levels, countries are seeking to address specific gaps they face in scientific capacities and information. Considering the many existing programmes, research initiatives and resources already seeking to generate evidence on DRR at all scales, how can science and technology improve delivery? Models and case studies prompt a useful discussion on what does and does not work. We provide an example of recent work in the UK disasters research community to assess scientific and technical capacity and collaborative effort to fulfil the commitment of the Sendai Framework. While there is no one-size-fits-all, any implementation approach needs to take into account the extraordinary, dynamic and localised nature of disasters and needs to be able to deliver relevant information to decision-makers at national and local levels, in a timely manner.

A Spatiotemporal Analysis of Brazilian Science from the Perspective of Researchers’ Career Trajectories

PubMed Central

Furtado, Caio Alves; Davis, Clodoveu A.; Gonçalves, Marcos André; de Almeida, Jussara Marques

2015-01-01

The growth of Brazilian scientific production in recent years is remarkable, which motivates an investigation on the factors, inside and outside the country, that helped shape this wealthy research environment. This article provides a thorough analysis of the education of researchers that constitute the main Brazilian research groups, using data on about 6,000 researchers involved in the country’s National Institutes of Science and Technology (INCT) initiative. Data on the steps taken by each researcher in her education, from the bachelor’s degree to doctorate, including a possible postdoctoral experience, and employment, are extracted from an official curriculum vitae repository. The location and the time at which each career step occurred define spatiotemporal career trajectories. We then analyze such trajectories considering additional data, including the area of knowledge of the INCTs to which each researcher is associated. We found an increasing prevalence of Brazilian institutions in the education of Brazilian scientists, as the number of doctorates earned abroad is decreasing over time. Postdoctoral stages, on the other hand, often take place in Europe or in the United States. Taking an international postdoctoral position after a full education in Brazil suggests a drive towards seeking higher-level exchange and cooperation with foreign groups in a more advanced career stage. Results also show that Brazilian researchers tend to seek employment in regions that are close to the institutions at which they received their bachelor’s degrees, suggesting low mobility within the country. This study can be instrumental in defining public policies for correcting distortions, and can help other developing countries that aim to improve their national science systems. PMID:26513743

Reflections on a Heart Surgery Career with Insights for Western-Trained Medical Specialists in Developing Countries

PubMed Central

Kabbani, Sami S.

2011-01-01

Herein, I describe my experience (spanning 40 years) in helping to develop the specialty of cardiovascular surgery in Syria. Especially in the early years, the challenges were daunting. We initially performed thoracic, vascular, and closed-heart operations while dealing with inadequate facilities, bureaucratic delays, and poorly qualified personnel. After our independent surgical center was established in early 1976, we performed 1 open-heart and 1 closed-heart procedure per day. Open-heart procedures evolved from the few and simple to the multiple and complex, and we solved difficulties as they arose. Today, our cardiac surgical center occupies an entire 6-floor building. We have 12 cardiac surgeons, 10 surgical residents, a formal 6-year surgical residency program, a pediatric cardiac unit, an annual caseload of 1,600, and plans to double our productivity in 2 years. The tribulations of establishing sophisticated surgical programs in a developing country are offset by the variety of clinicopathologic conditions that are encountered, and even more so by the psychological rewards of overcoming adversity and serving a population in need. This account may prove to be insightful for Western-trained physicians who seek to develop specialized medical care in emerging societies. PMID:21841854

Electives: isn't it time for a change?

PubMed

Dowell, Jon; Merrylees, Neil

2009-02-01

Medical student electives are memorable learning experiences, of which approximately 40% are spent in developing countries. Students often have laudable motivation but are rarely helped to learn most effectively or contribute meaningfully whilst away. Each year an estimated 350 years of elective time is spent in developing countries (by students from the UK alone), which represents substantial opportunity. We conducted a literature search prior to developing an alternative approach towards electives based upon educational and ethical principles. Despite their anecdotal value there has been little empirical research conducted into electives. From our review we identified four key learning domains (Clinical Knowledge and Skills, Attitudes, Global Perspectives, Personal and Professional Development) and two broader issues (Institutional Benefits and Moral/Ethical Considerations). Potentially beneficial and more structured alternatives are emerging and improvements appear possible through institutional collaborations and greater planning in order to maximise the educational experience, opportunities to contribute and minimise the risks involved in electives. Electives are a highlight of clinical training but probably often represent missed opportunities. There are both educational and moral reasons for seeking more considered approaches to reduce the 'medical tourism' that can result from the current largely ad hoc arrangements.

Reflections on a heart surgery career with insights for Western-trained medical specialists in developing countries.

PubMed

Kabbani, Sami S

2011-01-01

Herein, I describe my experience (spanning 40 years) in helping to develop the specialty of cardiovascular surgery in Syria. Especially in the early years, the challenges were daunting. We initially performed thoracic, vascular, and closed-heart operations while dealing with inadequate facilities, bureaucratic delays, and poorly qualified personnel. After our independent surgical center was established in early 1976, we performed 1 open-heart and 1 closed-heart procedure per day. Open-heart procedures evolved from the few and simple to the multiple and complex, and we solved difficulties as they arose. Today, our cardiac surgical center occupies an entire 6-floor building. We have 12 cardiac surgeons, 10 surgical residents, a formal 6-year surgical residency program, a pediatric cardiac unit, an annual caseload of 1,600, and plans to double our productivity in 2 years. The tribulations of establishing sophisticated surgical programs in a developing country are offset by the variety of clinicopathologic conditions that are encountered, and even more so by the psychological rewards of overcoming adversity and serving a population in need. This account may prove to be insightful for Western-trained physicians who seek to develop specialized medical care in emerging societies.

Socioeconomic profile of couples seeking the public healthcare system (SUS) for infertility treatment

PubMed Central

Tavares, Rachel; Cunha, Gisele; Aguiar, Lilian; Duarte, Shaytner Campos; Cardinot, Nilza; Bastos, Elizabeth; Coelho, Francisco

2016-01-01

Objective The number of couples seeking assisted reproduction services in pursuit of the dream of conceiving a child is growing. In developing countries 10 to 15% of couples of childbearing age cannot bear a child by natural means and the impossibility of conceiving a child has a significant impact on the health and well-being of the couple. The aim of this study was to evaluate the socioeconomic profile and the main causes of infertility of couples seeking assisted reproduction treatment through the public healthcare system. Methods We analyzed 600 medical records of couples who sought infertility treatment at the public healthcare system, and we divided them into three groups according to age: 35 years, 35 to 39, and 40 years or more. In each group we analyzed the cause of infertility, the number of children of the spouses, the education level and family income. Results The main cause of infertility was male-related in 34%, followed by tubal factor in 31.5%. We found that 56% of the women were less than 35 years old and 58% of the couples earned less than 3 minimum wages. Conclusion The profile of the couples was: low-income, low education and less than 35 years of age. The cost of assisted reproductive treatment is still high, being restricted to couples of higher socioeconomic statuses. An effective public healthcare policy could minimize this problem by improving the quality of care for couples seeking infertility treatment at the public healthcare system. PMID:27584602

Socioeconomic profile of couples seeking the public healthcare system (SUS) for infertility treatment.

PubMed

Tavares, Rachel; Cunha, Gisele; Aguiar, Lilian; Duarte, Shaytner Campos; Cardinot, Nilza; Bastos, Elizabeth; Coelho, Francisco

2016-08-01

The number of couples seeking assisted reproduction services in pursuit of the dream of conceiving a child is growing. In developing countries 10 to 15% of couples of childbearing age cannot bear a child by natural means and the impossibility of conceiving a child has a significant impact on the health and well-being of the couple. The aim of this study was to evaluate the socioeconomic profile and the main causes of infertility of couples seeking assisted reproduction treatment through the public healthcare system. We analyzed 600 medical records of couples who sought infertility treatment at the public healthcare system, and we divided them into three groups according to age: 35 years, 35 to 39, and 40 years or more. In each group we analyzed the cause of infertility, the number of children of the spouses, the education level and family income. The main cause of infertility was male-related in 34%, followed by tubal factor in 31.5%. We found that 56% of the women were less than 35 years old and 58% of the couples earned less than 3 minimum wages. The profile of the couples was: low-income, low education and less than 35 years of age. The cost of assisted reproductive treatment is still high, being restricted to couples of higher socioeconomic statuses. An effective public healthcare policy could minimize this problem by improving the quality of care for couples seeking infertility treatment at the public healthcare system.

Public Expenditure and Scheduled Community Enrolment in Higher Education: A Comparison across Indian States

ERIC Educational Resources Information Center

Sumithra, S.; Vardhan, R. Vishnu; Aruna, C.

2014-01-01

In India, the gross enrolment ratio has increased from 13.1 per cent in 2007-2008 to 15 per cent in 2011-2012 which moves the country from elite to a mass higher education system. This article seeks to examine the enrolment of scheduled caste (SC) students across various states in the country and the expenditure by each state and its effect on SC…

Factors affecting employment in the Arabian Gulf region, 1975-1985.

PubMed

Looney, R E

1991-01-01

"This paper attempts to shed light on factors contributing to the identification of the main employment patterns in the countries of the Arab Gulf region. It also seeks to answer the question of how determinants of employment vary between national and foreign workforces and whether these determinants have changed over time." The countries concerned are Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. excerpt

Models of "The Heavens and the Earth": An Investigation of German and Taiwanese Students' Alternative Conceptions of the Universe

ERIC Educational Resources Information Center

Liu, Shu-Chiu

2005-01-01

The paper reports a cross-cultural investigation conducted in 2001-2002 that seeks to reveal students' alternative ideas in two countries, Taiwan and Germany. It was carried out by means of semi-structured interviews in a story form. The targeted students were arbitrarily selected from grades 3 to 6 in both countries and amounted to 64. The…

Predictors and reasons for help-seeking behavior among women with urinary incontinence.

PubMed

Schreiber Pedersen, Louise; Lose, Gunnar; Høybye, Mette Terp; Jürgensen, Martina; Waldmann, Annika; Rudnicki, Martin

2018-04-01

The aim of the study was to evaluate the predictors and reasons for help-seeking behavior among women with urinary incontinence (UI) in Germany and Denmark. This international postal survey was conducted in 2014. In each country, 4,000 women of at least 18 years of age were randomly selected. The questionnaires included validated items regarding help-seeking behavior and the ICIQ-UI SF. UI was defined as any involuntary loss of urine. Binary logistic regression analysis was used to assess factors predicting help-seeking behavior. Reasons for seeking or not seeking help were evaluated in terms of the severity of UI and as the most frequently reported. Of 1,063 Danish women with UI, 25.3% had consulted a physician compared with 31.4% of 786 German women with UI (p = 0.004). The severity and duration of UI, and actively seeking information regarding UI, were significant independent predictors of help-seeking behavior. Women with slight/moderate UI did not seek help because they did not consider UI as a problem, whereas of women with severe/very severe UI, German women reported that other illnesses were more important and Danish women reported that they did not have enough resources to consult a physician. Only a small proportion of women with UI had consulted a physician, and the driving forces for help-seeking behavior were severity and duration of UI and actively seeking information regarding UI. Public information campaigns might enhance consultation rates providing that passively receiving and actively seeking information have the same effects on help-seeking behavior. We show for the first time that reasons for not consulting a physician for UI vary depending on the severity of the UI.

Whiplash Syndrome Reloaded: Digital Echoes of Whiplash Syndrome in the European Internet Search Engine Context.

PubMed

Noll-Hussong, Michael

2017-03-27

In many Western countries, after a motor vehicle collision, those involved seek health care for the assessment of injuries and for insurance documentation purposes. In contrast, in many less wealthy countries, there may be limited access to care and no insurance or compensation system. The purpose of this infodemiology study was to investigate the global pattern of evolving Internet usage in countries with and without insurance and the corresponding compensation systems for whiplash injury. We used the Internet search engine analytics via Google Trends to study the health information-seeking behavior concerning whiplash injury at national population levels in Europe. We found that the search for "whiplash" is strikingly and consistently often associated with the search for "compensation" in countries or cultures with a tort system. Frequent or traumatic painful injuries; diseases or disorders such as arthritis, headache, radius, and hip fracture; depressive disorders; and fibromyalgia were not associated similarly with searches on "compensation." In this study, we present evidence from the evolving viewpoint of naturalistic Internet search engine analytics that the expectations for receiving compensation may influence Internet search behavior in relation to whiplash injury. ©Michael Noll-Hussong. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 27.03.2017.

Impact of measles supplementary immunisation activities on utilisation of maternal and child health services in low-income and middle-income countries.

PubMed

Postolovska, Iryna; Helleringer, Stéphane; Kruk, Margaret E; Verguet, Stéphane

2018-01-01

Measles supplementary immunisation activities (SIAs) are an integral component of measles elimination in low-income and middle-income countries (LMICs). Despite their success in increasing vaccination coverage, there are concerns about their negative consequences on routine services. Few studies have conducted quantitative assessments of SIA impact on utilisation of health services. We analysed the impact of SIAs on utilisation of selected maternal and child health services using Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 28 LMICs, where at least one SIA occurred over 2000-2014. Logistic regressions were conducted to investigate the association between SIAs and utilisation of the following services: facility delivery, postnatal care and outpatient sick child care (for fever, diarrhoea, cough). SIAs do not appear to significantly impact utilisation of maternal and child services. We find a reduction in care-seeking for treatment of child cough (OR 0.67; 95% CI 0.48 to 0.95); and a few significant effects at the country level, suggesting the need for further investigation of the idiosyncratic effects of SIAs in each country. The paper contributes to the debate on vertical versus horizontal programmes to ensure universal access to vaccination. Measles SIAs do not seem to affect care-seeking for critical conditions.

Physicists without borders

NASA Astrophysics Data System (ADS)

Jeandron, Michelle

2008-06-01

The International Atomic Energy Agency (IAEA), which has its headquarters in Vienna, Austria, is a specialized agency of the United Nations (UN) that seeks to promote the safe, secure and peaceful use of nuclear technology. It has three main areas of expertise. It is the world's nuclear inspectorate, sending inspectors to more than 140 UN member states, from Brazil to Japan, to verify that nuclear technology is not being used for military purposes. The IAEA also helps countries to improve their nuclear safety procedures and to prepare for emergencies. Finally, it serves as a focal point for the world's development of nuclear science and technology across all fields.

Developing perspectives on Korean nursing theory: the influences of Taoism.

PubMed

Shin, K R

2001-10-01

Nursing theory provides a systematic explanation and description of nursing phenomena. Western nursing theories have widely influenced Korean nursing. And yet, although nursing theory has universal aspects, the differences in philosophy and culture that are unique to each country need to be considered. This inquiry seeks to investigate the Korean cultural heritage, which integrates Confucianism, Buddhism, and Taoism, and how it provides a unique worldview of human beings, the universe, health, and nursing. Essential principles and therapies consistent with Taoist philosophy are also identified. This framework is proffered as the basis for establishing understanding between Korean nurses and patients.

More Trees, More Poverty? The Socioeconomic Effects of Tree Plantations in Chile, 2001-2011

NASA Astrophysics Data System (ADS)

Andersson, Krister; Lawrence, Duncan; Zavaleta, Jennifer; Guariguata, Manuel R.

2016-01-01

Tree plantations play a controversial role in many nations' efforts to balance goals for economic development, ecological conservation, and social justice. This paper seeks to contribute to this debate by analyzing the socioeconomic impact of such plantations. We focus our study on Chile, a country that has experienced extraordinary growth of industrial tree plantations. Our analysis draws on a unique dataset with longitudinal observations collected in 180 municipal territories during 2001-2011. Employing panel data regression techniques, we find that growth in plantation area is associated with higher than average rates of poverty during this period.

More Trees, More Poverty? The Socioeconomic Effects of Tree Plantations in Chile, 2001-2011.

PubMed

Andersson, Krister; Lawrence, Duncan; Zavaleta, Jennifer; Guariguata, Manuel R

2016-01-01

Tree plantations play a controversial role in many nations' efforts to balance goals for economic development, ecological conservation, and social justice. This paper seeks to contribute to this debate by analyzing the socioeconomic impact of such plantations. We focus our study on Chile, a country that has experienced extraordinary growth of industrial tree plantations. Our analysis draws on a unique dataset with longitudinal observations collected in 180 municipal territories during 2001-2011. Employing panel data regression techniques, we find that growth in plantation area is associated with higher than average rates of poverty during this period.

The tropics and the crime they did not commit.

PubMed

Goorhuis, A; van Thiel, P P A M; Middeldorp, S; van Eck, B L F; Grobusch, M P

2013-02-01

Travellers to tropical destinations who seek medical attention after returning to their home country often present with fever, frequently as a result of an imported infectious disease. For this reason, clinicians initially focus on an infectious cause when a clear relationship in time exists between travel and disease onset. We present a case of a patient, who developed fever 2 weeks after his return from Ghana and who was finally diagnosed with an auto-immune disease: arteritis of the large arteries. This case illustrates that broad differential diagnostic thinking is paramount in the assessment of returned travellers.

Canada seeks US financing waiver to clear Alaska Gas Pipeline's path

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

Corrigan, R.

1981-09-26

A Canadian official outlines in an interview his government's hope that the US will proceed with the financing and construction of the Alaska Highway natural gas pipeline. The Canadian portion of the pipeline was begun under good faith because Canada sees her best interests served when US supply needs are met and when both countries have the energy to develop and prosper. Canada asks the Reagan administration to present Congress with a waiver package that will facilitate financing by eliminating a prohibition against pipeline share ownership by the owners of gas in Alaska. (DCK)

New Work Systems and Skill Requirements.

ERIC Educational Resources Information Center

Cappelli, Peter; Rogovsky, Nikolai

1994-01-01

The relationship between production systems, work organization, and skills has become a policy consideration in many industrialized countries seeking to improve competitiveness without reducing wage standards. Decision makers should weigh the costs of making these changes. (JOW)

Coping Behavior of International Late Adolescent Students in Selected Australian Educational Institutions

PubMed Central

Shahrill, Masitah; Mundia, Lawrence

2014-01-01

Using the Adolescent Coping Scale, ACS (Frydenberg & Lewis, 1993) we surveyed 45 randomly selected foreign adolescents in Australian schools. The coping strategies used most by the participants were: focus on solving the problem; seeking relaxing diversions; focusing on the positive; seeking social support; worry; seeking to belong; investing in close friends; wishful thinking; and keep to self (Table 4). With regard to coping styles, the most widely used was the productive coping followed by non-productive coping while the least used style was reference to others (Table 4). In terms of both genders the four coping strategies used most often were: work hard to achieve; seeking relaxing diversions; focus on solving the problem; and focus on the positive (Table 5). The most noticeable gender difference was the use of the physical recreation coping strategy in which male students engaged more (Fig 1). The usage of four coping strategies (solving problem; work hard; focus on positive; and social support) was higher for students who have been away from family more than once as compared to those who have been away once only while the usage of seeking relaxing diversions was higher for the first timers (Table 6). No significant differences were obtained on the sample’s performance on the ACS subscales by gender (Table 7), frequency of leaving own country (Table 8), country of origin (Table 9), and length of stay in Australia (Table 11). However, foundation students scored significantly higher on the reference to others variable than their secondary school peers (Table 10). We recommended counseling for students with high support needs and further large-scale mixed-methods research to gain additional insights. PMID:24373267

Socio-demographic and clinical characteristics of clients seeking assisted conception at Lagos State University Teaching Hospital, Ikeja, Nigeria.

PubMed

Adewunmi, Adeniyi A; Ottun, Tawakwalit A; Abiara, Tayo; Chukwuma, Jane-Frances; Okorie, Lauretta

2017-10-01

The socio-demographic and clinical characteristics of 246 consecutive couples seeking assisted conception in a university teaching hospital in Nigeria from inception in 2011 till 2014 were reviewed restrospectively. Eighty-five (34.5%) were in the 35-40 years age group. The body mass index of the women showed that 111 (45.1%) were overweight. One hundred and ninety five (88%) were referred on account of secondary infertility. The mean duration of infertility was 9.6 ± 4.8 years. Major factors identified were male factor 128 (52%), ovarian/age-related decline in fertility 107 (43.5%), tubal 83 (33.7%) and combined male/female factor 71 (28.9%). One hundred and ninety (77.2%) clients seeking assisted conception were Christians at advanced age (greater than 35 years) with a longstanding duration of infertility of more than 10 years. Government, private and religious organisations need to raise public awareness about the availability of in-vitro fertilisation services as well as encourage early resort to assisted reproductive technologies. Impact statement What we already know: Secondary infertility due mainly to tubal factor is reported to be the commonest cause of infertility in developing countries like Nigeria and clients affected seek assisted reproductive techniques late. What the results of this study add: Male factor infertility is more common amongst infertile couples seeking in vitro fertilisation in LASUTH. The implications of the findings for practice and/or further research: A thorough examination of the male partner followed by investigation is vital at the initial visit so that they can be referred early for assisted conception.

The role of care-seeking delays in intrauterine fetal deaths among 'near-miss' women in Herat, Afghanistan.

PubMed

Hirose, Atsumi; Borchert, Matthias; Niksear, Homa; Alkozai, Ahmad S; Gardiner, Julian; Filippi, Véronique

2012-09-01

Many pregnant women in resource-poor countries seek care only after developing severe complications during childbirth at home and often reach health facilities in moribund conditions. The objectives were to (i) investigate the association between care-seeking duration and fetal survival at admission; and (ii) assess the significance of care-seeking duration in relation to other determinants. Data were analysed for 266 women who were pregnant with a singleton and admitted in life-threatening conditions to the maternity ward of Herat Regional Hospital in Afghanistan from February 2007 to January 2008. Information about the women's care-seeking durations, social and financial resources, reproductive factors, household economic status and household types were collected during interviews with the women and their husbands. Information about fetal heartbeats at admission was extracted from the women's medical records. Fifty-four per cent of the women had a decision delay lasting 3 h or more; 69% had a transport delay lasting 3 h or more. Multivariable logistic regression analyses suggest that a decision delay lasting an hour or more increased the odds of fetal death by 6.6 (95% confidence interval [CI] 1.6, 26.3) compared with a delay less than 1 h. A woman's lack of financial autonomy and a distance from her natal home increased the odds of fetal death by 3.1 [95% CI 1.1, 8.4] and 2.5 [95% CI 1.0, 6.3] respectively. An integrated approach to improving fetal and maternal health from pre-pregnancy through childbirth (including increasing women's social and financial resources) is crucial particularly where senior family members act as gatekeepers to women's access to health care. © 2012 Blackwell Publishing Ltd.

Bangladesh.

PubMed

1987-04-01

The population of Bangladesh was 104 million in 1986, with an annual growth rate of 2.6%. The country's infant mortality rate is 12.1%, and life expectancy stands at 54 years. The literacy rate is 29%. The work force of 34.1 million is distributed among agriculture (74%), industry (11%), and services (15%). The gross domestic product (GDP) is US$15.3 billion, with a real annual growth rate of 3.6% and a per capita GDP of $151. As one of the world's poorest and most densely populated countries, Bangladesh must struggle to produce domestically and import enough food to feed its rapidly increasing population. The country's transportation, communications, and power infrastructure is relatively poorly developed. Since 1971, an emphasis has been placed on developing new industrial capacity and rehabilitating the economy. The statist economic model, including nationalization of the key jute industry, had resulted in inefficiency and economic stagnation. At present, rapid population growth, inefficiency in the public sector, and restricted natural resources and capital continue to impede economic development. On the other hand, economic policies aimed at encouraging private enterprise and investment, denationalizing public industries, reinstating budgetary discipline, and mobilizing domestic resources are beginning to have an impact. Underemployment remains a serious problem, and there are growing concerns regarding the ability of the agricultural sector to absorb additional manpower. To reach the goal of 10% annual industrial growth for the 1986-89 period, the government is aggressively seeking foreign investment.

A new era for drinking? Epidemiological evidence on adolescent male-female differences in drinking incidence in the United States and Europe.

PubMed

Cheng, Hui G; Anthony, James C

2017-01-01

We seek answers to three questions about adolescent risk of starting to drink alcoholic beverages: (1) in new United States (US) data, can we reproduce a recently discovered female excess risk? (2) has a female excess risk emerged in European countries? and (3) might the size of country-level female-male differences (FMD) be influenced by macro-level gender equality and development processes? Estimates are from US and European surveys of adolescents, 2010-2014. For US estimates, newly incident drinking refers to consuming the first full drink during the 12-month interval just prior to assessment. For all countries, lifetime cumulative incidence of drinking refers to any drinking before assessment of the sampled 15-16 years. Cumulative meta-analysis summary estimates from the US show a highly reproducible female excess in newly incident drinking among 12-17 years (final estimated female-male difference in risk, FMD = 2.1%; 95% confidence interval = 1.5%, 2.7%). Several European countries show female excess risk, estimated as lifetime cumulative incidence of drinking onsets before age 17 years. At the country level, the observed magnitude of FMD in risk is positively associated with the Gender Development Index (especially facets related to education and life expectancy of females relative to males), and with residence in a higher income European country. New FMD estimates support reproducibility of a female excess risk in the US. In Europe, evidence of a female excess is modest. Educational attainment, life expectancies, and income merit attention in future FMD research on suspected macro-level processes that influence drinking onsets.

Satisfaction des exigences minimales du marché du travail par le système éducatif: Evaluation dans un contexte de faible système d'information sur la formation et l'emploi

NASA Astrophysics Data System (ADS)

Pieume, Calice Olivier

2016-12-01

Satisfying the minimum requirements of the labour market through the education system: Assessment in a context of weak training and employment data - The number of young people entering the labour market in Africa will increase considerably over the next two decades. With nearly 200 million young people aged 15-24, Africa has the youngest population in the world; this volume will double by 2045. As the question of the professional integration of young people in Africa is set to become even more pressing over the next two decades, it is imperative that African countries prepare for this time bomb. The education system, while not the only deciding factor, bears a responsibility in the difficult professional integration of young people. To fully play its role, it must be organised according to the country's development needs and the demands of the labour market. Establishing a proven process of assessing, analysing and anticipating economic demand is an essential first step. Yet the majority of African countries have still not implemented such a system. Meanwhile, the education system must take steps to satisfy the minimum short-term requirements of the labour market. This article, which seeks to highlight these requirements, presents a method that enables countries to assess the minimum requirements of the labour market at specific periods and, in return, to assess the degree to which the education system satisfies these requirements. The method is developed especially for countries with weak systems of collecting data on education, training and employment, as is the case in most sub-Saharan countries.

A new era for drinking? Epidemiological evidence on adolescent male-female differences in drinking incidence in the United States and Europe

PubMed Central

Cheng, Hui G.; Anthony, James C.

2016-01-01

Purpose We seek answers to three questions about adolescent risk of starting to drink alcoholic beverages: (1) In new United States (US) data, can we reproduce a recently discovered female excess risk? (2) Has a female excess risk emerged in European countries? and (3) Might the size of country-level female-male differences (FMD) be influenced by macro-level gender equality and development processes? Methods Estimates are from US and European surveys of adolescents, 2010–2014. For US estimates, newly incident drinking refers to consuming the first full drink during the 12-month interval just prior to assessment. For all countries, lifetime cumulative incidence of drinking refers to any drinking before assessment of the sampled 15-to-16-year-olds. Results Cumulative meta-analysis summary estimates from the US show a highly reproducible female excess in newly incident drinking among 12-to-17-year-olds (final estimated female-male difference in risk, FMD = 2.1%; 95% confidence interval = 1.5%, 2.7%). Several European countries show female excess risk, estimated as lifetime cumulative incidence of drinking onsets before age 17 years. At the country level, the observed magnitude of FMD in risk is positively associated with the Gender Development Index (especially facets related to education and life expectancy of females relative to males), and with residence in a higher income European country. Conclusions New FMD estimates support reproducibility of a female excess risk in the US. In Europe, evidence of a female excess is modest. Educational attainment, life expectancies, and income merit attention in future FMD research on suspected macro-level processes that influence drinking onsets. PMID:27915406

Stabilisation and humanitarian access in a collapsed state: the Somali case.

PubMed

Menkhaus, Ken

2010-10-01

Somalia today is the site of three major threats: the world's worst humanitarian crisis; the longest-running instance of complete state collapse; and a robust jihadist movement with links to Al-Qa'ida. External state-building, counter-terrorism and humanitarian policies responding to these threats have worked at cross-purposes. State-building efforts that insist humanitarian relief be channelled through the nascent state in order to build its legitimacy and capacity undermine humanitarian neutrality when the state is a party to a civil war. Counter-terrorism policies that seek to ensure that no aid benefits terrorist groups have the net effect of criminalising relief operations in countries where poor security precludes effective accountability. This paper argues that tensions between stabilisation and humanitarian goals in contemporary Somalia reflect a long history of politicisation of humanitarian operations in the country. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

Individuals receiving specialized treatment for drug and alcohol dependence and gambling disorder in Israel--characteristics and implications for prevalence estimates.

PubMed

Lev-Ran, Shaul; Florentin, Iris; Feingold, Daniel; Rehm, Jürgen

2014-01-01

Substance dependence is one of the main factors contributing to morbidity and mortality worldwide. Gambling disorder has recently been included as an addictive disorder in DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) and is associated with substantial psychiatric comorbidity and respective disability. Nevertheless, the vast majority of those suffering from these disorders do not receive treatment. In Israel, prevalence of substance dependence has traditionally been estimated to be lower than those in high-income countries, though prevalence estimates from the recent decade are lacking. Moreover, characteristics of individuals seeking treatment for substance dependence and gambling disorder have not been published. In this study, the authors analyzed data from the Israel National Addiction Registry, a computerized database that includes sociodemographic characteristics of all individuals treated in specialized public facilities for substance dependence and gambling disorders in the years 2003-2012. The prevalence of treatment utilization for drug and alcohol dependence and gambling disorders were 0.2%, 0.1%, and 0.01%, respectively. These rates generally remained stable throughout the last decade. Individuals seeking treatment for alcohol dependence were in the lower socioeconomic status (SES) cluster, whereas those seeking treatment for drug dependence were in the midrange SES clusters, findings that are generally in concurrence with characteristics of treatment seekers in high-income countries. Prevalence estimates based on reports indicating that approximately 10% of individuals with substance dependence seek treatment suggest rates of alcohol dependence in Israel that are substantially higher those previously published, though still lower than most high-income countries. Nationwide epidemiologic studies exploring current rates of substance dependence and gambling disorder in Israel are urgently needed, and treatment options should be planned and funded accordingly. Potential reasons for these apparent low rates of treatment utilization for these disorders in Israel should be explored in order to improve services provided for this population.

Perceived Delay in Healthcare-seeking for Episodes of Serious Illness and Its Implications for Safe Motherhood Interventions in Rural Bangladesh

PubMed Central

Killewo, J.; Bashir, I.; Yunus, M.; Chakraborty, J.

2006-01-01

Delay in accessing emergency obstetric-care facilities during life-threatening obstetric complications is a significant determinant of high maternal mortality in developing countries. To examine the factors associated with delays in seeking care for episodes of serious illness and their possible implications for safe motherhood interventions in rural Bangladesh, a cross-sectional study was initiated in Matlab sub-district on the perceptions of household heads regarding delays in seeking care for episodes of serious illness among household members. Of 2,177 households in the study, 881 (40.5%) reported at least one household member who experienced an illness perceived to be serious enough to warrant care-seeking either from health facilities or from providers. Of these, 775 (88.0%) actually visited some providers for treatment, of whom 79.1% used transport. Overall, 69.3% perceived a delay in deciding to seek care, while 12.1% and 24.6% perceived a delay in accessing transport and in reaching the provider respectively. The median time required to make a decision to seek care was 72 minutes, while the same was 10 minutes to get transport and 80 minutes to reach a facility or a provider. Time to decide to seek care was shortest for pregnancy-related conditions and longest for illnesses classified as chronic, while time to reach a facility was longest for pregnancy-related illnesses and shortest for illnesses classified as acute. However, the perceived delay in seeking care did not differ significantly across socioeconomic levels or gender categories but differed significantly between those seeking care from informal providers compared to formal providers. Reasons for the delay included waiting time for results of informal treatment, inability to judge the graveness of disease, and lack of money. For pregnancy-related morbidities, 45% reported ‘inability to judge the graveness of the situation’ as a reason for delay in making decision. After controlling for possible confounders in multivariate analysis, type of illness and facility visited were the strongest determinants of delay in making decision to seek care. To reduce delays in making decision to seek care in rural Bangladesh, safe motherhood interventions should intensify behaviour change-communication efforts to educate communities to recognize pregnancy-danger signs for which a prompt action must be taken to save life. This strategy should be combined with efforts to train community-based skilled birth attendants, upgrading public facilities to provide emergency obstetric care, introduce voucher schemes to improve access by the poorest of the poor, and improve the quality of care at all levels. PMID:17591337

Rent-seeking behaviors in property development: A literature review

NASA Astrophysics Data System (ADS)

Ali, Suhaila; Aziz, Abdul Rashid Abdul

2017-11-01

This paper reviews the literature on rent-seeking behaviors in property development, and discusses three major areas: (1) definition and concept of rent-seeking; (2) factors for the rent-seeking behavior appeared; and (3) the impact of rent-seeking behaviors, particularly on property development. In general, there is no exact word that can define what rent-seeking is. It is found that from the reviewed studies that a few researches have adopted search tasks to predict rent-seeking behavior effects in the economy and the respective economic performance. Based on the findings of the review, rent-seeking behavior increases social cost and this might lead to problems such as corruption. This paper paves the way for future studies in examining rent-seeking behaviors in the Malaysian property development, especially for targeted actions to be taken to alleviate upward pressure on home prices.

China's Oral Care System in Transition: Lessons to be Learned from Germany

PubMed Central

Saekel, Ruediger

2010-01-01

Aim The objective of this discussion paper is to investigate whether the experience gained through the German paradigm shift in dental care can be of benefit in China's deliberations on the introduction of universal dental care for its people. Methodology A comparison of representative oral health outcome data from China and Germany, two countries at different stages in their development, is presented here in order to analyse whether the findings meet expected outcome and confirm the presumption that more developed countries perform better. Results The epidemiological comparison reveals surprising findings concerning the severity of dental diseases and, in particular, missing teeth per person in adults and rates of total edentulousness in seniors. In all of these areas German adults and seniors show significantly inferior outcomes compared with the Chinese population. The main reason for these striking discrepancies, as it turned out, is the decisive role played by the treatment philosophies and strategies of German dentists. Conclusion and recommendations If dentists take a less interventionist approach, checking as well as treating dental diseases with preventive and strictly tooth-preserving methods, dental treatment results in oral health. Under these conditions it can be assumed that modern dentistry is generally good for the teeth. These findings are important for developing countries that are seeking to integrate dental care into their health care system. On the basis of long-term experience from highly industrialized Western countries and especially from Germany we will attempt to put forward proposals for creating an effective and efficient dental care system in China. PMID:21125794

Are French general practitioners consulted before travel to developing countries? A cross-sectional study conducted in a French airport.

PubMed

Rovira, C; Buffel du Vaure, C; Partouche, H

2015-08-01

General practitioners (GPs) could play a central role in preventing travel-related health issues. The aim of this study was to assess, in travellers departing to developing countries from a French airport, the proportion of individuals having sought GP counseling before departure and to identify determinants for having consulted a GP. Cross-sectional study conducted between November 2012 and July 2013, in all adults living in France. Sociodemographic, health characteristics, type of travel and resources consulted before departure were collected. A descriptive analysis was performed. Determinants for having consulted a GP before departure were investigated using a logistic regression analysis. Of the 360 travellers included, 230 (64%) sought health counseling before departure. GPs were the main source of information for 134 (58%) travellers having sought health information and the only one for 49 (21%). Almost half of the travellers (48%) departing to sub-Saharan countries did not seek health counseling from a medical doctor (GP, non-GP specialist, specialist consulted in an international vaccination center or occupational physician). Individuals significantly more likely to travel without having consulted a GP were young and male, held foreign nationality, had travelled more than five times before, rarely consulted their GP and were travelling to a non-malarious area. GPs were the main but not the only source of information and counseling before traveling to a developing country. This study helps identify the characteristics of individuals likely to travel without having consulted a GP before departure. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Folate and folic acid in the periconceptional period: recommendations from official health organizations in thirty-six countries worldwide and WHO.

PubMed

Gomes, Sandra; Lopes, Carla; Pinto, Elisabete

2016-01-01

To summarize the recommendations on folate intake and folic acid supplementation and fortification in the periconceptional period, aimed at prevention of neural tube defects (NTD), provided by official health organizations in different countries worldwide and WHO. Information on recommendations for folate and folic acid intake in the periconceptional period was gathered from the websites of official national health organizations of several countries worldwide and from the WHO website. WHO, selected developed countries and emerging economies, totalling thirty-six countries worldwide (some European, BRICS, G8, Asian Tiger/Asian Dragon and Australia). Recommendations differ between countries, although the majority (69·4 %) recommend a healthy diet plus a folic acid supplement of 400 µg/d from preconception (4-12 weeks) until the end of the first trimester of pregnancy (8-12 weeks). The same recommendation is issued by the WHO. Dosages for women at high risk of NTD are up to 4-5 mg/d (for 41·7 % of studied countries). The recommended intake for folate is in the range of 300-400 µg/d for women of childbearing age and 500-600 µg/d for pregnant women in different countries and WHO. Five countries emphasize the importance of a healthy diet rendering supplementation needless. By contrast, five others advise a healthy diet and supplementation plus mandatory fortification. Only one mentions the importance of ensuring an adequate folate status and refers to checking with a health-care provider on the need for supplements. Different recommendations regarding folate and folic acid, seeking NTD prevention, are available worldwide; however, most countries and WHO focus on a healthy diet and folic acid supplementation of 400 µg/d periconceptionally.

Patterns and Determinants of Care-Seeking for Antepartum and Intrapartum Complications in Rural Bangladesh: Results from a Cohort Study.

PubMed

Khanam, Rasheda; Creanga, Andreea A; Koffi, Alain K; Mitra, Dipak K; Mahmud, Arif; Begum, Nazma; Moin, Syed Mamun Ibne; Ram, Malathi; Quaiyum, Md Abdul; Ahmed, Saifuddin; Saha, Samir K; Baqui, Abdullah H

2016-01-01

The burden of maternal complications during antepartum and intrapartum periods is high and care seeking from a trained provider is low, particularly in low middle income countries of sub-Saharan Africa and South Asia. Identification of barriers to access to trained care and development of strategies to address them will contribute to improvements in maternal health. Using data from a community-based cohort of pregnant women, this study identified the prevalence of antepartum and intrapartum complications and determinants of care-seeking for these complications in rural Bangladesh. The study was conducted in 24,274 pregnant women between June 2011 and December 2013 in rural Sylhet district of Bangladesh. Women were interviewed during pregnancy to collect data on demographic and socioeconomic characteristics; prior miscarriages, stillbirths, live births, and neonatal deaths; as well as data on their ability to make decision to go to health center alone. They were interviewed within the first 7 days of child birth to collect data on self-reported antepartum and intrapartum complications and care seeking for those complications. Bivariate analysis was conducted to explore association between predisposing (socio-demographic), enabling (economic), perceived need, and service related factors with care-seeking for self-reported antepartum and intrapartum complications. Multivariable multinomial logistic regression was performed to examine the association of selected factors with care-seeking for self-reported antepartum and intrapartum complications adjusting for co-variates. Self-reported antepartum and intrapartum complications among women were 14.8% and 20.9% respectively. Among women with any antepartum complication, 58.9% sought care and of these 46.5% received care from a trained provider. Of the women with intrapartum complications, 61.4% sought care and of them 46.5% did so from a trained provider. Care-seeking for both antepartum and intrapartum complications from a trained provider was significantly higher for women with higher household wealth status, higher literacy level of both women and their husbands, and for those living close to a health facility (<10 km). Women's decision making ability to go to health centre alone was associated with untrained care only for antepartum complications, but was associated with both trained and untrained care for intrapartum complications. Nearly 40.0% of the women who experienced either an antepartum or intrapartum complications did not seek care from any provider and 11.5% -14.9% received care from untrained providers, primarily because of economic and geographic barriers to access. Development and evaluation of context specific, cost-effective, and sustainable strategies that will address these barriers to access to care for the maternal complications will enhance care seeking from trained health care providers and improve maternal health.

Income inequality and subjective well-being: a systematic review and meta-analysis.

PubMed

Ngamaba, Kayonda Hubert; Panagioti, Maria; Armitage, Christopher J

2018-03-01

Reducing income inequality is one possible approach to boost subjective well-being (SWB). Nevertheless, previous studies have reported positive, null and negative associations between income inequality and SWB. This study reports the first systematic review and meta-analysis of the relationship between income inequality and SWB, and seeks to understand the heterogeneity in the literature. This systematic review was conducted according to guidance (PRISMA and Cochrane Handbook) and searches (between January 1980 and October 2017) were carried out using Web of Science, Medline, Embase and PsycINFO databases. Thirty-nine studies were included in the review, but poor data reporting meant that only 24 studies were included in the meta-analysis. The narrative analysis of 39 studies found negative, positive and null associations between income inequality and SWB. The meta-analysis confirmed these findings. The overall association between income inequality and SWB was almost zero and not statistically significant (pooled r = - 0.01, 95% CI - 0.08 to 0.06; Q = 563.10, I 2  = 95.74%, p < 0.001), suggesting no association between income inequality and SWB. Subgroup analyses showed that the association between income inequality and SWB was moderated by the country economic development (i.e. developed countries: r = - 0.06, 95% CI -0.10 to -0.02 versus developing countries: r = 0.16, 95% CI 0.09-0.23). The association between income inequality and SWB was not influenced by: (a) the measure used to assess SWB, (b) geographic region, or (c) the way in which income inequality was operationalised. The association between income inequality and SWB is weak, complex and moderated by the country economic development.

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

PubMed Central

Osamor, Pauline E; Grady, Christine

2016-01-01

Autonomy is considered essential for decision-making in a range of health care situations, from health care seeking and utilization to choosing among treatment options. Evidence suggests that women in developing or low-income countries often have limited autonomy and control over their health decisions. A review of the published empirical literature to identify definitions and methods used to measure women’s autonomy in developing countries describe the relationship between women’s autonomy and their health care decision-making, and identify sociodemographic factors that influence women’s autonomy and decision-making regarding health care was carried out. An integrated literature review using two databases (PubMed and Scopus) was performed. Inclusion criteria were 1) publication in English; 2) original articles; 3) investigations on women’s decision-making autonomy for health and health care utilization; and 4) developing country context. Seventeen articles met inclusion criteria, including eleven from South Asia, five from Africa, and one from Central Asia. Most studies used a definition of autonomy that included independence for women to make their own choices and decisions. Study methods differed in that many used study-specific measures, while others used a set of standardized questions from their countries’ national health surveys. Most studies examined women’s autonomy in the context of reproductive health, while neglecting other types of health care utilized by women. Several studies found that factors, including age, education, and income, affect women’s health care decision-making autonomy. Gaps in existing literature regarding women’s autonomy and health care utilization include gaps in the areas of health care that have been measured, the influence of sex roles and social support, and the use of qualitative studies to provide context and nuance. PMID:27354830

Confidentiality as a barrier to support seeking among physicians: the influence of psychosocial work factors in four European hospitals (the HOUPE study).

PubMed

Løvseth, Lise Tevik; Aasland, Olaf Gjerløw; Fridner, Ann; Schenck-Gustafsson, Karin; Jónsdóttir, Lilja Sigrun; Einarsdóttir, Torgerdur; Marini, Massimo; Minucci, Daria; Pavan, Luigi; Götestam, K Gunnar; Linaker, Olav Morten

2014-01-01

Concerns about protecting patient's privacy can interfere with proper stress adaptation which is associated with physician's health. It is important to investigate relevant organizational confounders to this phenomenon to enable interventions that can ameliorate the subjective burden of patient confidentiality. This study investigates factors in the psychosocial work environment that can explain patient confidentiality's prominence in social support seeking among physicians, and if these factors covary differently with support seeking according to country. University hospital physicians in four European cities (N=2095) in Sweden, Norway, Iceland and Italy participated in a cross-sectional survey. Questionnaire comprised items on psychosocial work environment, basic socio-demographics, presence of formal and informal meetings at work, and measurement of confidentiality as a barrier for support. High role conflict, availability of formal or informal meetings, lack of control over decisions, and lack of control over work pace were predictors of confidentiality as a barrier to support. There were differences between countries in how these factors covaried with confidentiality as a barrier to support. High role conflict was the strongest predictor of confidentiality as a barrier to support across all samples. Psychosocial work factors predicted confidentiality as a barrier to support seeking among physicians. It is important to create routines and an organizational framework that ensures both the patient's right to privacy and physician's ability to cope with emotional demanding situations from work.

Medical tourism's impact on health care equity and access in low- and middle-income countries: making the case for regulation.

PubMed

Chen, Y Y Brandon; Flood, Colleen M

2013-01-01

There is currently an evidentiary gap in the scholarship concerning medical tourism's impact on low- and middle-income destination countries (LMICs). This article reviews relevant evidence that exists and concludes that there are signs of correlation between medical tourism and the expansion of private, technology- intensive health care in LMICs, which has largely remained out of reach for the majority of the local patients. In light of this health care inequity between local residents and medical tourists in LMICs, we argue that the presumption should not be in favor of medical tourism and that governments have a legitimate interest in seeking to regulate this industry to ensure that the net effects for their citizens is positive. Moreover, sending countries, particularly those in the developed world, have the responsibility to adopt public policies to diminish demand on the part of their citizens for medical tourism and to work with LMICs to ensure that the growth of medical tourism does not occur at the expense of the poorest of the poor. © 2013 American Society of Law, Medicine & Ethics, Inc.

[The intervention of the immigration factor in Turco-European relations].

PubMed

Elmas, H B

1998-01-01

The legal dispositions governing Turkish immigration to European countries, the imperfect success of European efforts to discourage immigration, and factors in the elevated potential for continuing Turkish emigration are examined in this article. Turkey's 1963 5-year plan clearly revealed the government's intention to utilize external assistance to finance development efforts, while depending on labor migration to European countries to absorb surplus labor and provide remittances to ease the chronic balance of payments deficit. The Turkish government viewed with satisfaction the adoption in the 1963 Ankara Accord (a preliminary document in Turkey's quest for European Community membership) of articles concerning free circulation of workers, but the dispositions were never put into practice. The termination of immigration by the European countries in 1973-74 initially appeared to be a temporary response to the petroleum crisis and worldwide recession, but the measure became permanent policy, contributing to the deterioration of Turkish-European relations. Because of its internal policies of repression of minorities, sharp regional and ethnic disparities in development and income, and continuing high rate of population growth, Turkey has a very strong potential for further emigration. Some 4 million Turks constitute the largest foreign group in Europe. Immigration control measures have slowed entry of workers, but they have not prevented immigration for family regrouping or influx of refugees seeking asylum.

Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries.

PubMed

Sijbrandij, Marit; Acarturk, Ceren; Bird, Martha; Bryant, Richard A; Burchert, Sebastian; Carswell, Kenneth; de Jong, Joop; Dinesen, Cecilie; Dawson, Katie S; El Chammay, Rabih; van Ittersum, Linde; Jordans, Mark; Knaevelsrud, Christine; McDaid, David; Miller, Kenneth; Morina, Naser; Park, A-La; Roberts, Bayard; van Son, Yvette; Sondorp, Egbert; Pfaltz, Monique C; Ruttenberg, Leontien; Schick, Matthis; Schnyder, Ulrich; van Ommeren, Mark; Ventevogel, Peter; Weissbecker, Inka; Weitz, Erica; Wiedemann, Nana; Whitney, Claire; Cuijpers, Pim

2017-01-01

The crisis in Syria has resulted in vast numbers of refugees seeking asylum in Syria's neighbouring countries as well as in Europe. Refugees are at considerable risk of developing common mental disorders, including depression, anxiety, and posttraumatic stress disorder (PTSD). Most refugees do not have access to mental health services for these problems because of multiple barriers in national and refugee specific health systems, including limited availability of mental health professionals. To counter some of challenges arising from limited mental health system capacity the World Health Organization (WHO) has developed a range of scalable psychological interventions aimed at reducing psychological distress and improving functioning in people living in communities affected by adversity. These interventions, including Problem Management Plus (PM+) and its variants, are intended to be delivered through individual or group face-to-face or smartphone formats by lay, non-professional people who have not received specialized mental health training, We provide an evidence-based rationale for the use of the scalable PM+ oriented programmes being adapted for Syrian refugees and provide information on the newly launched STRENGTHS programme for adapting, testing and scaling up of PM+ in various modalities in both neighbouring and European countries hosting Syrian refugees.

Mainstreaming biodiversity and wildlife management into climate change policy frameworks in selected east and southern African countries

PubMed Central

Nhamo, Godwell

2016-01-01

The Rio+20 outcomes document, the Future We Want, enshrines green economy as one of the platforms to attain sustainable development and calls for measures that seek to address climate change and biodiversity management. This paper audits climate change policies from selected east and southern African countries to determine the extent to which climate change legislation mainstreams biodiversity and wildlife management. A scan of international, continental, regional and national climate change policies was conducted to assess whether they include biodiversity and/or wildlife management issues. The key finding is that many climate change policy–related documents, particularly the National Adaptation Programme of Actions (NAPAs), address threats to biodiversity and wildlife resources. However, international policies like the United Nations Framework Convention on Climate Change and Kyoto Protocol do not address the matter under deliberation. Regional climate change policies such as the East African Community, Common Market for Eastern and Southern Africa and African Union address biodiversity and/or wildlife issues whilst the Southern African Development Community region does not have a stand-alone policy for climate change. Progressive countries like Rwanda, Uganda, Tanzania and Zambia have recently put in place detailed NAPAs which are mainstream responsive strategies intended to address climate change adaptation in the wildlife sector.

Teachers' Perceptions of STEM Education and Its Impact on Students' Math Self-Efficacy

NASA Astrophysics Data System (ADS)

Reyes-Elizondo, Alejandra

New technologies and their benefits have become the norm, while past technologies are often overlooked. In the developed world, it is easily assumed that everyone has access to electricity, yet more than 1 billion people worldwide still live without it today. Electricity impacts all aspects of life: education, health, economy, and income, to name a few. This paper seeks to understand the relationship between having access to electricity and health outcomes, focusing on maternal mortality; mortality for those under 5 years of age; and mortality from non-communicable diseases, in 84 low and lower-middle income countries. Analyzing 84 countries using data from 1996 to 2014, this paper aims to understand how electricity impacts particular health outcomes. The key findings show that while having access to electricity is significantly associated with a reduction in maternal mortality and mortality for those under 5, it is not significantly associated with mortality from non-communicable diseases. These results indicate that enhancing access to electricity is merely a vessel towards improving health outcomes, but is not a magic policy in its own right. From a policy perspective, these findings imply that increasing access to electricity does not negate efforts towards improving the provision of health care alongside climate friendly and sustainable ways of electricity generation in developing countries.

Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries

PubMed Central

Sijbrandij, Marit; Acarturk, Ceren; Bird, Martha; Bryant, Richard A; Burchert, Sebastian; Carswell, Kenneth; de Jong, Joop; Dinesen, Cecilie; Dawson, Katie S.; El Chammay, Rabih; van Ittersum, Linde; Jordans, Mark; Knaevelsrud, Christine; McDaid, David; Miller, Kenneth; Morina, Naser; Park, A-La; Roberts, Bayard; van Son, Yvette; Sondorp, Egbert; Pfaltz, Monique C.; Ruttenberg, Leontien; Schick, Matthis; Schnyder, Ulrich; van Ommeren, Mark; Ventevogel, Peter; Weissbecker, Inka; Weitz, Erica; Wiedemann, Nana; Whitney, Claire; Cuijpers, Pim

2017-01-01

ABSTRACT The crisis in Syria has resulted in vast numbers of refugees seeking asylum in Syria’s neighbouring countries as well as in Europe. Refugees are at considerable risk of developing common mental disorders, including depression, anxiety, and posttraumatic stress disorder (PTSD). Most refugees do not have access to mental health services for these problems because of multiple barriers in national and refugee specific health systems, including limited availability of mental health professionals. To counter some of challenges arising from limited mental health system capacity the World Health Organization (WHO) has developed a range of scalable psychological interventions aimed at reducing psychological distress and improving functioning in people living in communities affected by adversity. These interventions, including Problem Management Plus (PM+) and its variants, are intended to be delivered through individual or group face-to-face or smartphone formats by lay, non-professional people who have not received specialized mental health training, We provide an evidence-based rationale for the use of the scalable PM+ oriented programmes being adapted for Syrian refugees and provide information on the newly launched STRENGTHS programme for adapting, testing and scaling up of PM+ in various modalities in both neighbouring and European countries hosting Syrian refugees. PMID:29163867

Plausible role for CHW peer support groups in increasing care-seeking in an integrated community case management project in Rwanda: a mixed methods evaluation.

PubMed

Langston, Anne; Weiss, Jennifer; Landegger, Justine; Pullum, Thomas; Morrow, Melanie; Kabadege, Melene; Mugeni, Catherine; Sarriot, Eric

2014-08-01

The Kabeho Mwana project (2006-2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda's 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In project districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. The 2005 and 2010 Demographic and Health Surveys were re-analyzed to evaluate how project and non-project districts differed in terms of care-seeking for fever, diarrhea, and acute respiratory infection symptoms and related indicators. We developed a logit regression model, controlling for the timing of the first CHW training, with the district included as a fixed categorical effect. We also analyzed qualitative data from the final evaluation to examine factors that may have contributed to improved outcomes. While there was notable improvement in care-seeking across all districts, care-seeking from any provider for each of the 3 conditions, and for all 3 combined, increased significantly more in the project districts. CHWs contributed a larger percentage of consultations in project districts (27%) than in non-project districts (12%). Qualitative data suggested that the PSG model was a valuable sub-level of CHW organization associated with improved CHW performance, supervision, and social capital. The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of iCCM should therefore include CHW management and social support mechanisms. Finally, re-analysis of national survey data improved evaluation findings by providing impact estimates.

Scientific Wealth in Middle East and North Africa: Productivity, Indigeneity, and Specialty in 1981-2013.

PubMed

Siddiqi, Afreen; Stoppani, Jonathan; Anadon, Laura Diaz; Narayanamurti, Venkatesh

2016-01-01

Several developing countries seek to build knowledge-based economies by attempting to expand scientific research capabilities. Characterizing the state and direction of progress in this arena is challenging but important. Here, we employ three metrics: a classical metric of productivity (publications per person), an adapted metric which we denote as Revealed Scientific Advantage (developed from work used to compare publications in scientific fields among countries) to characterize disciplinary specialty, and a new metric, scientific indigeneity (defined as the ratio of publications with domestic corresponding authors) to characterize the locus of scientific activity that also serves as a partial proxy for local absorptive capacity. These metrics-using population and publications data that are available for most countries-allow the characterization of some key features of national scientific enterprise. The trends in productivity and indigeneity when compared across other countries and regions can serve as indicators of strength or fragility in the national research ecosystems, and the trends in specialty can allow regional policy makers to assess the extent to which the areas of focus of research align (or not align) with regional priorities. We apply the metrics to study the Middle East and North Africa (MENA)-a region where science and technology capacity will play a key role in national economic diversification. We analyze 9.8 million publication records between 1981-2013 in 17 countries of MENA from Morocco to Iraq and compare it to selected countries throughout the world. The results show that international collaborators increasingly drove the scientific activity in MENA. The median indigeneity reached 52% in 2013 (indicating that almost half of the corresponding authors were located in foreign countries). Additionally, the regional disciplinary focus in chemical and petroleum engineering is waning with modest growth in the life sciences. We find repeated patterns of stagnation and contraction of scientific activity for several MENA countries contributing to a widening productivity gap on an international comparative yardstick. The results prompt questions about the strength of the developing scientific enterprise and highlight the need for consistent long-term policy for effectively addressing regional challenges with domestic research.

Transportation sector advisory services : part 1 : final report

DOT National Transportation Integrated Search

1998-03-01

The report provides advisory services to the member countries of the South Balkan Initiative (SBDI) Program (Albania, Macedonia, and Bulgaria), which are seeking to improve their transportation infrastructure links, in addition to raising the level o...

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

Workable solutions to FP in Africa.

PubMed

1991-12-01

The 3rd Pan African Conference on the Integrated Family Planning, Nutrition and Parasite Control Project (PANFRICO III) was held in October 1991 and organized by JOICFP, UNFPA and IPPF. The Ghana IP Steering Committee implemented it. In addition to the 5 IP implementing countries--Ethiopia, the Gambia, Ghana, Tanzania, and Zambia--other countries attending were: Kenya, Lesotho, Madagascar, Mali, Nigeria, Senegal, Sierra Leone, Swaziland, Togo, and Uganda. Governmental and nongovernmental organizations (NGOs) and international groups such as UNFPA, IPPF, FAO, and USAID also attended. The theme was seeking a strategic approach to family planning through primary health care. Participants resolved to increase the support and involvement of African governments in IP implementation. It was recognized that self-reliance, cost effectiveness, and efficient use of resources were important to sustainability. It was also agreed that IP should integrate family planning (FP) with Maternal and Child Health (MCH) and Primary Health Care (PHC) in order to overcome traditional and cultural obstacles to FP and to gain full participation of men in the communities. Horizontal integration was the primary thrust. there was agreement that there should be collaboration between UNFPA, IPPF, and JOICFP, and relevant governments and NGOs. Country-specific attention needs to be paid to expanding IP functions within the 5 IP countries. In Ghana, IP pilot areas have been successful in increasing the FP acceptance rate from 17.4% in 1988 to 51.9% in 1991. IP experiences in Indonesia were presented, including the concept of fee-charged PHC services in order to achieve self-reliance in FP/MCH projects. The response was the request for further technical cooperation between developing countries. The workshop activities were particularly beneficial, and requests were made for discussion of IEC, management, service delivery, nutrition, environmental sanitation, self-reliance, community participation, and evaluation. To further regional IP development within the country, it was suggested that national workshops be held. It was emphasized that FP and population are basic elements of socioeconomic development.

Mechanisms of host seeking by parasitic nematodes.

PubMed

Gang, Spencer S; Hallem, Elissa A

2016-07-01

The phylum Nematoda comprises a diverse group of roundworms that includes parasites of vertebrates, invertebrates, and plants. Human-parasitic nematodes infect more than one billion people worldwide and cause some of the most common neglected tropical diseases, particularly in low-resource countries [1]. Parasitic nematodes of livestock and crops result in billions of dollars in losses each year [1]. Many nematode infections are treatable with low-cost anthelmintic drugs, but repeated infections are common in endemic areas and drug resistance is a growing concern with increasing therapeutic and agricultural administration [1]. Many parasitic nematodes have an environmental infective larval stage that engages in host seeking, a process whereby the infective larvae use sensory cues to search for hosts. Host seeking is a complex behavior that involves multiple sensory modalities, including olfaction, gustation, thermosensation, and humidity sensation. As the initial step of the parasite-host interaction, host seeking could be a powerful target for preventative intervention. However, host-seeking behavior remains poorly understood. Here we review what is currently known about the host-seeking behaviors of different parasitic nematodes, including insect-parasitic nematodes, mammalian-parasitic nematodes, and plant-parasitic nematodes. We also discuss the neural bases of these behaviors. Copyright © 2016 Elsevier B.V. All rights reserved.

Health care seeking for Childhood Diarrhea in Developing Countries: Evidence from Seven Sites in Africa and Asia

PubMed Central

Nasrin, Dilruba; Wu, Yukun; Blackwelder, William C.; Farag, Tamer H.; Saha, Debasish; Sow, Samba O.; Alonso, Pedro L.; Breiman, Robert F.; Sur, Dipika; Faruque, Abu S. G.; Zaidi, Anita K. M.; Biswas, Kousick; Van Eijk, Anna Maria; Walker, Damian G.; Levine, Myron M.; Kotloff, Karen L.

2013-01-01

We performed serial Health Care Utilization and Attitudes Surveys (HUASs) among caretakers of children ages 0–59 months randomly selected from demographically defined populations participating in the Global Enteric Multicenter Study (GEMS), a case-control study of moderate-to-severe diarrhea (MSD) in seven developing countries. The surveys aimed to estimate the proportion of children with MSD who would present to sentinel health centers (SHCs) where GEMS case recruitment would occur and provide a basis for adjusting disease incidence rates to include cases not seen at the SHCs. The proportion of children at each site reported to have had an incident episode of MSD during the 7 days preceding the survey ranged from 0.7% to 4.4% for infants (0–11 months of age), from 0.4% to 4.7% for toddlers (12–23 months of age), and from 0.3% to 2.4% for preschoolers (24–59 months of age). The proportion of MSD episodes at each site taken to an SHC within 7 days of diarrhea onset was 15–56%, 17–64%, and 7–33% in the three age strata, respectively. High cost of care and insufficient knowledge about danger signs were associated with lack of any care-seeking outside the home. Most children were not offered recommended fluids and continuing feeds at home. We have shown the utility of serial HUASs as a tool for optimizing operational and methodological issues related to the performance of a large case-control study and deriving population-based incidence rates of MSD. Moreover, the surveys suggest key targets for educational interventions that might improve the outcome of diarrheal diseases in low-resource settings. PMID:23629939

Nuclear Symbiosis - A Means to Achieve Sustainable Nuclear Growth while Limiting the Spread of Sensititive Nuclear Technology

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

David Shropshire

Global growth of nuclear energy in the 21st century is creating new challenges to limit the spread of nuclear technology without hindering adoption in countries now considering nuclear power. Independent nuclear states desire autonomy over energy choices and seek energy independence. However, this independence comes with high costs for development of new indigenous fuel cycle capabilities. Nuclear supplier states and expert groups have proposed fuel supply assurance mechanisms such as fuel take-back services, international enrichment services and fuel banks in exchange for recipient state concessions on the development of sensitive technologies. Nuclear states are slow to accept any concessions tomore » their rights under the Non-Proliferation Treaty. To date, decisions not to develop indigenous fuel cycle capabilities have been driven primarily by economics. However, additional incentives may be required to offset a nuclear state’s perceived loss of energy independence. This paper proposes alternative economic development incentives that could help countries decide to forgo development of sensitive nuclear technologies. The incentives are created through a nuclear-centered industrial complex with “symbiotic” links to indigenous economic opportunities. This paper also describes a practical tool called the “Nuclear Materials Exchange” for identifying these opportunities.« less

Increasing organ donation by presumed consent and allocation priority: Chile.

PubMed

Zúñiga-Fajuri, Alejandra

2015-03-01

Chile, a middle-income country, recently joined Israel and Singapore as the world's only countries to require reciprocity as a precondition for organ transplantation. The Chilean reform includes opt-out provisions designed to foster donation and priority for organ transplantation for registered people. Although the reform has had serious difficulties in achieving its mission, it can be reviewed by other countries that seek to address the serious shortage of organs. As increased organ donation can substantially enhance or save more lives, the effect on organ availability due to incentives arising from rules of preference should not be underestimated.

Space commerce in a global economy: Comparison of US and Australian approaches

NASA Technical Reports Server (NTRS)

Stone, Barbara A.; Page, John R.

1993-01-01

The United States and Australia are among the 20 or more nations of the world having industries currently engaging in some form of space commerce. As a matter of national policy, the United States has encouraged private investment and involvement in space activities since 1984, when the Congress declared it in the best interest of the Nation that NASA '...seek and encourage to the maximum extent possible, the fullest commercial use of space.' Australia's space policy, announced in 1986, has the objective of encouraging greater involvement by industry in space research and development, and the development of commercial space activities. This paper discusses the underlying policies, current status, and prospects for the future of commercial space business activities in the two countries.

Biodiesel fuel management best practices for transit

DOT National Transportation Integrated Search

2007-11-27

Public transportation systems play a key role throughout the country not only in providing vital services to citizens but also in the environmental quality of our communities. Transit systems nationwide are seeking out new technologies in order to in...

EPA Seeks Public Input for National Plan to Manage PFAS at First Community Engagement Event

EPA Pesticide Factsheets

New Englanders know that our part of the country is special. New England boasts vibrant communities, many with histories dating to before the American Revolution. Our environment is also unique and wonderful.

Visceral leishmaniasis diagnosis and reporting delays as an obstacle to timely response actions in Nepal and India.

PubMed

Boettcher, Jan P; Siwakoti, Yubaraj; Milojkovic, Ana; Siddiqui, Niyamat A; Gurung, Chitra K; Rijal, Suman; Das, Pradeep; Kroeger, Axel; Banjara, Megha R

2015-02-06

To eliminate visceral leishmaniasis (VL) in India and Nepal, challenges of VL diagnosis, treatment and reporting need to be identified. Recent data indicate that VL is underreported and patients face delays when seeking treatment. Moreover, VL surveillance data might not reach health authorities on time. This study quantifies delays for VL diagnosis and treatment, and analyses the duration of VL reporting from district to central health authorities in India and Nepal. A cross-sectional study conducted in 12 districts of Terai region, Nepal, and 9 districts of Bihar State, India, in 2012. Patients were interviewed in hospitals or at home using a structured questionnaire, health managers were interviewed at their work place using a semi-structured questionnaire and in-depth interviews were conducted with central level health managers. Reporting formats were evaluated. Data was analyzed using two-tailed Mann-Whitney U or Fisher's exact test. 92 VL patients having experienced 103 VL episodes and 49 district health managers were interviewed. Patients waited in Nepal 30 days (CI 18-42) before seeking health care, 3.75 times longer than in Bihar (8d; CI 4-12). Conversely, the lag time from seeking health care to receiving a VL diagnosis was 3.6x longer in Bihar (90d; CI 68-113) compared to Nepal (25d; CI 13-38). The time span between diagnosis and treatment was short in both countries. VL reporting time was in Nepal 19 days for sentinel sites and 76 days for "District Public Health Offices (DPHOs)". In Bihar it was 28 days for "District Malaria Offices". In Nepal, 73% of health managers entered data into computers compared to 16% in Bihar. In both countries reporting was mainly paper based and standardized formats were rarely used. To decrease the delay between onset of symptoms and getting a proper diagnosis and treatment the approaches in the two countries vary: In Nepal health education for seeking early treatment are needed while in Bihar the use of private and non-formal practitioners has to be discouraged. Reinforcement of VL sentinel reporting in Bihar, reorganization of DPHOs in Nepal, introduction of standardized reporting formats and electronic reporting should be conducted in both countries.

[Emotion regulation among psychostimulants drug users at techno parties].

PubMed

Lillaz, C; Varescon, I

2012-10-01

Deficits in the communication and identifying of feelings are usually observed in substance abuse. Research in several countries has reported sensation seeking and alexithymia implication in addiction. According to a cognitive-developmental model of emotional experience proposed, alexithymia is a deficit in the cognitive processing of emotion that can be seen as an impairment in the ability to consciously experience feeling in the context of autonomic activation indicate of emotional arousal. The primary objective of this study was to identify certain personality dimensions linked with emotions' regulation, i.e. Zuckerman's sensation seeking, alexithymia, and emotional awareness in ecstasy and cocaine users at techno parties. Subjects were divided in two groups: 37 male ecstasy or cocaine abusers, and 37 male non-drug users. We hypothesized that ecstasy and cocaine users would exhibit high levels of sensation seeking (high level of sensation seeking,), and emotional dysregulation (high level of alexithymia and depression, low level of emotional awareness). The methodology comprised a questionnaire developed for the study, designed to record sociodemographic data and evaluate psychoactive substance use, the MlINI (mini international psychiatric interview), the Zuckerman 40-item Sensation Seeking Scale (SSS-IV), the Toronto Alexithymia Scale (TAS-20), the Levels of Emotional Awareness Scale (LEAS), and the Beck Depression Inventory (BDI-13). Subjects were recruited during rave-parties. The results showed significantly higher sensation seeking scores for ecstasy and cocaine users for the score total and the disinhibition and experience seeking subdimensions. Ecstasy and cocaine abusers exhibited higher TAS-20 and BDI-13 scores and lower levels of emotional awareness than non-drug users. No correlation between the TAS-20 and depression symptomatology emerged. No significant correlations were found between LEAS and TAS-20. These results provide new elements concerning the profile of drug users at techno parties and illustrate the changing practices of ecstasy use. The LEAS and the TAS-20 were not intercorrelated; it seems plausible that they reflect two sides of the emotional states self-report. These results reinforce the suggestion of combining the use of self-reports with non self-report methods. Copyright © 2011 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Facilitators and Barriers to Health-Seeking Behaviours among Filipino Migrants: Inductive Analysis to Inform Health Promotion

PubMed Central

Salamonson, Y.; Descallar, J.; Davidson, P. M.

2015-01-01

Understanding factors that influence health-seeking behaviour of migrants is necessary to intervene for behaviour change. This paper explores Filipino migrants' perceptions of facilitators and barriers to maintaining health in Australia. Open-ended survey item responses reflecting factors that assisted and hindered health following migration to Australia were inductively analysed. Three hundred and thirty-seven of the 552 survey respondents (61%) provided open-ended responses. Responses were grouped into two major categories: individual factors, including personal resources and cultural influences, and environmental factors encompassing both the physical conditions in the host country and health service access. Awareness of practices that enhance health was a major personal facilitator of health-seeking behaviour; however, competing priorities of daily living were perceived as barriers. Cultural beliefs and practices influenced health-seeking behaviour. Despite high self-rated English language skills in this population, new migrants and the elderly cited communication difficulties as barriers to accessing health services. Insight into facilitators and barriers to health-seeking behaviour in this less researched migrant population revealed tools for enhancing engagement in health promotion programs addressing healthy lifestyle. PMID:26380277

The Afya Bora Fellowship: An Innovative Program Focused on Creating an Interprofessional Network of Leaders in Global Health.

PubMed

Green, Wendy M; Farquhar, Carey; Mashalla, Yohana

2017-09-01

Most current health professions education programs are focused on the development of clinical skills. As a result, they may not address the complex and interconnected nature of global health. Trainees require relevant clinical, programmatic, and leadership skills to meet the challenges of practicing in an increasingly globalized environment. To develop health care leaders within sub-Saharan Africa, the Afya Bora Consortium developed a one-year fellowship for medical doctors and nurses. Fellows from nine institutions in the United States and sub-Saharan Africa participate in 12 learning modules focused on leadership development and program management. Classroom-based training is augmented with an experiential apprenticeship component. Since 2011, 100 fellows have graduated from the program. During their apprenticeships, fellows developed projects beneficial to their development and to host organizations. The program has developed fellows' skills in leadership, lent expertise to local organizations, and built knowledge in local contexts. Most fellows have returned to their countries of origin, thus building local capacity. U.S.-based fellows examine global health challenges from regional perspectives and learn from sub-Saharan African experts and peers. The Consortium provides ongoing support to alumni through career development awards and alumni network engagement with current and past fellow cohorts. The Consortium expanded from its initial network of five countries to six and continues to seek opportunities for geographical and institutional expansion.

The impact of TRIPS on innovation and exports: a case study of the pharmaceutical industry in India.

PubMed

Malhotra, Prabodh

2008-01-01

Currently, there is a debate on what impact the implementation of the Trade Related Aspects of Intellectual Property Rights (TRIPS) in India would have on its pharmaceutical industry and health care. The debate hinges primarily on two major questions. First, will the new patent regime provide an impetus for innovation in the pharmaceutical industry? Second, how far will India's pharmaceutical exports of copied versions of patented drugs to developing countries be restricted under the new regime? The first question seeks to find out if TRIPS will increase India's innovative capabilities to fill the current vacuum to develop drugs for tropical diseases. The large multinational companies (MNCs) that dominate the global pharmaceutical industry have no interest in commercial ventures that have little potential for great returns on investment. The second question attempts to find a solution to the lack of access to medicine in most developing countries. Indian manufacturers' supply of reverse-engineered drugs, which cost only a fraction of the prices charged by MNCs, may be coming to an end under the new regime. Against this backdrop, this article attempts to analyse the impact of strengthening intellectual property rights in India.

Predictors of Help-Seeking Intentions in Operation Enduring Freedom and Operation Iraqi Freedom Veterans and Service Members.

PubMed

Porcari, Carole; Koch, Ellen I; Rauch, Sheila A M; Hoodin, Flora; Ellison, Grant; McSweeney, Lauren

2017-05-01

Despite significant numbers of Afghanistan and Iraqi veterans and service members who report symptoms of posttraumatic stress disorder, depression, anxiety, and substance abuse, the majority do not seek help for these problems. A better understanding of the help-seeking process might aid providers and administrators in outreach and provision of services for those who need them. Past research has shown several variables that influence an individual's help-seeking behavior: demographic variables, the nature and severity of a mental health problem, and psychological variables. The three goals of the study were to determine which variables predicted help-seeking intentions from various sources for a psychological problem, identify barriers to help seeking, and identify sources of help sought in the past year. All Operation Enduring Freedom and Operation Iraqi Freedom veterans and service members registered with a Midwestern VA Healthcare System between 2001 and 2007 received a letter requesting participation in an Internet-based survey. Participants completed nine questionnaires regarding their current physical and psychological health, social support, self-efficacy, public and self-stigma, and barriers to seeking help for a psychological problem. In addition, patterns of help seeking from informal (i.e., partner/spouse, family, friends) and formal (i.e., physician, psychiatrist, or psychologist, either from Veterans Affairs [VA] or the private sector) sources of help were examined. Results from the linear regression model including all formal and informal sources of help indicated a significant model fit with attitudes toward psychotherapy, social support, and current mental health status as significant coefficients. Of note, attitudes toward psychotherapy were a significant coefficient in all help-seeking models; stigma was a significant coefficient with formal and VA sources, and social support was found to be a significant predictor with informal sources. Documentation of a mental health problem on one's record was found to be a significant barrier to help seeking and participants indicated they would most likely seek help in the next year from their partner/spouse, family, or friends versus formal VA or non-VA sources. This is one of the first studies to examine attitudes toward psychotherapy as contributing to help-seeking intentions of veterans and service members and results provide strong support for inclusion of this variable in future studies in addition to social support and stigma. Limitations of the study are discussed as well as suggestions for future research. It is our hope that findings from this study may inform administrators and providers regarding assessment, outreach, and program development for our country's veterans and service members. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Value innovation: an important aspect of global surgical care

PubMed Central

2014-01-01

Introduction Limited resources in low- and middle-income countries (LMICs) drive tremendous innovation in medicine, as well as in other fields. It is not often recognized that several important surgical tools and methods, widely used in high-income countries, have their origins in LMICs. Surgical care around the world stands much to gain from these innovations. In this paper, we provide a short review of some of these succesful innovations and their origins that have had an important impact in healthcare delivery worldwide. Review Examples of LMIC innovations that have been adapted in high-income countries include the Bogotá bag for temporary abdominal wound closure, the orthopaedic external fixator for complex fractures, a hydrocephalus fluid valve for normal pressure hydrocephalus, and intra-ocular lens and manual small incision cataract surgery. LMIC innovations that have had tremendous potential global impact include mosquito net mesh for inguinal hernia repair, and a flutter valve for intercostal drainage of pneumothorax. Conclusion Surgical innovations from LMICs have been shown to have comparable outcomes at a fraction of the cost of tools used in high-income countries. These innovations have the potential to revolutionize global surgical care. Advocates should actively seek out these innovations, campaign for the financial gains from these innovations to benefit their originators and their countries, and find ways to develop and distribute them locally as well as globally. PMID:24393237

Value innovation: an important aspect of global surgical care.

PubMed

Cotton, Michael; Henry, Jaymie Ang; Hasek, Lauren

2014-01-06

Limited resources in low- and middle-income countries (LMICs) drive tremendous innovation in medicine, as well as in other fields. It is not often recognized that several important surgical tools and methods, widely used in high-income countries, have their origins in LMICs. Surgical care around the world stands much to gain from these innovations. In this paper, we provide a short review of some of these successful innovations and their origins that have had an important impact in healthcare delivery worldwide. Examples of LMIC innovations that have been adapted in high-income countries include the Bogotá bag for temporary abdominal wound closure, the orthopaedic external fixator for complex fractures, a hydrocephalus fluid valve for normal pressure hydrocephalus, and intra-ocular lens and manual small incision cataract surgery. LMIC innovations that have had tremendous potential global impact include mosquito net mesh for inguinal hernia repair, and a flutter valve for intercostal drainage of pneumothorax. Surgical innovations from LMICs have been shown to have comparable outcomes at a fraction of the cost of tools used in high-income countries. These innovations have the potential to revolutionize global surgical care. Advocates should actively seek out these innovations, campaign for the financial gains from these innovations to benefit their originators and their countries, and find ways to develop and distribute them locally as well as globally.

Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis.

PubMed

Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

2017-01-05

Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. The study focused on all 72 health districts of Zambia. We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. 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/.

Changing choices in health care: implications for equity, efficiency and cost.

PubMed

Bevan, Gwyn; Helderman, Jan-Kees; Wilsford, David

2010-07-01

Although choice may be seen as an end in itself, the papers included in this special issue of Health Economics, Policy and Law, examine choice policies in European systems of health care, which aim to be effective instruments for ameliorating the systemic pressures from the iron triangle of equity, efficiency, and cost. Three papers consider the nature of differences between and within countries following the Beveridge and Bismarck models of financing and organising the delivery of care, and how choices are changing within different systems. Within countries following the Beveridge model, current policies in England, Denmark and Sweden emphasise increasing patient choice of provider. Within countries following the Bismarck model, current policies in France and Germany seek to restrict choice of specialists by introducing 'soft' gatekeeping; and in the Netherlands there is a system of managed competition with choice of insurer that, in principle, allows insurers to contract selectively with providers. A fourth paper considers how government policies that seek to restrict choice within systems of universal coverage have been subject to challenges in the courts. A commentary explores the implications of the fraught and complex nature of choices between insurers and providers of health care for designing effective choice policies.

Impact of measles supplementary immunisation activities on utilisation of maternal and child health services in low-income and middle-income countries

PubMed Central

Postolovska, Iryna; Helleringer, Stéphane; Kruk, Margaret E; Verguet, Stéphane

2018-01-01

Background Measles supplementary immunisation activities (SIAs) are an integral component of measles elimination in low-income and middle-income countries (LMICs). Despite their success in increasing vaccination coverage, there are concerns about their negative consequences on routine services. Few studies have conducted quantitative assessments of SIA impact on utilisation of health services. Methods We analysed the impact of SIAs on utilisation of selected maternal and child health services using Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 28 LMICs, where at least one SIA occurred over 2000–2014. Logistic regressions were conducted to investigate the association between SIAs and utilisation of the following services: facility delivery, postnatal care and outpatient sick child care (for fever, diarrhoea, cough). Results SIAs do not appear to significantly impact utilisation of maternal and child services. We find a reduction in care-seeking for treatment of child cough (OR 0.67; 95% CI 0.48 to 0.95); and a few significant effects at the country level, suggesting the need for further investigation of the idiosyncratic effects of SIAs in each country. Conclusion The paper contributes to the debate on vertical versus horizontal programmes to ensure universal access to vaccination. Measles SIAs do not seem to affect care-seeking for critical conditions. PMID:29755760

Incentives to promote breastfeeding: a systematic review.

PubMed

Moran, Victoria Hall; Morgan, Heather; Rothnie, Kieran; MacLennan, Graeme; Stewart, Fiona; Thomson, Gillian; Crossland, Nicola; Tappin, David; Campbell, Marion; Hoddinott, Pat

2015-03-01

Few women in industrialized countries achieve the World Health Organization's recommendation to breastfeed exclusively for 6 months. Governments are increasingly seeking new interventions to address this problem, including the use of incentives. The goal of this study was to assess the evidence regarding the effectiveness of incentive interventions, delivered within or outside of health care settings, to individuals and/or their families seeking to increase and sustain breastfeeding in the first 6 months after birth. Searches of electronic databases, reference lists, and grey literature were conducted to identify relevant reports of published, unpublished, and ongoing studies. All study designs published in English, which met our definition of incentives and that were from a developed country, were eligible for inclusion. Abstract and full-text article review with sequential data extraction were conducted by 2 independent authors. Sixteen full reports were included in the review. The majority evaluated multicomponent interventions of varying frequency, intensity, and duration. Incentives involved providing access to breast pumps, gifts, vouchers, money, food packages, and help with household tasks, but little consensus in findings was revealed. The lack of high-quality, randomized controlled trials identified by this review and the multicomponent nature of the interventions prohibited meta-analysis. This review found that the overall effect of providing incentives for breastfeeding compared with no incentives is unclear due to study heterogeneity and the variation in study quality. Further evidence on breastfeeding incentives offered to women is required to understand the possible effects of these interventions. Copyright © 2015 by the American Academy of Pediatrics.

Sharing good NEWS across the world: developing comparable scores across 12 countries for the Neighborhood Environment Walkability Scale (NEWS).

PubMed

Cerin, Ester; Conway, Terry L; Cain, Kelli L; Kerr, Jacqueline; De Bourdeaudhuij, Ilse; Owen, Neville; Reis, Rodrigo S; Sarmiento, Olga L; Hinckson, Erica A; Salvo, Deborah; Christiansen, Lars B; Macfarlane, Duncan J; Davey, Rachel; Mitáš, Josef; Aguinaga-Ontoso, Ines; Sallis, James F

2013-04-08

The IPEN (International Physical Activity and Environment Network) Adult project seeks to conduct pooled analyses of associations of perceived neighborhood environment, as measured by the Neighborhood Environment Walkability Scale (NEWS) and its abbreviated version (NEWS-A), with physical activity using data from 12 countries. As IPEN countries used adapted versions of the NEWS/NEWS-A, this paper aimed to develop scoring protocols that maximize cross-country comparability in responses. This information is also highly relevant to non-IPEN studies employing the NEWS/NEWS-A, which is one of the most popular measures of perceived environment globally. The following countries participated in the IPEN Adult study: Australia, Belgium, Brazil, Colombia, Czech Republic, Denmark, Hong Kong, Mexico, New Zealand, Spain, the United Kingdom, and the United States. Participants (N = 14,305) were recruited from neighborhoods varying in walkability and socio-economic status. Countries collected data on the perceived environment using a self- or interviewer-administered version of the NEWS/NEWS-A. Confirmatory Factor Analysis (CFA) was used to derive comparable country-specific measurement models of the NEWS/NEWS-A. The level of correspondence between standard and alternative versions of the NEWS/NEWS-A factor-analyzable subscales was determined by estimating the correlations and mean standardized difference (Cohen's d) between them using data from countries that had included items from both standard and alternative versions of the subscales. Final country-specific measurement models of the NEWS/NEWS-A provided acceptable levels of fit to the data and shared the same factorial structure with six latent factors and two single items. The correspondence between the standard and alternative versions of subscales of Land use mix - access, Infrastructure and safety for walking/cycling, and Aesthetics was high. The Brazilian version of the Traffic safety subscale was highly, while the Australian and Belgian versions were marginally, comparable to the standard version. Single-item versions of the Street connectivity subscale used in Australia and Belgium showed marginally acceptable correspondence to the standard version. We have proposed country-specific modifications to the original scoring protocol of the NEWS/NEWS-A that enhance inter-country comparability. These modifications have yielded sufficiently equivalent measurement models of the NEWS/NEWS-A. Some inter-country discrepancies remain. These need to be considered when interpreting findings from different countries.

Sharing good NEWS across the world: developing comparable scores across 12 countries for the neighborhood environment walkability scale (NEWS)

PubMed Central

2013-01-01

Background The IPEN (International Physical Activity and Environment Network) Adult project seeks to conduct pooled analyses of associations of perceived neighborhood environment, as measured by the Neighborhood Environment Walkability Scale (NEWS) and its abbreviated version (NEWS-A), with physical activity using data from 12 countries. As IPEN countries used adapted versions of the NEWS/NEWS-A, this paper aimed to develop scoring protocols that maximize cross-country comparability in responses. This information is also highly relevant to non-IPEN studies employing the NEWS/NEWS-A, which is one of the most popular measures of perceived environment globally. Methods The following countries participated in the IPEN Adult study: Australia, Belgium, Brazil, Colombia, Czech Republic, Denmark, Hong Kong, Mexico, New Zealand, Spain, the United Kingdom, and the United States. Participants (N = 14,305) were recruited from neighborhoods varying in walkability and socio-economic status. Countries collected data on the perceived environment using a self- or interviewer-administered version of the NEWS/NEWS-A. Confirmatory Factor Analysis (CFA) was used to derive comparable country-specific measurement models of the NEWS/NEWS-A. The level of correspondence between standard and alternative versions of the NEWS/NEWS-A factor-analyzable subscales was determined by estimating the correlations and mean standardized difference (Cohen’s d) between them using data from countries that had included items from both standard and alternative versions of the subscales. Results Final country-specific measurement models of the NEWS/NEWS-A provided acceptable levels of fit to the data and shared the same factorial structure with six latent factors and two single items. The correspondence between the standard and alternative versions of subscales of Land use mix – access, Infrastructure and safety for walking/cycling, and Aesthetics was high. The Brazilian version of the Traffic safety subscale was highly, while the Australian and Belgian versions were marginally, comparable to the standard version. Single-item versions of the Street connectivity subscale used in Australia and Belgium showed marginally acceptable correspondence to the standard version. Conclusions We have proposed country-specific modifications to the original scoring protocol of the NEWS/NEWS-A that enhance inter-country comparability. These modifications have yielded sufficiently equivalent measurement models of the NEWS/NEWS-A. Some inter-country discrepancies remain. These need to be considered when interpreting findings from different countries. PMID:23566032

Consumers' disease information-seeking behaviour on the Internet in Korea.

PubMed

Yun, Eun Kyoung; Park, Hyeoun-Ae

2010-10-01

This study was conducted to explain the relationships of the factors affecting consumers' disease information-seeking behaviour on the Internet in Korea. Similar to other countries, Korea is facing an increasing use of Internet as a resource of health information. With the paradigm shifts towards consumer-centred health service, it is expected that more health care consumers will use the Internet actively in the future. A survey was conducted using a self-selected convenience sample. A conceptual model was derived by extending technology acceptance model and tested via structural equation modelling. The overall goodness of fit of the conceptual model was acceptable. Consumers' health consciousness, perceived health risk and Internet health information use efficacy were found to influence consumers' beliefs, attitude and intention of use disease information on the Internet. But Internet health information use efficacy did not significantly influence perceived usefulness. It was also identified that consumers' perceived credibility of the information in the websites was the main determinant in forming of attitude towards disease information on the Internet. Technology acceptance model has been extended and examined successfully in explaining consumers' disease information-seeking behaviour on the Internet. It was found that consumers' cognitive and affective characteristics, determined as initiators in health-related behaviour, also impacted consumers' disease information-seeking behaviour on the Internet. These findings may be used to help nurses to predict and identify the factors affecting individual's use of disease information on the Internet. Based on this knowledge, nurses will be able to develop nursing intervention programmes for the patients' health management. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Consequences of hypertension and chronic obstructive pulmonary disease, healthcare-seeking behaviors of patients, and responses of the health system: a population-based cross-sectional study in Bangladesh.

PubMed

Uddin, Md Jasim; Alam, Nurul; Koehlmoos, Tracey P; Sarma, Haribondhu; Chowdhury, Muhammad Ashique Haider; Alam, Dewan S; Niessen, Louis

2014-06-03

Non-communicable diseases are a threat to human health and economic development of low-income countries. Hypertension (HT) and chronic obstructive pulmonary disease (COPD) are two major causes of deaths, worldwide. This study assesses the health status, health-care seeking, and health provider responses among patients with these conditions. The study carried out population-based cross-sectional survey in a rural and an urban surveillance area in Bangladesh. It interviewed all patients identified with HT and COPD at home using a structured questionnaire on the health consequences, healthcare-seeking behaviours, and coping strategies. Qualitative techniques identified key factors relating to the behaviours of patients and providers. COPD and HT correlate with lower activities of daily living (ADL) scores. The odds ratio (OR) for ADL scores in the combied conditions are high (OR: 3.04, p < 0.05) as compared to hypertension. Financial crises occur significantly more frequently among COPD patients in the urban site as compared to those in rural ares (12.5% vs. 2.4%, p < 0.01). Self-treatment at the onset is common. Seeking care from trained providers is higher in urban settings and is higher for HT. Referral for both COPD and hypertension was inadequate until the disease severity increased. COPD and HT significantly are associated with lower ADL scores and financial problems. Public-sector primary healthcare facilities should be better organised to address both conditions with the aim to reduce household poverty.

The Background to Language Change in Hong Kong.

ERIC Educational Resources Information Center

Harrison, Godfrey; So, Lydia K. H.

1996-01-01

Seeks to link the rapid pace of societal change in Hong Kong over the past 50 years with changing patterns of language use there. Shows how the country has changed demographically, economically, politically, socially, and technologically. (16 references) (Author/CK)

Scientific Wealth in Middle East and North Africa: Productivity, Indigeneity, and Specialty in 1981–2013

PubMed Central

Stoppani, Jonathan; Anadon, Laura Diaz; Narayanamurti, Venkatesh

2016-01-01

Several developing countries seek to build knowledge-based economies by attempting to expand scientific research capabilities. Characterizing the state and direction of progress in this arena is challenging but important. Here, we employ three metrics: a classical metric of productivity (publications per person), an adapted metric which we denote as Revealed Scientific Advantage (developed from work used to compare publications in scientific fields among countries) to characterize disciplinary specialty, and a new metric, scientific indigeneity (defined as the ratio of publications with domestic corresponding authors) to characterize the locus of scientific activity that also serves as a partial proxy for local absorptive capacity. These metrics—using population and publications data that are available for most countries–allow the characterization of some key features of national scientific enterprise. The trends in productivity and indigeneity when compared across other countries and regions can serve as indicators of strength or fragility in the national research ecosystems, and the trends in specialty can allow regional policy makers to assess the extent to which the areas of focus of research align (or not align) with regional priorities. We apply the metrics to study the Middle East and North Africa (MENA)—a region where science and technology capacity will play a key role in national economic diversification. We analyze 9.8 million publication records between 1981–2013 in 17 countries of MENA from Morocco to Iraq and compare it to selected countries throughout the world. The results show that international collaborators increasingly drove the scientific activity in MENA. The median indigeneity reached 52% in 2013 (indicating that almost half of the corresponding authors were located in foreign countries). Additionally, the regional disciplinary focus in chemical and petroleum engineering is waning with modest growth in the life sciences. We find repeated patterns of stagnation and contraction of scientific activity for several MENA countries contributing to a widening productivity gap on an international comparative yardstick. The results prompt questions about the strength of the developing scientific enterprise and highlight the need for consistent long-term policy for effectively addressing regional challenges with domestic research. PMID:27820831

Sociodemographic characteristics and drug abuse patterns of adolescents admitted for substance use disorder treatment in Istanbul.

PubMed

Çiftçi Demirci, Arzu; Erdoğan, Ayten; Yalçın, Özhan; Yıldızhan, Eren; Koyuncu, Zehra; Eseroğlu, Tuğba; Önder, Arif; Evren, Cuneyt

2015-05-01

Adolescent substance use is an increasing major health problem in developing countries. To evaluate the sociodemographic characteristics and drug abuse patterns of children and youth seeking treatment in Turkey. This retrospective study reviewed the demographic and clinical data of substance users who visited the substance addiction treatment clinic for children and youth in Bakırköy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery in Istanbul, between January 2011 and December 2012. The sample comprised of 1969 children and youth aged between 11 and 20 (346 female and 1623 male). Cannabis (60.1%), followed by solvents/inhalants (38.3%) and ecstasy (33.4%), were the most prevalent substances used. The use of solvents/inhalants was more common among males, whereas ecstasy and cocaine use were more common among females. The mean age for the onset of substance use was 13 years. The proportion of polysubstance use was 60.2%. There was a mean duration of 2.28 ± 1.91 years between the first substance use and seeking treatment. The risk factors for most of the drug usage were onset of substance use at a young age, gender, treatment admission at older ages, higher parental criminal history, and having substance using parents or relatives. Findings of the very early onset of substance and polysubstance use indicated easy accessibility of legal and illicit substances by children and youth in Istanbul. These findings on Turkish children and youth who seek substance use treatment can be useful in developing preventive early interventions and treatment facilities.

[Control of tuberculosis as seen "in the field": popular perceptions of the disease and access to care in Conakry, Guinea].

PubMed

Diallo, A B; Diallo, M; Jaffré, Y

2004-01-01

Tuberculosis is a public health priority especially in developing countries. A variety of control programs have been implemented. The purpose of this survey was to study the perceptions and practices of the victims of this disease "in the field". The findings of this survey carried out in a cohort of 65 patients and their families in Conakry, Guinea underline the importance of popular perceptions of the disease in care-seeking behavior. This survey also shows that health care workers share the same perceptions as the general population, which constitutes a major impediment for screening and treatment.

Space - It's not just for governments anymore

NASA Technical Reports Server (NTRS)

Stone, Barbara A.; Kleber, Peter

1992-01-01

Space initiatives have traditionally been in the exclusive domain of national government. Over the last decades, this has begun to change dramatically as commercial development of space has attracted increasing international attention. Businesses in at least 20 countries worldwide now engage in some form of space commerce. These businesses, which range from strictly entrepreneurial to government corporations, are seeking to do business in every commercial space sector. This paper details the current status and prospects for the future of space commerce in the United States and Europe, focusing on the programs of France, Germany, and Italy. Included are analyses of representative successes and failures of these activities.

Fascioliasis: An Ongoing Zoonotic Trematode Infection

PubMed Central

Nyindo, Mramba; Lukambagire, Abdul-Hamid

2015-01-01

Zoonotic trematode infections are an area of the neglected tropical diseases that have become of major interest to global and public health due to their associated morbidity. Human fascioliasis is a trematode zoonosis of interest in public health. It affects approximately 50 million people worldwide and over 180 million are at risk of infection in both developed and underdeveloped countries. The one health paradigm is an area that seeks to address the problem of zoonotic infections through a comprehensive and sustainable approach. This review attempts to address the major challenges in managing human and animal fascioliasis with valuable insights gained from the one health paradigm to global health and multidisciplinary integration. PMID:26417603

Fascioliasis: An Ongoing Zoonotic Trematode Infection.

PubMed

Nyindo, Mramba; Lukambagire, Abdul-Hamid

2015-01-01

Zoonotic trematode infections are an area of the neglected tropical diseases that have become of major interest to global and public health due to their associated morbidity. Human fascioliasis is a trematode zoonosis of interest in public health. It affects approximately 50 million people worldwide and over 180 million are at risk of infection in both developed and underdeveloped countries. The one health paradigm is an area that seeks to address the problem of zoonotic infections through a comprehensive and sustainable approach. This review attempts to address the major challenges in managing human and animal fascioliasis with valuable insights gained from the one health paradigm to global health and multidisciplinary integration.

Equipment and skills shortage in Uzbekistan.

PubMed

Khodjibaev, Abdukhakim M; Anvarov, Khikmat; Borisova, Elena; Schmitt, Roger; Murotova, Nigora

2014-05-01

In this article, supplied with the help of the International Federation of Hospital Engineering (IFHE), five co-authors from the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ)--a German organisation that seeks to encourage and co-ordinate international cooperation in areas ranging from sustainable development to fund management, and its partner organisation, IFHE member, the Republican Research Center of Emergency Medicine (RRCEM) in Uzbekistan, discuss the use of medical technology in the central Asian country. They also explain how a GIZ project is helping to boost the number of skilled staff, improve quality assurance and management in procurement, logistics, and maintenance, and promote good training of medical and technical staff, across Uzbekistan.

Socio-cultural factors, gender roles and religious ideologies contributing to Caesarian-section refusal in Nigeria.

PubMed

Ugwu, Nnanna U; de Kok, Bregje

2015-08-12

The death of women from pregnancy-related causes is a serious challenge that international development initiatives, including the Millennium Development Goals, have been trying to redress for decades. The majority of these pregnancy-related deaths occur in developing countries especially in Sub-Saharan Africa. The provision of Emergency Obstetric Care (EmOC), including Caesarean section (CS) has been identified as one of the key ingredients necessary for the reduction of high maternal mortality ratios. However, it appears that creating access to EmOC facilities is not all that is required to reduce maternal mortality: socio-cultural issues in Sub-Saharan countries including Nigeria seem to deter women from accepting CS. This study seeks to explore some of the socio-cultural concerns that reinforce delays and non-acceptance of CS in a Nigerian community. This is a mixed method study that combined both qualitative and quantitative strategies of enquiry. The hospital's delivery records from 2006-2010 provided data for quantitative analysis. This quantitative data was supplemented with prospective data collected during one month. Semi-structured interviews, focus group discussions (FGD) and informal observations served as the sources of data on the qualitative end. In total, 22% of maternity clients refused CS and more than 90% of the CSs in the focal hospital were emergencies which may indicate late arrival at the hospital after seeking assistance elsewhere. The qualitative analysis reveals that socio-cultural meanings informed by gender and religious ideologies, the relational consequences of having a C-section, and the role of alternative providers are some key factors which influence when, where and whether women will accept C-section or not. There is need to find means of facilitating necessary CS by addressing the prevailing socio-cultural norms and expectations that hinder its acceptance. Engaging and guiding alternative providers (traditional birth attendants and faith healers) who wield much power in their communities, will be important to minimize delays and improve cultural acceptability of CS.

Access to healthcare and alternative health-seeking strategies among undocumented migrants in Denmark

PubMed Central

2011-01-01

Background As in many European countries, undocumented migrants in Denmark have restricted access to healthcare. The aim of this study is to describe and analyse undocumented migrants' experiences of access to healthcare, use of alternative health-seeking strategies; and ER nurses' experiences in encounters with undocumented migrants. Methods Qualitative design using semi-structured interviews and observations. The participants included ten undocumented South Asian migrants and eight ER nurses. Results Undocumented migrants reported difficulties accessing healthcare. The barriers to healthcare were: limited medical rights, arbitrariness in healthcare professionals' attitudes, fear of being reported to the police, poor language skills, lack of network with Danish citizens, lack of knowledge about the healthcare system and lack of knowledge about informal networks of healthcare professionals. These barriers induced alternative health-seeking strategies, such as self-medication, contacting doctors in home countries and borrowing health insurance cards from Danish citizens. ER nurses expressed willingness to treat all patients regardless of their migratory status, but also reported challenges in the encounters with undocumented migrants. The challenges for ER nurses were: language barriers, issues of false identification, insecurities about the correct standard procedures and not always being able to provide appropriate care. Conclusions Undocumented migrants face formal and informal barriers to the Danish healthcare system, which lead to alternative health-seeking strategies that may have adverse effects on their health. This study shows the need for policies and guidelines, which in accordance with international human rights law, ensure access to healthcare for undocumented migrants and give clarity to healthcare professionals. PMID:21752296

Does the organizational structure of health care systems influence care-seeking decisions? A qualitative analysis of Danish cancer patients' reflections on care-seeking.

PubMed

Andersen, Rikke Sand; Vedsted, Peter; Olesen, Frede; Bro, Flemming; Søndergaard, Jens

2011-09-01

The absence of a more significant improvement in cancer survival in countries such as the UK and Denmark may be partly rooted in delayed care-seeking among cancer patients. Past research on patient delay has mainly focused on patient characteristics (e.g. sociodemographic and psychological factors and symptom recognition) as causes of delayed care-seeking, while few studies have examined how the organizational structure of health care systems may influence patients' reflections on seeking care. The aim of this study was to explore this relationship. The analysis presented is based on semi-structured interviews with 30 cancer patients and their families. The article raises two hypotheses on the relationship between structural elements of a health care system and people's reflections on seeking health care: (1) Gatekeeping introduces an asymmetrical relationship between the patient and the GP which potentially results in self-restricting care-seeking, (2) Continuity in the doctor-patient relationship may negatively influence patient reflections on access to health care, as the focus shifts from the medical issues of the consultation to reflections on how to properly interact with the GP and the system in which she/he is situated. It is concluded that these hypotheses form a sound basis for further primary care research on how the organizational structure of health care systems influences patient reflections on access to medical care.

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

PubMed

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

2009-01-01

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

The SLMTA programme: Transforming the laboratory landscape in developing countries

PubMed Central

Maruta, Talkmore; Luman, Elizabeth T.; Nkengasong, John N.

2014-01-01

Background Efficient and reliable laboratory services are essential to effective and well-functioning health systems. Laboratory managers play a critical role in ensuring the quality and timeliness of these services. However, few laboratory management programmes focus on the competencies required for the daily operations of a laboratory in resource-limited settings. This report provides a detailed description of an innovative laboratory management training tool called Strengthening Laboratory Management Toward Accreditation (SLMTA) and highlights some challenges, achievements and lessons learned during the first five years of implementation (2009–2013) in developing countries. Programme SLMTA is a competency-based programme that uses a series of short courses and work-based learning projects to effect immediate and measurable laboratory improvement, while empowering laboratory managers to implement practical quality management systems to ensure better patient care. A SLMTA training programme spans from 12 to 18 months; after each workshop, participants implement improvement projects supported by regular supervisory visits or on-site mentoring. In order to assess strengths, weaknesses and progress made by the laboratory, audits are conducted using the World Health Organization’s Regional Office for Africa (WHO AFRO) Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist, which is based on International Organization for Standardization (ISO) 15189 requirements. These internal audits are conducted at the beginning and end of the SLMTA training programme. Conclusion Within five years, SLMTA had been implemented in 617 laboratories in 47 countries, transforming the laboratory landscape in developing countries. To our knowledge, SLMTA is the first programme that makes an explicit connection between the performance of specific management behaviours and routines and ISO 15189 requirements. Because of this close relationship, SLMTA is uniquely positioned to help laboratories seek accreditation to ISO 15189. PMID:26752335

[The role of a specialised risk analysis group in the Veterinary Services of a developing country].

PubMed

Urbina-Amarís, M E

2003-08-01

Since the World Trade Organization (WTO) Agreement on the Application of Sanitary and Phytosanitary Measures was established, risk analysis in trade, and ultimately in Veterinary and Animal Health Services, has become strategically important. Irrespective of their concept (discipline, approach, method, process), all types of risk analysis in trade involve four periods or phases:--risk identification-- risk assessment--risk management--risk information or communication. All veterinarians involved in a risk analysis unit must have in-depth knowledge of statistics and the epidemiology of transmissible diseases, as well as a basic knowledge of veterinary science, economics, mathematics, data processing and social communication, to enable them to work with professionals in these disciplines. Many developing countries do not have enough well-qualified professionnals in these areas to support a risk analysis unit. This will need to be rectified by seeking strategic alliances with other public or private sectors that will provide the required support to run the unit properly. Due to the special nature of its risk analysis functions, its role in supporting decision-making, and the criteria of independence and transparency that are so crucial to its operations, the hierarchical position of the risk analysis unit should be close to the top management of the Veterinary Service. Due to the shortage of personnel in developing countries with the required training and scientific and technical qualifications, countries with organisations responsible for both animal and plant health protection would be advised to set up integrated plant and animal risk analysis units. In addition, these units could take charge of all activities relating to WTO agreements and regional agreements on animal and plant health management.

Scaling-up health information systems to improve HIV treatment: An assessment of initial patient monitoring systems in Mozambique.

PubMed

Hochgesang, Mindy; Zamudio-Haas, Sophia; Moran, Lissa; Nhampossa, Leopoldo; Packel, Laura; Leslie, Hannah; Richards, Janise; Shade, Starley B

2017-01-01

The rapid scale-up of HIV care and treatment in resource-limited countries requires concurrent, rapid development of health information systems to support quality service delivery. Mozambique, a country with an 11.5% prevalence of HIV, has developed nation-wide patient monitoring systems (PMS) with standardized reporting tools, utilized by all HIV treatment providers in paper or electronic form. Evaluation of the initial implementation of PMS can inform and strengthen future development as the country moves towards a harmonized, sustainable health information system. This assessment was conducted in order to 1) characterize data collection and reporting processes and PMS resources available and 2) provide evidence-based recommendations for harmonization and sustainability of PMS. This baseline assessment of PMS was conducted with eight non-governmental organizations that supported the Ministry of Health to provide 90% of HIV care and treatment in Mozambique. The study team conducted structured and semi-structured surveys at 18 health facilities located in all 11 provinces. Seventy-nine staff were interviewed. Deductive a priori analytic categories guided analysis. Health facilities have implemented paper and electronic monitoring systems with varying success. Where in use, robust electronic PMS facilitate facility-level reporting of required indicators; improve ability to identify patients lost to follow-up; and support facility and patient management. Challenges to implementation of monitoring systems include a lack of national guidelines and norms for patient level HIS, variable system implementation and functionality, and limited human and infrastructure resources to maximize system functionality and information use. This initial assessment supports the need for national guidelines to harmonize, expand, and strengthen HIV-related health information systems. Recommendations may benefit other countries with similar epidemiologic and resource-constrained environments seeking to improve PMS implementation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Conservation Research Is Not Happening Where It Is Most Needed.

PubMed

Wilson, Kerrie A; Auerbach, Nancy A; Sam, Katerina; Magini, Ariana G; Moss, Alexander St L; Langhans, Simone D; Budiharta, Sugeng; Terzano, Dilva; Meijaard, Erik

2016-03-01

Target 19, set by the Convention on Biological Diversity, seeks to improve the knowledge, science base, and technologies relating to biodiversity. We will fail to achieve this target unless prolific biases in the field of conservation science are addressed. We reveal that comparatively less research is undertaken in the world's most biodiverse countries, the science conducted in these countries is often not led by researchers based in-country, and these scientists are also underrepresented in important international fora. Mitigating these biases requires wide-ranging solutions: reforming open access publishing policies, enhancing science communication strategies, changing author attribution practices, improving representation in international processes, and strengthening infrastructure and human capacity for research in countries where it is most needed.

Conservation Research Is Not Happening Where It Is Most Needed

PubMed Central

Wilson, Kerrie A.; Auerbach, Nancy A.; Sam, Katerina; Magini, Ariana G.; Moss, Alexander St. L.; Langhans, Simone D.; Budiharta, Sugeng; Terzano, Dilva; Meijaard, Erik

2016-01-01

Target 19, set by the Convention on Biological Diversity, seeks to improve the knowledge, science base, and technologies relating to biodiversity. We will fail to achieve this target unless prolific biases in the field of conservation science are addressed. We reveal that comparatively less research is undertaken in the world’s most biodiverse countries, the science conducted in these countries is often not led by researchers based in-country, and these scientists are also underrepresented in important international fora. Mitigating these biases requires wide-ranging solutions: reforming open access publishing policies, enhancing science communication strategies, changing author attribution practices, improving representation in international processes, and strengthening infrastructure and human capacity for research in countries where it is most needed. PMID:27023288

Postpartum contraception utilization among low-income women seeking immunization for infants in Mumbai, India.

PubMed

Mody, Sheila K; Nair, Saritha; Dasgupta, Anindita; Raj, Anita; Donta, Balaiah; Saggurti, Niranjan; Naik, D D; Silverman, Jay G

2014-06-01

The objective was to examine postpartum contraception utilization among Indian women seeking immunization for their infants in three low-income communities in Mumbai, India. We conducted a cross-sectional questionnaire of low-income postpartum women seeking immunization for their infants at three large urban health centers in Mumbai. Contraceptive utilization data were collected as part of a larger study focused on the impact of postpartum domestic violence on maternal and infant health. Descriptive, bivariate and multivariate analyses were conducted to describe and identify predictors of postpartum contraceptive utilization. Postpartum women aged 17-45 years (N=1049) completed the survey; 44.5% (n=467) reported resuming sexual relations with their husbands. Among these women, the majority (65.3%; n=305) reported not currently using contraception. In multivariate analyses, women who did not discuss postpartum family planning with their husbands, had not used contraception previous to the recent birth, and had experienced physical violence or forced sex were more likely to not use postpartum contraception (adjusted odds ratios=1.47-1.77). Among the 162 women using contraception, the most common time to initiation of contraception was 5 weeks postpartum, and the most common method used was condoms 77.8% (n=126). Contraception nonuse was common among urban, low-income postpartum women in India. This study highlights the importance of developing interventions to increase use of highly effective contraceptive methods postpartum, and that spousal violence and lack of marital communication may present barriers to postpartum contraception utilization. Infant immunization may represent an opportunity for provision of contraceptives and contraceptive counseling. This original research study is a unique contribution to the literature because it presents data regarding the nonuse of postpartum contraception among women seeking immunizations for their infants in urban centers in a developing country. It also reveals barriers to not using postpartum contraception and provides data for future interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

Postpartum contraception utilization among low-income women seeking immunization for infants in Mumbai, India

PubMed Central

Mody, Sheila K; Nair, Saritha; Dasgupta, Anindita; Raj, Anita; Donta, Balaiah; Saggurti, Niranjan; Naik, DD; Silverman, Jay G

2014-01-01

Objective To examine postpartum contraception utilization among Indian women seeking immunization for their infants in three low-income communities in Mumbai, India. Study Design We conducted a cross-sectional questionnaire of low-income postpartum women seeking immunization for their infants at three large urban health centers in Mumbai. Contraceptive utilization data was collected as part of a larger study focused on the impact of postpartum domestic violence on maternal and infant health. Descriptive, bivariate and multivariate analyses were conducted to describe and identify predictors of postpartum contraceptive utilization. Results Postpartum women aged 17–45 years (N=1049) completed the survey; 44.5% (n= 467) reported resuming sexual relations with their husbands. Among these women, the majority (65.3%; n=305) reported not currently using contraception. In multivariate analyses, women who did not discuss postpartum family planning with their husbands, had not used contraception previous to the recent birth, and who had experienced physical violence or forced sex were more likely to not use postpartum contraception (AORs = 1.47–1.77). Among the 162 women using contraception, the most common time to initiation of contraception was 5 weeks postpartum and the most common method used was condoms 77.8% (n=126). Conclusion Contraception non-use was common among urban, low-income postpartum women in India. This study highlights the importance of developing interventions to increase use of highly effective contraceptive methods postpartum, and that spousal violence and lack of marital communication may present barriers to postpartum contraception utilization. Infant immunization may represent an opportunity for provision of contraceptives and contraceptive counseling. Implications This original research study is a unique contribution to the literature because it presents data regarding the non-use of postpartum contraception among women seeking immunizations for their infants in urban centers in a developing country. It also reveals barriers to not using postpartum contraception and provides data for future interventions. PMID:24560478

Approaches and Concerns in Myanmar

ERIC Educational Resources Information Center

Mar, Naing Yee

2005-01-01

The information age has changed the economic and social environment in such ways that countries are moving from being "traditional pull" to "technology push" societies. This makes technical and vocational education and training (TVET) policy especially significant as it seeks to promote specialized practical and professional…

Agrarian Visions.

ERIC Educational Resources Information Center

Theobald, Paul

A new feature in "Country Teacher,""Agrarian Visions" reminds rural teachers that they can do something about rural decline. Like to populism of the 1890s, the "new populism" advocates rural living. Current attempts to address rural decline are contrary to agrarianism because: (1) telecommunications experts seek to…

A Field and Simulator Evaluation of All-Red Clearance Intervals for Use in Left-Turn Applications

DOT National Transportation Integrated Search

2018-03-01

As the implementation of the novel flashing yellow arrow (FYA) traffic control device advances throughout the country, agencies continually seek ways to improve intersection operations and safety, especially on left turns. For example, permissive lef...

Investigating financial incentives for maternal health: an introduction.

PubMed

Stanton, Mary Ellen; Higgs, Elizabeth S; Koblinsky, Marge

2013-12-01

Projection of current trends in maternal and neonatal mortality reduction shows that many countries will fall short of the UN Millennium Development Goal 4 and 5. Underutilization of maternal health services contributes to this poor progress toward reducing maternal and neonatal morbidity and mortality. Moreover, the quality of services continues to lag in many countries, with a negative effect on the health of women and their babies, including deterring women from seeking care. To enhance the use and provision of quality maternal care, countries and donors are increasingly using financial incentives. This paper introduces the JHPN Supplement, in which each paper reviews the evidence of the effectiveness of a specific financial incentive instrument with the aim of improving the use and quality of maternal healthcare and impact. The US Agency for International Development and the US National Institutes of Health convened a US Government Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives on 24-25 April 2012 in Washington, DC. The Summit brought together leading global experts in finance, maternal health, and health systems from governments, academia, development organizations, and foundations to assess the evidence on whether financial incentives significantly and substantially increase provision, use and quality of maternal health services, and the contextual factors that impact the effectiveness of these incentives. Evidence review teams evaluated the multidisciplinary evidence of various financial mechanisms, including supply-side incentives (e.g. performance-based financing, user fees, and various insurance mechanisms) and demand-side incentives (e.g. conditional cash transfers, vouchers, user fee exemptions, and subsidies for care-seeking). At the Summit, the teams presented a synthesis of evidence and initial recommendations on practice, policy, and research for discussion. The Summit enabled structured feedback on recommendations which the teams included in their final papers appearing in this Supplement. Papers in this Supplement review the evidence for a specific financial incentive mechanism (e.g. pay for performance, conditional cash transfer) to improve the use and quality of maternal healthcare and makes recommendations for programmes and future research. While data on programmes using financial incentives for improved use and indications of the quality of maternal health services support specific conclusions and recommendations, including those for future research, data linking the use of financial incentives with improved health outcomes are minimal.

Increasing organ donation by presumed consent and allocation priority: Chile

PubMed Central

2015-01-01

Abstract Chile, a middle-income country, recently joined Israel and Singapore as the world’s only countries to require reciprocity as a precondition for organ transplantation. The Chilean reform includes opt-out provisions designed to foster donation and priority for organ transplantation for registered people. Although the reform has had serious difficulties in achieving its mission, it can be reviewed by other countries that seek to address the serious shortage of organs. As increased organ donation can substantially enhance or save more lives, the effect on organ availability due to incentives arising from rules of preference should not be underestimated. PMID:25767299

Professionalisation as development and as regulation: Adult education in Germany, the United Kingdom and India

NASA Astrophysics Data System (ADS)

Doyle, Lesley; Egetenmeyer, Regina; Singai, Chetan; Devi, Uma

2016-06-01

In this paper, the authors seek to disentangle what they see as contradictory uses of the term "professionalisation" with reference to adult educator development and training (AEDT). They set out to distinguish professionalisation from professionalism, and to identify the locus of control of AEDT in Germany, the UK and India. In these three countries, all of which have a long tradition of adult education, "professionalisation" and "professionalism" are used interchangeably to describe conflicting purposes. The authors aim to identify and critically explore the organisations and policies which control and support AEDT in their own countries using American sociologist Eliot Freidson's "third logic" model, and drawing on his juxtaposition of "professions", "the market" and "bureaucracy". Applying Freidson's models to the organisations highlights the role of bureaucracy and that where adult education is concerned, national governments, the European Union and aid organisations not only serve bureaucracy but also support the market rather than operating separately from it. While the term "professionalisation" continues to be used to mean professional development, either by adult educators and representative organisations (as in the UK) or by organisations acting on their behalf (as in Germany and India), it is also used to denote regulation and standardisation issuing from bureaucratic institutions and adult education provider organisations in the interests of the market. The authors suggest that Freidson's model provides a useful tool for adult educators in other countries to reflect on their professional position and to engage in the development of their own professional standards, both in their own interests and in the interests of those they educate.

The progression of disability among older adults in Mexico.

PubMed

Díaz-Venegas, Carlos; Reistetter, Timothy A; Wang, Ching-Yi; Wong, Rebeca

2016-10-01

This paper seeks to document the progression of disability in a developing country and to examine gender differences in this process. The data come from the Mexican Health and Aging Study (MHAS), a nationally representative sample of older adults. An ordinal logistic regression (n = 3283) is used to measure the progression of disability that considers: (1) no disability, (2) mobility problems, (3) mobility problems with IADLs limitations, (4) mobility problems with ADLs limitations, (5) combinations of the latter three and (6) death. Approximately 43% of the sample remained in the same level of disability after 2 years. The patterns of progression with two disabilities differ for men and women. Our model reflects the importance of separating ADLs and IADLs in the study of disability progression in Mexico. Varying risk profiles and cultural differences might influence the divergent disability paths followed by each gender. Implications for Rehabilitation The disablement process involving transitions from mobility impairments to IADL and ADL limitations seen in developed countries differs for older adults in Mexico. Cultural differences may influence the progression from non-disabled to becoming disabled in different ways for females in developing countries like Mexico. One-fifth of individuals showed greater function and independence over time, suggesting that the disablement process is reversible. This finding highlights the need to focus on improving mobility, ADL, and IADL skills to facilitate successful aging. Although disability is often conceptualised as a combination of ADL and IADL limitations, gender differences seen in Mexico indicate the need to separate ADL and IADL when developing approaches to prevent or ameliorate disability.

Libya: A Country in Transition Seeking to Assert its Influence.

DTIC Science & Technology

1983-06-02

the political situation. Moreover, classical and neoclassical economic principles appeared to go awry in a country where 44 percent of the population...of Libyan airfields in the event of a Mediterranean crisis . Even if Qadhaafi himself might never gront such facilities, there is always the danger of...August 18, 1980. P. 167. "To Blame for Gasoline Crisis ." The Gallnp Poll. July 22, 1979. P. 200. "Main Cause of Trouble Between Arabs and Israelis." The

Wind Lidar Activities in the United States

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

Clifton, Andrew; Newman, Jennifer; St. Pe, Alexandra

2017-06-28

IEA Wind Task 32 seeks to identify and mitigate the barriers to the adoption of lidar for wind energy applications. This work is partly achieved by sharing experience across researchers and practitioners in the United States and worldwide. This presentation is a short summary of some wind lidar-related activities taking place in the country, and was presented by Andrew Clifton at the Task 32 meeting in December 2016 in his role as the U.S. Department of Energy-nominated country representative to the task.

The childbearing health and related service needs of newcomers (CHARSNN) study protocol

PubMed Central

Gagnon, Anita J; Wahoush, Olive; Dougherty, Geoffrey; Saucier, Jean-François; Dennis, Cindy-Lee; Merry, Lisa; Stanger, Elizabeth; Stewart, Donna E

2006-01-01

Background Refugee and asylum-seeking women in Canada may have significant harmful childbearing health outcomes and unmet health and social care needs. The most vulnerable of these women are: those who have left their countries by force (e.g., war, rape or abuse histories), are separated from their families, have limited knowledge of the host country languages, and are visible minorities. Asylum-seekers face additional stresses related to their unknown future status and are marginalized with regards to access to provincial health care systems. The prevalence and severity of health issues in this population is not known nor is the extent of response from social service and health care systems (including variation in provincial service delivery). Understanding the magnitude of health and social concerns of newcomers requires data from a representative sample of childbearing refugee and asylum-seeking women resettling in Canada to permit comparisons to be made with non-refugee immigrant and Canadian-born women. Our research questions are: (1) Do refugee or asylum-seeking women and their infants, experience a greater number or a different distribution of harmful health events during pregnancy, at birth, and during the postpartum period than non-refugee immigrant or Canadian-born women? (2) Are the harmful health events experienced postpartum by asylum-seeking women and their infants, addressed less often (compared to refugees, non-refugee immigrants, and Canadian-born women) by the Canadian health care system as delivered in each of the three major receiving cities for newcomers? Methods/design This is a four-year multi-site prospective cohort study (pregnancy to 4 months postpartum). We will seek to recruit 2400 women [200 in each of 4 groups (refugees, asylum-seekers, non-refugee immigrants, and Canadian-born) from 1 of 12 postpartum hospital units across the 3 largest receiving cities for newcomers to Canada – Montreal, Toronto, and Vancouver]. Discussion Knowledge of the extent of harmful health events occurring to asylum-seeking, refugee, immigrant, and Canadian-born women, and the response of the health care system to those events and group differences, if they exist, will inform immigration and health policy makers as well as providers of services. PMID:17190589

Household roles and care-seeking behaviours in response to severe childhood illness in Mali.

PubMed

Ellis, Amy A; Doumbia, Seydou; Traoré, Sidy; Dalglish, Sarah L; Winch, Peter J

2013-11-01

Malaria is a major cause of under-five mortality in Mali and many other developing countries. Malaria control programmes rely on households to identify sick children and either care for them in the home or seek treatment at a health facility in the case of severe illness. This study examines the involvement of mothers and other household members in identifying and treating severely ill children through case studies of 25 rural Malian households. A wide range of intra-household responses to severe illness were observed among household members, both exemplifying and contravening stated social norms about household roles. Given their close contact with children, mothers were frequently the first to identify illness symptoms. However, decisions about care-seeking were often taken by fathers and senior members of the household. As stewards of the family resources, fathers usually paid for care and thus significantly determined when and where treatment was sought. Grandparents were frequently involved in diagnosing illnesses and directing care towards traditional healers or health facilities. Relationships between household members during the illness episode were found to vary from highly collaborative to highly conflictive, with critical effects on how quickly and from where treatment for sick children was sought. These findings have implications for the design and targeting of malaria and child survival programming in the greater West African region.

Corporate good citizenship pays off in Central America.

PubMed

1974-07-22

Fear of expropriation and increasing public scrutiny of the activities of multinational companies are forcing these companies to develop social programs in the countries where they operate. Frequently these programs are viewed as products of colonialism or as veiled attempts to dominate the nationals employed by these companies. The United Brands Company, which is involved in large scale banana production in several Central American countries, has adopted a program which seeks to reduce the paternalism which was associated with the operations of the United Fruit Company, the predecessor of the United Brands Company. A series of new programs emphasizing community self help projects were developed by a company-hired sociologist and initiated 4 years ago. In Panama, the projects were started by holding town meetings in which the citizens decided what projects to pursue. With company help the community has begun to build recreational and educational facilities and are also building new docks. The company is contributing $10 million annually to promote these projects. Other programs involve selling homes to workers for half the cost of constructing these homes and increasing efforts to put host country citizens into management positions. Home ownership is expected to stabilize the work force and increased opportunities for advancement are expected to increase productivity. Future plans include the construction of technical schools which will provide a pool of skilled technicians needed by the banana company.

Turning Schools around

ERIC Educational Resources Information Center

Johnson, Sabrina

2011-01-01

Schools across the country are seeking creative ways to meet the high demands of school accountability. For example, in Montgomery (AL) Public Schools, "turnaround specialists" work at the direction of the local system's board of education. The district decided to treat turnaround specialists as partners who work with school principals…

19 CFR 177.30 - Review of final determinations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... THE TREASURY (CONTINUED) ADMINISTRATIVE RULINGS Government Procurement; Country-of-Origin... Federal Register, and may seek judicial review of a refusal to issue a final determination within 30 days after such refusal. The Court of International Trade shall have exclusive jurisdiction to review a final...

19 CFR 177.30 - Review of final determinations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... THE TREASURY (CONTINUED) ADMINISTRATIVE RULINGS Government Procurement; Country-of-Origin... Federal Register, and may seek judicial review of a refusal to issue a final determination within 30 days after such refusal. The Court of International Trade shall have exclusive jurisdiction to review a final...

19 CFR 177.30 - Review of final determinations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... THE TREASURY (CONTINUED) ADMINISTRATIVE RULINGS Government Procurement; Country-of-Origin... Federal Register, and may seek judicial review of a refusal to issue a final determination within 30 days after such refusal. The Court of International Trade shall have exclusive jurisdiction to review a final...

19 CFR 177.30 - Review of final determinations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... THE TREASURY (CONTINUED) ADMINISTRATIVE RULINGS Government Procurement; Country-of-Origin... Federal Register, and may seek judicial review of a refusal to issue a final determination within 30 days after such refusal. The Court of International Trade shall have exclusive jurisdiction to review a final...

3 CFR 8418 - Proclamation 8418 of September 16, 2009. Constitution Day and Citizenship Day, Constitution Week...

Code of Federal Regulations, 2010 CFR

2010-01-01

... beacon of hope for Americans and those who seek new lives in the United States. Every day, we welcome new... can better our country and breathe life into the freedoms established in the Constitution. The right...

Perceived Barriers to Information Access Among Medical Residents in Iran: Obstacles to Answering Clinical Queries in Settings with Limited Internet Accessibility

PubMed Central

Mazloomdoost, Danesh; Mehregan, Shervineh; Mahmoudi, Hilda; Soltani, Akbar; Embi, Peter J.

2007-01-01

Studies performed in the US and other Western countries have documented that physicians generate many clinical questions during a typical day and rely on various information sources for answers. Little is known about the information seeking behaviors of physicians practicing in other countries, particularly those with limited Internet connectivity. We conducted this study to document the perceived barriers to information resources used by medical residents in Iran. Our findings reveal that different perceived barriers exist for electronic versus paper-based resources. Notably, paper-based resources are perceived to be limited by resident time-constraints and availability of resources, whereas electronic resources are limited by cost decentralized resources (such as PDAs) and accessibility of centralized, Internet access. These findings add to the limited literature regarding health information-seeking activities in international healthcare settings, particularly those with limited Internet connectivity, and will supplement future studies of and interventions in such settings. PMID:18693891

Perceived barriers to information access among medical residents in Iran: obstacles to answering clinical queries in settings with limited Internet accessibility.

PubMed

Mazloomdoost, Danesh; Mehregan, Shervineh; Mahmoudi, Hilda; Soltani, Akbar; Embi, Peter J

2007-10-11

Studies performed in the US and other Western countries have documented that physicians generate many clinical questions during a typical day and rely on various information sources for answers. Little is known about the information seeking behaviors of physicians practicing in other countries, particularly those with limited Internet connectivity. We conducted this study to document the perceived barriers to information resources used by medical residents in Iran. Our findings reveal that different perceived barriers exist for electronic versus paper-based resources. Notably, paper-based resources are perceived to be limited by resident time-constraints and availability of resources, whereas electronic resources are limited by cost decentralized resources (such as PDAs) and accessibility of centralized, Internet access. These findings add to the limited literature regarding health information-seeking activities in international healthcare settings, particularly those with limited Internet connectivity, and will supplement future studies of and interventions in such settings.

Trade Agreements and Direct-to-Consumer Advertising of Pharmaceuticals

PubMed Central

Gleeson, Deborah; Menkes, David B.

2018-01-01

There is growing international concern about the risks posed by direct-to-consumer advertising (DTCA) of prescription pharmaceuticals, including via the internet. Recent trade agreements negotiated by the United States, however, incorporate provisions that may constrain national regulation of DTCA. Some provisions explicitly mention DTCA; others enable foreign investors to seek compensation if new regulations are seen to harm their investments. These provisions may thus prevent countries from restricting DTCA or put them at risk of expensive legal action from companies seeking damages due to restrictions on advertising. While the most recent example, the Trans-Pacific Partnership Agreement (TPP), collapsed following US withdrawal in January 2017, early indications of the Trump Administration’s trade policy agenda signal an even more aggressive approach on the part of the United States in negotiating advantages for American businesses. Furthermore, the eleven remaining TPP countries may decide to proceed with the agreement in the absence of the United States, with most of the original text (including the provisions relevant to DTCA) intact. PMID:29524933

The National Institutes of Health Affordable Cancer Technologies Program: Improving Access to Resource-Appropriate Technologies for Cancer Detection, Diagnosis, Monitoring, and Treatment in Low- and Middle-Income Countries

PubMed Central

Divi, Rao; Gwede, Michael; Tandon, Pushpa; Sorg, Brian S.; Ossandon, Miguel R.; Agrawal, Lokesh; Pai, Vinay; Baker, Houston; Lash, Tiffani Bailey

2016-01-01

Point-of-care (POC) technologies have proved valuable in cancer detection, diagnosis, monitoring, and treatment in the developed world, and have shown promise in low-and-middle-income countries (LMIC) as well. Despite this promise, the unique design constraints presented in low-resource settings, coupled with the variety of country-specific regulatory and institutional dynamics, have made it difficult for investigators to translate successful POC cancer interventions to the LMIC markets. In response to this need, the National Cancer Institute has partnered with the National Institute of Biomedical Imaging and Bioengineering to create the National Institutes of Health Affordable Cancer Technologies (ACTs) program. This program seeks to simplify the pathway to market by funding multidisciplinary investigative teams to adapt and validate the existing technologies for cancer detection, diagnosis, and treatment in LMIC settings. The various projects under ACTs range from microfluidic cancer diagnostic tools to novel treatment devices, each geared for successful clinical adaptation to LMIC settings. Via progression through this program, each POC innovation will be uniquely leveraged for successful clinical translation to LMICs in a way not before seen in this arena. PMID:27730015

Bioethics and transnational medical travel: India,"medical tourism," and the globalisation of healthcare.

PubMed

Runnels, Vivien; Turner, Leigh

2011-01-01

Health-related travel, also referred to as "medical tourism" is historically well-known. Its emerging contemporary form suggests the development of a form of globalised for-profit healthcare. Medical tourism to India, the focus of a recent conference in Canada, provides an example of the globalisation of healthcare. By positioning itself as a low-cost, high-tech, fast-access and high-quality healthcare destination country, India offers healthcare to medical travellers who are frustrated with waiting lists and the limited availability of some procedures in Canada. Although patients have the right to travel and seek care at international medical facilities, there are a number of dimensions of medical tourism that are disturbing. The diversion of public investments in healthcare to the private sector, in order to serve medical travellers, perversely transfers public resources to international patients at a time when the Indian public healthcare system fails to provide primary healthcare to its own citizens. Further, little is known about patient safety and quality care in transnational medical travel. Countries that are departure points as well as destination countries need to carefully explore the ethical, social, cultural, and economic consequences of the growing phenomenon of for-profit international medical travel.

Renewable Energy Development in Indian Country: A Handbook for Tribes

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

MacCourt, D. C.

2010-06-01

This handbook is designed to be an accessible reference for those who are new to tribal energy project development or seek a refresher on key development issues as they navigate the project development process. It builds upon the wealth of feedback and experiences shared by tribal and other participants in the National Renewable Energy Laboratory's tribal energy training sessions to provide tribal leaders, tribal economic and energy enterprises, and those supporting them with a general overview of the renewable energy project development process as well as detailed guidance on the following: how to structure a renewable energy project transaction tomore » protect tribal interests, with an emphasis on joint project development efforts undertaken with nontribal parties; key energy development agreements, including power sale agreements, transmission and interconnection agreements, and land leases; and ways tribes can finance renewable energy projects, including the sources of funding or financing that may be available, the types of investors that may be available, and federal tax incentives for renewable energy projects.« less

Cost of production of live attenuated dengue vaccines: a case study of the Instituto Butantan, Sao Paulo, Brazil.

PubMed

Mahoney, R T; Francis, D P; Frazatti-Gallina, N M; Precioso, A R; Raw, I; Watler, P; Whitehead, P; Whitehead, S S

2012-07-06

A vaccine to prevent dengue disease is urgently needed. Fortunately, a few tetravalent candidate vaccines are in the later stages of development and show promise. But, if the cost of these candidates is too high, their beneficial potential will not be realized. The price of a vaccine is one of the most important factors affecting its ultimate application in developing countries. In recent years, new vaccines such as those for human papilloma virus and pneumococcal disease (conjugate vaccine) have been introduced with prices in developed countries exceeding $50 per dose. These prices are above the level affordable by developing countries. In contrast, other vaccines such as those against Japanese encephalitis (SA14-14-2 strain vaccine) and meningitis type A have prices in developing countries below one dollar per dose, and it is expected that their introduction and use will proceed more rapidly. Because dengue disease is caused by four related viruses, vaccines must be able to protect against all four. Although there are several live attenuated dengue vaccine candidates under clinical evaluation, there remains uncertainty about the cost of production of these tetravalent vaccines, and this uncertainty is an impediment to rapid progress in planning for the introduction and distribution of dengue vaccines once they are licensed. We have undertaken a detailed economic analysis, using standard industrial methodologies and applying generally accepted accounting practices, of the cost of production of a live attenuated vaccine, originally developed at the US National Institutes of Health (National Institute of Allergy and Infectious Diseases), to be produced at the Instituto Butantan in Sao Paulo, Brazil. We determined direct costs of materials, direct costs of personnel and labor, indirect costs, and depreciation. These were analyzed assuming a steady-state production of 60 million doses per year. Although this study does not seek to compute the price of the final licensed vaccine, the cost of production estimate produced here leads to the conclusion that the vaccine can be made available at a price that most ministries of health in developing countries could afford. This conclusion provides strong encouragement for supporting the development of the vaccine so that, if it proves to be safe and effective, licensure can be achieved soon and the burden of dengue disease can be reduced. Copyright © 2012 Elsevier Ltd. All rights reserved.

Help-seeking for mental health problems in young refugees: a review of the literature with implications for policy, practice, and research.

PubMed

de Anstiss, Helena; Ziaian, Tahereh; Procter, Nicholas; Warland, Jane; Baghurst, Peter

2009-12-01

The large and diverse bodies of literature on refugee child and adolescent mental health have not been matched by a commensurate interest in help-seeking. Most help-seeking research has centred on Western and, to a lesser extent, non-refugee ethnic minority adult populations. An emerging child and adolescent help-seeking literature consistently reports widespread underutilization of mental health services by children in the general population. Current research and opinion suggest a similar trend for refugee and other ethnic minority children. While service underutilization appears to be an issue for all children, those from refugee backgrounds may be at increased risk of mental health problems and have greater difficulty accessing mental health care. From a policy and practice perspective, the most important explanation for low uptake of services by refugee families concerns an overall failure of Western mental health systems to accommodate the needs of ethnically diverse populations in general and refugees in particular. In order to effectively plan for the mental health needs of refugee children and adolescents, Western host country governments need a clear understanding of help-seeking behaviour.

A Comparative Study of Exceptional Experiences of Clients Seeking Advice and of Subjects in an Ordinary Population

PubMed Central

Fach, W.; Atmanspacher, H.; Landolt, K.; Wyss, T.; Rössler, W.

2012-01-01

Exceptional experiences (EE) occur frequently within the populations of many countries and across various socio-cultural contexts. Although some EE show similarities with mental disorders, it would be a mistake to identify them in general as disorders. In fact, the vast number of individuals reporting EE includes subclinical and completely healthy subjects. We conducted a comparative empirical study of several characteristics of EE for two samples – one from ordinary population and the other from clients seeking advice. We found surprisingly similar phenomenological patterns of EE in both samples, but the frequency and intensity of EE for clients seeking advice significantly exceeded those for the ordinary population. Our results support the hypothesis of a continuous spectrum between mental health and mental disorder for the types of experiences analyzed. PMID:23423775

Attitudes and barriers towards HIV screening: A qualitative study of people living with HIV/AIDS (PLWHA) in Malaysia.

PubMed

Ahmed, Syed Imran; Syed Sulaiman, Syed Azhar; Hassali, Mohamed Azmi; Thiruchelvam, Kaeshaelya; Hasan, Syed Shahzad; Lee, Christopher Kc

2017-09-01

Understanding patients' perspective towards HIV screening in Malaysia is pivotal to explore challenges faced by these individuals. This would be beneficial for developing local plans to improve the health-seeking behaviours among population at risk of HIV/AIDS. A qualitative research methodology was adopted to explore HIV/AIDS patients' views about disease screening. A semi-structured interview guide was used for in-depth patient interviews. All interviews were audio-recorded and were subjected to a standard content analysis framework for data analysis. Most patients were positive about screening and the value of knowing about their status early. However, fear of social stigma, discrimination, lack of support system and lack of public understanding were identified as major concerns affecting their willingness to be screened. They were concerned about mandatory screening being implemented without improvement in support system and public education. Reluctance to seek HIV screening is an important factor contributing to transmission in developing countries. In the Malaysian context, efforts should be made to strengthen screening strategies especially in the most-at-risk populations to monitor the epidemic and target prevention strategies. In a multicultural context, HIV preventive strategies must include disease awareness, including measure to tackle barriers towards screening.

Pipelines for New Chemicals: a strategy to create new value chains and stimulate innovation-based economic revival in Southern European countries.

PubMed

Timmis, Kenneth; de Lorenzo, Victor; Verstraete, Willy; Garcia, Jose Luis; Ramos, Juan Luis; Santos, Helena; Economidis, Ioannis; Nogales, Balbina; Timmis, James Kenneth; Fonseca, César; Pruzzo, Carla; Karagouni, Amalia; Panopoulos, Nickolas; Dixon, Bernard

2014-01-01

Countries of Southern Europe are currently suffering from severe socio-economic pain resulting from high debt levels and austerity measures which constrain investment in innovation-based recovery strategies that are essential for entry into a long-term sustainable period of increasing employment and wealth creation. Young university-educated people are particularly innovative, and hence vital to the development of such strategies, but employment opportunities are poor and many are forced to seek employment that neither profits from their training nor satisfies their justified career expectations, or to emigrate. They are the 'lost generation'. A strategy is proposed here for the creation of Pipelines for New Chemicals, national centre-network partnerships for the discovery-synthesis of new chemicals obtained though harvesting new biological diversity, and their exploitation to develop new medicines, agrochemicals, materials, and other products and applications. The goal is to create new regional motors of economic growth and development, by harnessing the knowledge, motivation and innovation potential of the excellently educated young people of Europe to catalyse the development of new small, medium and large enterprises centred around novel chemicals, and the value chains that will evolve with them, and thereby develop a powerful sector of sustainable growth in employment and social and economic prosperity in Southern Europe. © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd.

Use of comparative effectiveness research in drug coverage and pricing decisions: a six-country comparison.

PubMed

Sorenson, Corinna

2010-07-01

Comparative effectiveness research (CER) has assumed an increasing role in drug coverage and, in some cases, pricing decisions in Europe, as decision-makers seek to obtain better value for money. This issue brief comparatively examines the use of CER across six countries--Denmark, England, France, Germany, the Netherlands, and Sweden. With CER gaining traction in the United States, these international experiences offer insights and potential lessons. Investing in CER can help address the current gap in publicly available, credible, up-to-date, and scientifically based comparative information on the effectiveness of drugs and other health interventions. This information can be used to base coverage and pricing decisions on evidence of value, thereby facilitating access to and public and private investment in the most beneficial new drugs and technologies. In turn, use of CER creates incentives for more efficient, high-quality health care and encourages development of innovative products that offer measurable value to patients.

The multinational Men's Attitudes to Life Events and Sexuality (MALES) Study Phase II: understanding PDE5 inhibitor treatment seeking patterns, among men with erectile dysfunction.

PubMed

Fisher, William A; Rosen, Raymond C; Eardley, Ian; Niederberger, Craig; Nadel, Andrea; Kaufman, Joel; Sand, Michael

2004-09-01

The aim of Phase II of the Men's Attitudes to Life Events and Sexuality (MALES) Study is to explore PDE5 inhibitor treatment seeking among men with erectile dysfunction (ED). Phase II of the MALES study involved 2,912 men, aged 20-75 years, from 8 countries (U.S., U.K., Germany, France, Italy, Spain, Mexico, and Brazil), who reported ED. Participants were recruited from the MALES Phase I sample [1] and via booster methods (e.g., physician referral, street interception), and completed self-report questionnaires concerning the characteristics of their ED, their efforts to seek PDE5 inhibitor treatment for their sexual dysfunction, and attitudinal and referent influences that potentially affect treatment-seeking. Statistical analyses focus on identification of correlates of PDE5 inhibitor treatment seeking. PDE5 inhibitor utilization is strongly associated with ED sufferers' assessment of the severity of their sexual dysfunction, with their belief that medication for ED is dangerous, and with their perceptions of whether physicians, other professionals, and spouses or family members are supportive of their seeking treatment. ED sufferers who evaluate their sexual dysfunction as severe, who believe that medication for ED is not dangerous, and who perceive support for treatment seeking from referent others, are more likely to utilize PDE5 inhibitor treatment. Findings indicate that perceived ED severity, beliefs about ED medication, and referent influences are strongly correlated with utilization of PDE5 inhibitor therapy. These findings aid our understanding of factors that may incline men with ED to seek-or to avoid-PDE5 inhibitor therapy for their sexual dysfunction, and provide a basis for clinical and educational interventions to assist men with ED to seek appropriate treatment.

Household costs and time to seek care for pregnancy related complications: The role of results-based financing.

PubMed

Chinkhumba, Jobiba; De Allegri, Manuela; Mazalale, Jacob; Brenner, Stephan; Mathanga, Don; Muula, Adamson S; Robberstad, Bjarne

2017-01-01

Results-based financing (RBF) schemes-including performance based financing (PBF) and conditional cash transfers (CCT)-are increasingly being used to encourage use and improve quality of institutional health care for pregnant women in order to reduce maternal and neonatal mortality in low-income countries. While there is emerging evidence that RBF can increase service use and quality, little is known on the impact of RBF on costs and time to seek care for obstetric complications, although the two represent important dimensions of access. We conducted this study to fill the existing gap in knowledge by investigating the impact of RBF (PBF+CCT) on household costs and time to seek care for obstetric complications in four districts in Malawi. The analysis included data on 2,219 women with obstetric complications from three waves of a population-based survey conducted at baseline in 2013 and repeated in 2014(midline) and 2015(endline). Using a before and after approach with controls, we applied generalized linear models to study the association between RBF and household costs and time to seek care. Results indicated that receipt of RBF was associated with a significant reduction in the expected mean time to seek care for women experiencing an obstetric complication. Relative to non-RBF, time to seek care in RBF areas decreased by 27.3% (95%CI: 28.4-25.9) at midline and 34.2% (95%CI: 37.8-30.4) at endline. No substantial change in household costs was observed. We conclude that the reduced time to seek care is a manifestation of RBF induced quality improvements, prompting faster decisions on care seeking at household level. Our results suggest RBF may contribute to timely emergency care seeking and thus ultimately reduce maternal and neonatal mortality in beneficiary populations.

Cross-national comparison of prenatal methamphetamine exposure on infant and early child physical growth: A natural experiment

PubMed Central

Abar, Beau; LaGasse, Linda L.; Wouldes, Trecia; Derauf, Chris; Newman, Elana; Shah, Rizwan; Smith, Lynne M.; Arria, Amelia M.; Huestis, Marilyn A.; DellaGrotta, Sheri; Dansereau, Lynne M.; Wilcox, Tara; Neal, Charles R.; Lester, Barry M.

2013-01-01

The current study seeks to compare the effects of prenatal methamphetamine exposure (PME) on infant and child physical growth between the United States (US) and New Zealand (NZ). This cross-national comparison provides a unique opportunity to examine the potential impact of services provided to drug using mothers on child health. Methods The longitudinal Infant Development, Environment and Lifestyle (IDEAL) study of PME from birth to 36 months was conducted in the US and NZ. The US cohort included 204 children with PME and 212 non-PME matched comparisons (NPME); the NZ cohort included 108 children with PME and 115 NPME matched comparisons. Latent growth curve models were used to examine effects of PME, country of origin, and the country × PME interaction on growth in length/height and weight. Results In regard to length/height, PME and country of origin were associated with initial length and growth over time. There was also a significant interaction effect, such that children with PME in the US were shorter at birth than children with PME in NZ after controlling for other prenatal exposures, infant set, socioeconomic status, and maternal height. In regard to weight, there was only an effect of country of origin. Conclusions Effects of PME on infant and child growth were shown to differ across countries, with exposed children in NZ faring better than exposed children in the US. Implications for prevention programs and public policy are discussed. PMID:23943149

Job-Seeking Stress, Mental Health Problems, and the Role of Perceived Social Support in University Graduates in Korea.

PubMed

Lim, Ah Young; Lee, Seung-Hee; Jeon, Yeongju; Yoo, Rankyung; Jung, Hee-Yeon

2018-05-07

Increases in unemployment and suicide in the young Korean population have recently become major social concerns in the country. The purpose of this study was to examine mental health status in young job seekers and identify sociodemographic factors related to job-seeking stress, depression, and suicidal ideation. We also explored the mediating effect of depression on the relationship between job-seeking stress and suicidal ideation and examined whether social support moderated this effect. In total, 124 university graduates completed the Job-Seeking Stress Scale, Beck Depression Inventory-II, Beck Scale for Suicide Ideation, and Multidimensional Scale of Perceived Social Support. Descriptive statistics were calculated for participants' general characteristics, and t-tests or analyses of variance, correlation analysis, simple mediation analysis, and mediated moderation analysis were performed. Of the 124 participants, 39.5% and 15.3% exhibited clinical levels of depression and suicidal ideation, respectively. Sociodemographic factors (i.e., sex, academic major, educational expenses loan, and willingness to accept irregular employment) were associated with job-seeking stress, depression, and suicidal ideation. Women and graduates who were willing to accept irregular employment exhibited high levels of job-seeking stress, depression, and suicidal ideation. Job-seeking stress affected suicidal ideation via depression, and perceived social support moderated the effect of job-seeking stress on depression and the effect of depression on suicidal ideation. The results suggest that depression management and interventions are urgently required for young job seekers, and social support should be provided to assist them both emotionally and economically.

Job-Seeking Stress, Mental Health Problems, and the Role of Perceived Social Support in University Graduates in Korea

PubMed Central

2018-01-01

Background Increases in unemployment and suicide in the young Korean population have recently become major social concerns in the country. The purpose of this study was to examine mental health status in young job seekers and identify sociodemographic factors related to job-seeking stress, depression, and suicidal ideation. We also explored the mediating effect of depression on the relationship between job-seeking stress and suicidal ideation and examined whether social support moderated this effect. Methods In total, 124 university graduates completed the Job-Seeking Stress Scale, Beck Depression Inventory-II, Beck Scale for Suicide Ideation, and Multidimensional Scale of Perceived Social Support. Descriptive statistics were calculated for participants' general characteristics, and t-tests or analyses of variance, correlation analysis, simple mediation analysis, and mediated moderation analysis were performed. Results Of the 124 participants, 39.5% and 15.3% exhibited clinical levels of depression and suicidal ideation, respectively. Sociodemographic factors (i.e., sex, academic major, educational expenses loan, and willingness to accept irregular employment) were associated with job-seeking stress, depression, and suicidal ideation. Women and graduates who were willing to accept irregular employment exhibited high levels of job-seeking stress, depression, and suicidal ideation. Job-seeking stress affected suicidal ideation via depression, and perceived social support moderated the effect of job-seeking stress on depression and the effect of depression on suicidal ideation. Conclusion The results suggest that depression management and interventions are urgently required for young job seekers, and social support should be provided to assist them both emotionally and economically. PMID:29736162

Mental health, health care utilisation of migrants in Europe.

PubMed

Lindert, J; Schouler-Ocak, M; Heinz, A; Priebe, S

2008-01-01

Migration during the 1990s has been high and has been characterised by new migrations. Migration has been a key force in the demographic changes of the European population. Due to the different condition of migration in Europe, variables related to mental health of migrants are: motivation for migration, living conditions in the home and in the host country. To give an overview on (i) prevalence of mental disorders; suicide; alcohol and drug abuse; (ii) access to mental health and psychosocial care facilities of migrants in the European region, and (iii) utilisation of health and psychosocial institution of these migrants. Non-system review of the literature concerning mental health disorders of migrants and their access to and their consumption of health care and psychosocial services in Europe. It is impossible to consider "migrants" as a homogeneous group concerning the risk for mental illness. The literature showed (i) mental health differs between migrant groups, (ii) access to psychosocial care facilities is influenced by the legal frame of the host country; (iii) mental health and consumption of care facilities is shaped by migrants used patterns of help-seeking and by the legal frame of the host country. Data on migrant's mental health is scarce. Longitudinal studies are needed to describe mental health adjusting for life conditions in Europe to identify those factors which imply an increased risk of psychiatric disorders and influence help seeking for psychosocial care. In many European countries migrants fall outside the existing health and social services, particularly asylum seekers and undocumented immigrants.

Universal health coverage in 'One ASEAN': are migrants included?

PubMed

Guinto, Ramon Lorenzo Luis R; Curran, Ufara Zuwasti; Suphanchaimat, Rapeepong; Pocock, Nicola S

2015-01-01

As the Association of South East Asian Nations (ASEAN) gears toward full regional integration by 2015, the cross-border mobility of workers and citizens at large is expected to further intensify in the coming years. While ASEAN member countries have already signed the Declaration on the Protection and Promotion of the Rights of Migrant Workers, the health rights of migrants still need to be addressed, especially with ongoing universal health coverage (UHC) reforms in most ASEAN countries. This paper seeks to examine the inclusion of migrants in the UHC systems of five ASEAN countries which exhibit diverse migration profiles and are currently undergoing varying stages of UHC development. A scoping review of current migration trends and policies as well as ongoing UHC developments and migrant inclusion in UHC in Indonesia, Malaysia, Philippines, Singapore, and Thailand was conducted. In general, all five countries, whether receiving or sending, have schemes that cover migrants to varying extents. Thailand even allows undocumented migrants to opt into its Compulsory Migrant Health Insurance scheme, while Malaysia and Singapore are still yet to consider including migrants in their government-run UHC systems. In terms of predominantly sending countries, the Philippines's social health insurance provides outbound migrants with portable insurance yet with limited benefits, while Indonesia still needs to strengthen the implementation of its compulsory migrant insurance which has a health insurance component. Overall, the five ASEAN countries continue to face implementation challenges, and will need to improve on their UHC design in order to ensure genuine inclusion of migrants, including undocumented migrants. However, such reforms will require strong political decisions from agencies outside the health sector that govern migration and labor policies. Furthermore, countries must engage in multilateral and bilateral dialogue as they redefine UHC beyond the basis of citizenship and reimagine UHC systems that transcend national borders. By enhancing migrant coverage, ASEAN countries can make UHC systems truly 'universal'. Migrant inclusion in UHC is a human rights imperative, and it is in ASEAN's best interest to protect the health of migrants as it pursues the path toward collective social progress and regional economic prosperity.

Universal health coverage in ‘One ASEAN’: are migrants included?

PubMed Central

Guinto, Ramon Lorenzo Luis R.; Curran, Ufara Zuwasti; Suphanchaimat, Rapeepong; Pocock, Nicola S.

2015-01-01

Background As the Association of South East Asian Nations (ASEAN) gears toward full regional integration by 2015, the cross-border mobility of workers and citizens at large is expected to further intensify in the coming years. While ASEAN member countries have already signed the Declaration on the Protection and Promotion of the Rights of Migrant Workers, the health rights of migrants still need to be addressed, especially with ongoing universal health coverage (UHC) reforms in most ASEAN countries. This paper seeks to examine the inclusion of migrants in the UHC systems of five ASEAN countries which exhibit diverse migration profiles and are currently undergoing varying stages of UHC development. Design A scoping review of current migration trends and policies as well as ongoing UHC developments and migrant inclusion in UHC in Indonesia, Malaysia, Philippines, Singapore, and Thailand was conducted. Results In general, all five countries, whether receiving or sending, have schemes that cover migrants to varying extents. Thailand even allows undocumented migrants to opt into its Compulsory Migrant Health Insurance scheme, while Malaysia and Singapore are still yet to consider including migrants in their government-run UHC systems. In terms of predominantly sending countries, the Philippines's social health insurance provides outbound migrants with portable insurance yet with limited benefits, while Indonesia still needs to strengthen the implementation of its compulsory migrant insurance which has a health insurance component. Overall, the five ASEAN countries continue to face implementation challenges, and will need to improve on their UHC design in order to ensure genuine inclusion of migrants, including undocumented migrants. However, such reforms will require strong political decisions from agencies outside the health sector that govern migration and labor policies. Furthermore, countries must engage in multilateral and bilateral dialogue as they redefine UHC beyond the basis of citizenship and reimagine UHC systems that transcend national borders. Conclusions By enhancing migrant coverage, ASEAN countries can make UHC systems truly ‘universal’. Migrant inclusion in UHC is a human rights imperative, and it is in ASEAN's best interest to protect the health of migrants as it pursues the path toward collective social progress and regional economic prosperity. PMID:25626624

Competence in coping with stress in adolescents from three regions of the world.

PubMed

Persike, Malte; Seiffge-Krenke, Inge

2012-07-01

The ways adolescents develop and use strategies to cope with stress vary according to cultural scripts and values. This cross-sectional study tested the impact of region and gender on adolescents' stress perceptions and coping styles. A total sample of 10,941 adolescents (51.3% female) from 20 countries completed questionnaires on stress and coping behaviors in four domains (school, parents, peers, and romantic relationships). Standardized samples of n = 200 were drawn from each country, resulting in a sample of N = 4,000 adolescents (mean age 15.18, SD = 1.76, balanced gender distribution). Based on the results of discriminant analysis, the adolescents could be grouped into three world regions (Western, Eastern/Asian, and Southern). Results revealed that levels of perceived stressfulness of issues in different domains were universally similar among adolescents from all three regions. Parent- and school-related stress received the highest rankings, and peer- and romance-related stress the lowest. Differences emerged with respect to coping style, depending on region and gender. Coping styles characterized by negotiating, seeking support, and emotional outlet were used more often by adolescents from the Western region than those from the Eastern/Asian or Southern regions. Females in all regions had higher rates in the use of negotiating and seeking support than males did. Adolescents from all countries, despite regional variations, exhibited more emotional outlet in response to conflicts with parents than with peers or romantic partners. Overall, adolescents from all regions of the world demonstrated an impressive level of coping competencies, as only about one fifth of all coping responses involved the use of withdrawal and denial. The findings are discussed with respect to how the effects of globalization and changing societal expectations may have contributed to similar levels of perceived stressfulness and increased coping agency in adolescents in different parts of the world.

Programmatic pathways to child survival: results of a multi-country evaluation of Integrated Management of Childhood Illness.

PubMed

Bryce, Jennifer; Victora, Cesar G; Habicht, Jean-Pierre; Black, Robert E; Scherpbier, Robert W

2005-12-01

To summarize the expectations held by World Health Organization programme personnel about how the introduction of the Integrated Management of Childhood Illness (IMCI) strategy would lead to improvements in child health and nutrition, to compare these expectations with what was learned from the Multi-Country Evaluation of IMCI Effectiveness, Cost and Impact (MCE-IMCI), and to discuss the implications of these findings for child survival policies and programmes. The MCE-IMCI study designs were based on an impact model developed in 1999-2000 to define how IMCI would be implemented at country level and below, and the outcomes and impact it would have on child health and survival. MCE-IMCI studies included: feasibility assessments documenting IMCI implementation in 12 countries (1999-2001); in-depth studies using compatible designs in Bangladesh, Brazil, Peru, Tanzania and Uganda; and cross-site analyses addressing the effectiveness of specific subsets of IMCI activities. The IMCI strategy was successfully introduced in the great majority of countries with moderate to high levels of child mortality in the period from 1996 to 2001. Seven years of country-based evaluation, however, indicates that some of the basic expectations underlying the development of IMCI were not met. Four of the five countries (the exception is Tanzania) had difficulties in expanding the strategy at national level while maintaining adequate intervention quality. Technical guidelines on delivering interventions at family and community levels were slow to appear, and in their absence countries stalled in their efforts to increase population coverage with essential interventions related to care-seeking, nutrition, and correct care of the sick child at home. The full weight of health system limitations on IMCI implementation was not appreciated at the outset, and only now is it clear that solutions to larger problems in political commitment, human resources, financing, integrated or at least coordinated programme management, and effective decentralization are essential underpinnings of successful efforts to reduce child mortality. This analysis highlights the need for a shift if child survival efforts are to be successful. Delivery systems that rely solely on government health facilities must be expanded to include the full range of potential channels in a setting and strong community-based approaches. The focus on process within child health programmes must change to include greater accountability for intervention coverage at population level. Global strategies that expect countries to make massive adaptations must be complemented by country-level implementation guidelines that begin with local epidemiology and rely on tools developed for specific epidemiological profiles.

Improving outcomes from breast cancer in a low-income country: lessons from bangladesh.

PubMed

Story, H L; Love, R R; Salim, R; Roberto, A J; Krieger, J L; Ginsburg, O M

2012-01-01

Women in low- and middle-income countries (LMICs) have yet to benefit from recent advances in breast cancer diagnosis and treatment now experienced in high-income countries. Their unique sociocultural and health system circumstances warrant a different approach to breast cancer management than that applied to women in high-income countries. Here, we present experience from the last five years working in rural Bangladesh. Case and consecutive series data, focus group and individual interviews, and clinical care experience provide the basis for this paper. These data illustrate a complex web of sociocultural, economic, and health system conditions which affect womens' choices to seek and accept care and successful treatment. We conclude that health system, human rights, and governance issues underlie high mortality from this relatively rare disease in Bangladesh.