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PubMed2004

Biodiversity conservation and the eradication of poverty.

It is widely accepted that biodiversity loss and poverty are linked problems and that conservation and poverty reduction should be tackled together. However, success with integrated strategies is elusive. There is sharp debate about the social impacts of conservation programs and the success of community-based approaches to conservation. Clear conceptual frameworks are needed if policies in these two areas are to be combined. We review the links between poverty alleviation and biodiversity conservation and present a conceptual typology of these relationships.

Animals↗
PubMed2005

How Philip Morris built Marlboro into a global brand for young adults: implications for international tobacco control.

OBJECTIVE: To describe Philip Morris' global market research and international promotional strategies targeting young adults. METHODS: Analysis of previously secret tobacco industry documents. RESULTS: Philip Morris pursued standardised market research and strategic marketing plans in different regions throughout the world using research on young adults with three principle foci: lifestyle/psychographic research, brand studies, and advertising/communication effectiveness. Philip Morris identified core similarities in the lifestyles and needs of young consumers worldwide, such as independence, hedonism, freedom, and comfort. In the early 1990s Philip Morris adopted standardised global marketing efforts, creating a central advertising production bank and guidelines for brand images and promotions, but allowing regional managers to create regionally appropriate individual advertisements. CONCLUSIONS: Values and lifestyles play a central role in the global marketing of tobacco to young adults. Worldwide counter marketing initiatives, coupled with strong, coherent global marketing policies such as the Framework Convention on Tobacco Control, are needed to break associations between young adult values and tobacco brands. As globalisation promotes the homogenisation of values and lifestyles, tobacco control messages that resonate with young adults in one part of the world may appeal to young adults in other countries. Successful tobacco control messages that appeal to young people, such as industry denormalisation, may be expanded globally with appropriate tailoring to appeal to regional values.

Adult↗
PubMedDate not supplied

An analysis of optimal resource allocation for prevention of infection with human immunodeficiency virus (HIV) in injection drug users and non-users.

Millions of dollars are spent annually to prevent infection with human immunodeficiency virus (HIV) without a thorough understanding of the most effective way to allocate these resources. The authors' objective was to determine the allocation of new resources among prevention programs targeted to a population of injection drug users (IDUs) and a population of non-injection drug users (non-IDUs) that would minimize the total number of incident cases of HIV infection over a given time horizon. They developed a dynamic model of HIV transmission in IDUs and non-IDUs and estimated the relationship between prevention program expenditures and reductions in HIV transmission. They evaluated three prevention programs: HIV testing with routine counseling, HIV testing with intensive counseling, and HIV testing and counseling linked to methadone maintenance programs. They modeled a low-risk IDU population (5% HIV prevalence) and a moderate-risk IDU population (10% HIV prevalence). For different available budgets, they determined the allocation of resources among the prevention programs and populations that would minimize the number of new cases of HIV infection over a five-year period, as well as the incremental value of additional prevention funds. The study framework provides a quantitative, systematic approach to funding programs to prevent HIV infection that accounts for HIV transmission dynamics, population size, and the costs and effectiveness of the interventions in reducing HIV transmission. The approach is general and can be used to evaluate a broader group of prevention programs and risk populations. This framework thus could enable policy makers and clinicians to identify a portfolio of programs that provide, collectively, the most benefit for a given budget.

AIDS Serodiagnosis↗
PubMed2003

Titrating versus targeting home care services to frail elderly clients: an application of agency theory and cost-benefit analysis to home care policy.

The article summarizes the shortcomings of current home care targeting policy, provides a conceptual framework for understanding the sources of its problems, and proposes an alternative resource allocation method. Methods required for different aspects of the study included synthesis of the published literature, regression analysis of risk predictors, and comparison of actual resource allocations with simulated budgets. Problems of imperfect agency ranging from unclear goals and inappropriate incentives to lack of information about the marginal effectiveness of home care could be mitigated with an improved budgeting method that combines client selection and resource allocation. No program can produce its best outcome performance when its goals are unclear and its technology is unstandardized. Titration of care would reallocate resources to maximize marginal benefit for marginal cost.

Aged↗
PubMed2001

Analyzing end-of-life care legislation: a social work perspective.

Several policy approaches are currently being considered in an attempt to organize a national response to the crisis surrounding quality end-of-life care. Recent healthcare efforts aimed at supporting individuals facing advanced illness are marked by debate over assisted suicide, untimely referrals to hospice care, inconsistent adherence to advance directives, and substantive amounts of unrelieved pain in end-of-life. Social workers require a clear understanding of the current political and social climate if they are to navigate the ethical dilemmas as they are presented in end-of-life care. This article discusses recently proposed policy responses to the various political and social controversies surrounding end-of-life care for individuals facing advanced illness. The analysis will suggest criteria for evaluating end-of-life policy in general and offer a framework for evaluating proposed legislation. Suggestions for making end-of-life policy more effective and areas for future research will be proposed. Finally, the implications of this policy analysis for social work will be delineated.

Advance Directives↗
PubMedDate not supplied

Regional scale variability in sediment and nutrient delivery from small agricultural watersheds.

Although many studies have pointed out the various controlling factors of sediment and nutrient delivery on a plot or watershed scale, little is known on the spatial variability of sediment and nutrient delivery on a regional scale. This study was conducted to reveal regional variations in sediment-associated nutrient delivery in central Belgium. Sediment deposited in 13 small retention ponds was sampled and analyzed for total phosphorus (TP), K, Mg, and Ca content. The TP content of the sediment deposits varied from 510 to 2001 mg P per kg sediment. Nutrients are predominantly fixed on the very fine sediment fraction (<16 microm), which is the reason why the nutrient trap efficiency of the ponds is only a fraction of the sediment trap efficiency. Average nutrient trap efficiency of the studied ponds varies between 4 and 31%, whereas sediment trap efficiency varies between 10 and 72%. For watersheds ranging from 7 to 4873 ha, sediment yield ranged between 1.2 and 20.6 Mg ha(-1) yr(-1), whereas TP export varied from 1.8 to 39.7 kg ha(-1) yr(-1). The observed spatial variability in nutrient losses is primarily attributed to regional variations in erosion and sediment yield values and to a far lesser degree to the spatial variations in fertilizer application. Redistribution of manure in the framework of an agricultural policy may increase the rate of nutrient delivery by ways of erosion and sediment transport.

Agriculture↗
PubMed2006

Gram-positive cocci infections in intensive care: guide to antibacterial selection.

The incidence of multiresistance in Gram-positive cocci causing infections in critically ill patients admitted to the intensive care unit (ICU) has increased notably in recent years. Thus, therapeutic proposals have been modified according to the emergence of multiresistant cocci and adapted to epidemiological markers of individual infectious processes, geographical variations of these markers, the availability of new antibacterials, and advances in the knowledge of pharmacokinetic and pharmacodynamic aspects of their use. The current management of critically ill patients should consider new therapeutic approaches, such as the "de-escalating strategy", which includes the administration of empirical antibacterials active against multiresistant pathogens followed by directed treatment based on unequivocal data from antibacterial-susceptibility testing. Optimisation of antibacterial treatment should be viewed in the context of the need to determine plasma drug concentrations, pharmacoeconomic considerations and control of drug-related adverse events. Therapeutic proposals should be developed within the framework of the antibacterial policy of each hospital. The present review is focused on the description of the therapeutic strategies for the main infectious processes caused by Gram-positive cocci in severely ill patients admitted to the ICU according to a review of the pertinent literature and the clinical experience of the authors.

Anti-Bacterial Agents↗
PubMed2003

The burden of emissions restrictions.

Models with time horizons of 100 years are customarily used to predict anthropogenic greenhouse gas emissions. Historical evidence indicates that over this time span the current consumption patterns in developing countries are likely to change and converge to the present patterns in developed countries. This study deals with modeling this type of convergence in consumption patterns within the MIT Emission Prediction and Policy Analysis Model (EPPA) framework. We find that the differences in the model with static consumption-function coefficients from that in the model with dynamic coefficients have significant implications for the costs of emissions restrictions in developing countries, even though the regional emissions profiles are virtually the same. Our results suggest that the costs of emissions restrictions in developing countries would be higher if the changes in consumption patterns are taken account of than if they are ignored in the simulation model.

Journal Article↗
PubMedDate not supplied

An ontology of quality initiatives and a model for decentralized, collaborative quality management on the (semantic) World-Wide-Web.

This editorial provides a model of how quality initiatives concerned with health information on the World Wide Web may in the future interact with each other. This vision fits into the evolving "Semantic Web" architecture - ie, the prospective that the World Wide Web may evolve from a mess of unstructured, human-readable information sources into a global knowledge base with an additional layer providing richer and more meaningful relationships between resources. One first prerequisite for forming such a "Semantic Web" or "web of trust" among the players active in quality management of health information is that these initiatives make statements about themselves and about each other in a machine-processable language. I present a concrete model on how this collaboration could look, and provide some recommendations on what the role of the World Health Organization (WHO) and other policy makers in this framework could be.

Internet↗
PubMed1999

Researching harm reduction--care and contradictions.

This paper sets out to identify why research is important in realizing the potential a harm-reduction framework has for informing policy and practice in relation to all psychoactive drugs. In doing so it includes examples of research about alcohol and tobacco, since legitimizing the harm-reduction approach requires strengthening the research foundation across both licit and illicit drugs. There are some practical as well as ethical and theoretical complexities in conducting research in this area, some of which are novel or exaggerated using harm-reduction principles. Potential impediments to research are identified. Articulation of these complexities might help to facilitate research which can help to determine the validity of harm reduction. The notion of the researchers "duty of care" might offer a way of deciding among competing accountabilities, but needs further articulation to be useful. [Translations are provided in the International Abstracts Section of this issue.]

Alcoholism↗
PubMed1999

[Primary health care in China: problems and challenges].

The World Health Organization (WHO) put forward a global strategy goal of "Health for All by year 2000" and pointed out the task of achieving this based on the primary health care (PHC) during the Alma-Ate Conference in 1978. The government of China have endorsed the WHO agreement and performed much work toward it. However, the gap between urban areas and rural areas is widening. The accomplishment of the goal of "Health for All by the year 2000" is still a critical task in China. In this study, main health problems, government policies and measures on the framework of quality of life, health status, lifestyle and health-supporting environment, medical, health and welfare system and health policies in PHC of China were diagnosed and evaluated according to the "diagnosis and evaluation for health promotion" by Green and Kreuter (1991). Japanese experiences in a combined medical, health and welfare system, elderly care, environmental protection and health education are very helpful to strengthen PHC in China. A new partnership for "Health for All" between Japan and China to achieve the goal of "Health for All by the year 2000" is imperative.

China↗
PubMed1985

Urban decline in the world's developed economies: an examination of the trends.

"The purpose of this paper is to provide a definition and overview of urban decline. It is intended to establish a framework for evaluating the policies that various countries have used to address the costs and benefits of urban decline...." The geographic focus is on the developed countries who are members of the Organization for Economic Co-operation and Development (OECD). Urban declines are defined as decreases in population and/or loss of economic base as measured by the level and composition of employment.

Demography↗
PubMed2005

Analysis of scenarios for wastewater and urban drainage systems in Brazil based on an integrated modeling approach.

Brazil is currently facing widespread problems in the urban environment associated with inadequate wastewater and urban drainage systems, particularly for low-income communities. These problems are promoted by the rapid and often unplanned urbanization process in developing cities and are compounded by a lack of funding, absence of planning, ineffective institutional arrangements, and inappropriate policies to provide the framework for integrated wastewater and stormwater management. Because planning for the provision of wastewater and urban drainage systems is a complex task, an integrated-modeling approach is proposed to provide a practical methodology for sanitation and urban drainage planning in Brazilian cities. In the model development, as well as technical aspects, other aspects related to institutional, financial, socio-economic, environmental and public health issues were also taken into account.

Brazil↗
PubMed2006

Providing HIV care for tuberculosis patients in sub-Saharan Africa.

Human immunodeficiency virus (HIV)/acquired immunedeficiency syndrome (AIDS) and tuberculosis (TB) cause an immense burden of disease in sub-Saharan Africa. A large amount of knowledge has been gathered in the last 15 years about the negative impact that HIV has on TB control, both at a programme level and at the level of the individual patient. Equally, interventions that are known to benefit patients have been tested and piloted, and these form important components of international TB-HIV guidelines, a TB-HIV strategic framework and an interim policy on TB-HIV coordination. Unfortunately, in sub-Saharan Africa there is little evidence that these interventions are being implemented on the ground, and one of the reasons for this paralysis is that the operational details are not well developed. This paper takes the three important HIV interventions of HIV testing and counselling, cotrimoxazole preventive treatment and antiretroviral treatment, and discusses some of the practical details of on-the-ground implementation. We hope that this will generate discussion, but above all, the impetus to start delivering services to patients.

Africa South of the Sahara↗
PubMed1990

Inadequacies in the promotion of life before birth in South Africa.

The legal and ethical principles relating to the protection of the unborn foetus in South Africa are expounded and discussed. It is submitted that, while the law intends to be over-protective towards the unborn foetus in some respects, it is seriously deficient in others. Consideration should perhaps be given to a comprehensive consolidation of the legal principles relating to the protection of the unborn foetus within the framework of a fundamental policy in respect of the matter.

Aborted Fetus↗
PubMed1990

[Veterinary drugs and good veterinary practice].

The following definition of 'Good Veterinary Practice' in relation to pharmacotherapy is presented: 'The selective use (in accordance with directions for users) of veterinary drugs registered by the authorities in those indications in which they are permitted when the diagnosis has been established and in which the problem of residues in foods of animal origin on using these agents has been taken into account'. The following recommendations are made with reference to 'Good Principles of Veterinary Practice': (1) Current training and supplementary training in the fields of pharmacy and pharmacotherapy should be adjusted in the light of recent developments in society. (2) The development of simple, rapid and reliable tests for the detection of pathogenic agents and residues of veterinary drugs should stimulated. (3) The development of conveniently arranged and standardised data sheets in generally comprehensible terms should receive sufficient attention. (4) Quality control, particularly of generic products, deserves adequate attention. (5) The institution of a Side-Effects of Veterinary Drugs Office, in which the authorities, manufacturers and other parties concerned co-operate closely, is eminently desirable. (6) The establishment of a Veterinary Drugs Committee in which all interested parties are represented, is of the utmost importance within the framework of recommendations on policy to the authorities.

Animals↗
PubMed1978

[Hospital and outpatient clinic for dentistry-past and future].

A short historical survey deals with the development of the Clinic and Policlinic of Stomatology of the Magdeburg Medical Academy. Apart from especially marked stages prior to the erection of the new building in 1958 and the appreciation of the merits of F. Meyer, founder of the Clinic, the present paper treats the interdisciplinary connexion of the Clinic with other institutions of the Magdeburg Medical Academy and indicates its tasks in the fields of medical care, of medical education, training and continuing education, and of research. From a discussion on its significance and importance in the framework of the health policy of the Socialist Health Service of the GDR, certain speculations on its prospects are deduced (with reference to certain facts), and the consequences necessary for the continuation of its present development are pointed to.

Dental Clinics↗
PubMed2007

Developing, integrating, and perpetuating new ways of applying sociology to health, medicine, policy, and everyday life.

As a framework for presenting ideas on developing ways to make sociology more applicable, we focus on the recent state of medical sociology research. Data for this paper were generated through a content analysis of a twelve-year period (1993-2004) of the Journal of Health and Social Behavior (JHSB) and Social Science & Medicine (SSM). The analysis aims to determine if the content of JHSB and SSM reflect the breadth of the sub-discipline of medical sociology as well as the stated goals of the journals. The selected issues of JHSB and SSM were coded on the basis of the following attributes: (1) Primary Substantive Topic, (2) Methodology, (3) Data Type and Analytic Technique, and (4) Research and Policy Recommendations. We found that the orientation of JHSB articles was towards generating research and theory that shy away from policy, interdisciplinary approaches, and applied issues. SSM content tends to display more interdisciplinary breadth and variety, but also reflects a dearth of applied recommendations. Our discussion focuses on what JHSB and SSM could be. We present ideas on how the sociological discipline in general-and JHSB and SSM in particular-can help generate and nourish new forms of inquiry that can impact the way research questions are framed. We conclude that such a shift is needed in order to maximize the applicability of social scientific evidence to everyday life, and we share examples situated within a socio-medical context, where there is a particular need for the application of social evidence to practice.

Bibliometrics↗