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PubMed1986

Flexor tendon injuries. Treatment of the acute problem.

The management of flexor tendon injuries continues to evolve as our knowledge of tendon biology and physiology improves. The concept of early motion after tendon repair is a key part of this evolutionary process. This section has provided a brief review of the history of early motion and presented a postoperative therapy program for flexor tendon repairs. Patient education, splinting (protective and corrective) and an exercise and activity program have been stressed. It must be emphasized that if early motion is used postoperatively, it must be done in conjunction with a closely supervised hand therapy program.

Adult↗
PubMedDate not supplied

How are we doing with physical activity?

An estimated 60% of U.S. adults are inactive or underactive, and nearly half of America's youth (aged 12 to 21 years) are not vigorously active on a regular basis. Downstream interventions provide individual strategies that effectively increase short-term participation in physical activity by 10% to 25%. Downstream and midstream approaches tailored to individual preferences have greater success. Packaging and disseminating physical activity programs for community, worksite, and health care settings are not as far along as for other areas, although inactivity prevalence is about twice that of smoking, and both risk factors have substantial morbidity and mortality. Less is known about effectiveness of upstream approaches, which have potential for the greatest public health impact. Suggestions include continued promotion of moderate-intensity physical activity, greater dissemination of successful programs, and investigation of physical environment influences.

Cardiovascular Diseases↗
PubMedDate not supplied

UNICEF supports birth control despite Holy See.

The Vatican has failed in its attempt to prevent the UN Children's Fund (UNICEF) from spreading the message of family planning in developing countries. Over the strong objections of the Holy See, the 41-member Executive Board of UNICEF has asked the agency to cooperate with the UN Population Fund (UNFPA) and the WHO "to support family planning in the context of sustainable national healthcare systems." A member of the Executive Board said the Vatican held the view that UNICEF had no legitimate right to be involved in family planning. "But the Holy See was in a minority of one," he said, adding that "the whole problem arises from the fact that the Vatican continues to equate birth control and abortion with family planning." A recently concluded board meeting unanimously adopted a resolution requesting UNICEF to "contribute substantively" to the UNFPA-sponsored International Conference on Population and Development (CPF) set to take place in 1994 in Cairo. The board also asked UNICEF Executive Director James Grant to submit a policy paper "on the involvement of UNICEF in family planning, taking into account the health of the child and the mother." The paper is to be presented for the consideration of the board at its regular session next year, with a view to approving it prior to the ICPD. Prior to the adoption of the resolution, J. Klink, a spokesman for the Holy See, told the Executive Board that there were "concerns" over calls for UNICEF to involve itself in family planning activities. He said UNICEF should not be concerned with family planning because there were other agencies entrusted with that mandate. Responding to the support given by Nordic countries to the UNICEF resolution, Klink said that wealthy nations must not impose dictates as to the "appropriate" size of poor families. "The Holy See would not propose that UNICEF halt its current balanced, informational approach to the spacing of births," he said. "Families must be free to decide their size." UNICEF, he pointed out, had clearly stated that it was not involved in abortion or sterilization and did not provide contraceptives. "UNICEF must continue to respect cultural and religious diversity," he said. At a meeting of the Preparatory Committee of the UN Conference on Environment and Development (UNCED) in April this year, the Vatican succeeded in striking a reference to family planning from a blueprint for development known as Agenda 21. Paragraph 99 of Agenda 21 had originally referred to the need for "integrated healthcare, including universal access to family planning services and the provision of safe contraceptives." But this paragraph was deleted in the final document adopted at UNCED in Rio de Janeiro in June. Given that family planning is the single most effective means with which to contain population growth, the UNFPA considered the omission a retrograde step in handling the dangers of overpopulation and environmental degradation. In Rio de Janeiro, Werner Fornos, president of the Washington-based Population Institute, criticized the Holy See "for interfering in the lives of people throughout the world because of religious dogmas." Grant told the board meeting last month that UNICEF would work with the UNFPA to spread knowledge and support program activities for successful family planning which he said was integral to safe motherhood. Birte Poulsen of Denmark told the meeting that reduced population growth was a prerequisite for sustainable development, and the UNICEF "must accord family planning issues top priority." And Inger Ann Ravum of Norway said the integration of family planning activities into UNICEF's program was welcome.

Behavior↗
PubMed1989

National Alzheimer's disease program.

The psycho-behavioral troubles of patients with an Alzheimer's Disease (AD) are such that it is very difficult to keep those patients within the normal family environment, and that it therefore proves necessary to have them placed in a specially adapted residence manned by a highly specialised medical and para-medical staff. Within the frame of such an approach, a new type of residence has been devised "Asclepios Gardens", a one-level ranch-type residence, including 44 individual apartments, each opening, on the one hand, on a little private garden opening itself on a large, strictly enclosed and protected, 5-acre park, and, on the other hand, on a collective living structure conceived for social activities under attentive medical care, to help the patients restore their social structures. In a such residences, besides the special training given to the staff (medical, para-medical), aimed at developing as much as possible the patients' autonomy and self-reliance in every aspect of everyday life, you find a psychometric computerized "activation" program, devised both on a collective basis with differentiated subprograms, for groups of patients that have been classified according to the degree of seriousness of their problem, and-whenever possible, with individual attention programs; the whole of this "activation" method has thus clearly a double target; first to develop what is left of the patients' autonomy, for instance by psychometric exercises, and moreover, to have them start new activities, which they had never practised before--this latter action with a view to developing their neuroplasticity resources. And finally, a new chemical therapy is proposed. This substance induced a significant improvement in 40% of cases and a slight improvement in 20%. These results were observed through a series of specific psychometric tests (Visuo Retention Test of Benton, Mnesic profile of Rey), a global scale (Mini Mental State), and a general evaluation of the patients' daily activities by the General Practitioner and by the family. These preliminary data very interesting yet must be confirmed in a larger Alzheimer population.

Alzheimer Disease↗
PubMed2000

Physical activity, falls, and fractures among older adults: a review of the epidemiologic evidence.

OBJECTIVES: Assess the relationship between physical activity and risk for falls and osteoporotic fractures among older adults. DESIGN: Review and synthesis of published literature. MEASUREMENTS: We searched the literature using MEDLINE, Current Contents, and the bibliographies of articles identified. We included randomized controlled trials (RCT) of the effects of physical activity on the incidence of falls and case-control and prospective cohort studies of the association of physical activity with osteoporotic fracture risk. We also summarized mechanisms whereby physical activity may influence risk for falls and fractures. RESULTS: Observational epidemiologic studies and randomized clinical trials evaluating the effectiveness of physical activity programs to prevent falls have been inconclusive. However, many studies have lacked adequate statistical power, and recent trials suggest that exercise, particularly involving balance and lower extremity strength training, may reduce risk of falling. There is consistent evidence from prospective and case-control studies that physical activity is associated with a 20-40% reduced risk of hip fracture relative to sedentary individuals. The few studies that have examined the association between physical activity and risk of other common osteoporotic fractures, such as vertebral and wrist fractures, have not found physical activity to be protective. CONCLUSIONS: Epidemiologic studies suggest that higher levels of leisure time physical activity prevent hip fractures and RCTs suggest certain exercise programs may reduce risk of falls. Future research needs to evaluate the types and quantity of physical activity needed for optimal protection from falls and identify which populations will benefit most from exercise.

Accidental Falls↗
PubMed1998

Motivation, recruitment, and screening of volunteers for a phase I/II HIV preventive vaccine trial in Thailand.

Data from recruitment and screening for a phase I/II preventive HIV-1 vaccine trial in Thailand were evaluated with respect to correlates of participation at each phase. Correlates included demographic variables, motivation for interest in the trial, and factors related to communication and contact. Participants were recruited at two sites through varied methods. The majority of prescreenees reported altruistic motives for interest in the trial and blood donors emerged as a group that may have been particularly altruistic. Findings indicated site differences in attrition during recruitment and screening, but not in enrollment into the vaccine trial. Blood donation and willingness to be contacted by phone at home were significantly related to making and keeping screening appointments.

AIDS Vaccines↗
PubMed1996

Labor contractors: a conceptual overview.

"The purpose of this paper is to provide an overview of labor brokering or contracting that helps to explain why employers turn to foreign workers to fill certain vacant jobs, and how the presence of foreign workers brought to a country by labor contractors can affect the size and duration of migration flows. The major conclusion is that East Asian policies that aim to avoid the settlement of unskilled foreign workers also make labor brokering a prominent feature of labor migration and migrant labor markets in the region."

Asia↗
PubMed1996

Labor contracting in international migration: the Japanese case and implications for Asia.

"This paper is intended to be a prelude of a study on intermediaries in international migration in Asia, based primarily on the Japanese case. In the next section, I introduce the legal framework of labor contracting in Japan.... In Section 3, I pick up several actual examples of the channels of migrant workers coming to Japan. They are: (i) Japanese-descended migrant workers from Brazil, (ii) job-trainees from China, (iii) entertainers from the Philippines, (iv) ¿slavery' women from Thailand, and (v) workers smuggled from China by snake heads. This illustrates differences according to types of migrants, as well as common features across them. In Section 4, I try to explain the features by using simple economic concepts. Section 5 considers a broader Asian context. Section 6 concludes with a summary of major findings in this paper."

Asia↗
PubMed1996

Foreign workers recruiting policies in Japan.

"This article presents the basic characteristics of the foreign workers recruiting policy in Japan, which consists [of] barring entry to unskilled workers, and confronts it with the actual tolerance for a large number of illegal unskilled workers. After a historical overview of the reasons for the current policy, the article examines elements which reveal that a seclusionist policy is based on mistaken assumptions and reviews policy options to deal with the issue of illegal migration."

Asia↗
PubMed1996

Recruiting and managing of foreign workers in Taiwan.

"The first part of this article reviews the reasons for a labor migration policy in Taiwan and the characteristics of foreign workers currently employed in the country. The second part examines the procedures and practices for recruiting and managing labor migrants and explores the reasons for the biggest issue in... Taiwanese labor migration policy: the runaway foreign workers. Admitting that illegal migration cannot be controlled, the paper recommends to limit employment of migrants only where it is absolutely necessary."

Asia↗
PubMed1996

Economic interdependence and migration dynamics in Asia.

"This paper searches first for alternative explanations about migration dynamics and, in particular, the migration transition in Asian countries. It raises the question whether increasing economic interdependence will increase labor mobility and attempts to explain the association between them with a simple model. Countries in the region are divided [into] three groups with regard to international labor migration: transitional, non-transitional exporters, and non-transitional importers. Increasing economic integration will lead to migration transition for many Asian countries, but with uncertainties concerning in particular China and South Asia."

Asia↗
PubMed1994

The making of an immigrant niche.

"This article speaks to the conceptual and methodological issues in research on the making of an immigrant niche through a case study of immigrant professionals in New York City government." The author argues that "the growth of this immigrant niche resulted from changes in the relative supply of native workers and in the structure of employment, which opened the bureaucracy to immigrants and reduced native/immigrant competition. These shifts opened hiring portals; given the advantages of network hiring for workers and managers, and an immigrant propensity for government employment, network recruitment led to a rapid buildup in immigrant ranks."

Americas↗
PubMed1994

Taikongs and Calos: the role of middlemen and brokers in Javanese international migration.

"This article discusses international migration from Java in the past and present and the role brokers have played in stimulating this movement. It describes legal and clandestine labor migration to Singapore, Malaysia, and Saudi Arabia, the influence of employment brokers on the process, and the organization of the recruitment networks. The involvement of brokers is crucial but not always beneficial for the migrants. Migrants are dependent on the brokers and risk exploitation. In the case of movement to Saudi Arabia, there is a linkage with religious institutions and the Islamic pilgrimage."

Asia↗