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PubMed2007

Human impacts on land cover and water balances in a coastal Mediterranean county.

We analyzed the effects of changes in land cover on the water balance in Spain's Marina Baixa County, on the Mediterranean coast. To reveal how different land management strategies have affected the area's environment, four municipalities within the same catchment were studied: Benidorm, Callosa d'en Sarrià, Beniardà, and Guadalest. In the municipalities of Callosa and Benidorm, the proportion of the area covered by woodland declined by 4.2% and 30.2%, respectively, and woodland was replaced by agriculture and urban development. The abandonment of farmland produced a 17% increase in the proportion of the area covered by vegetation in Guadalest and Beniardá, where frequent forest fires have exacerbated a decrease in the area of pine woodland. Tourism development in Benidorm has been accompanied by an increase in the transportation infrastructure and by an expansion of areas with an impermeable surface, with the lowest level of infiltration into the aquifer system. These changes have generated a net water deficit in Callosa and Benidorm of more than 6 Mm(3)/year, creating a high demand for water imported from other municipalities (Guadalest and Beniardá) or from outside of the county to maintain the sustainability of the current water management strategies. The Marina Baixa case study is representative of many of the world's coastal areas that are undergoing rapid urban development based on an inappropriate understanding of human progress based mainly on economic development and thus provides insights into water management in other areas.

Environment↗
PubMed2005

The socioeconomic correlates of global complication prevalence in type 1 diabetes (T1D): a multinational comparison.

We sought to determine the extent to which the geographic variation in the complications of type 1 diabetes (T1D) may reflect the socioeconomic status (SES) conditions and health care performance (HCP) of countries around the world. The World Health Organization (WHO) DiaMond complications study (DiaComp) is a multinational, cross-sectional study of complications in T1D. Information on complications was identified for 892 subjects from 14 clinical centers in 12 countries. All participants were diagnosed with diabetes in childhood (<15 years of age) and had disease duration of 5-24 years. Complications were assessed by self-report, and by clinical exam, with microalbuminuria identified by Micral II dipstick, neuropathy by the Michigan Neuropathy Screening Instrument exam and hypertension using the HDFP protocol. These data were linked to center-specific information on the local social and economic landscape, health care access and diabetes management practices and health care costs. Country-specific indicators of social and economic development were also linked to the complications data. Both diabetes complications and economic and health care factors vary widely across the DiaComp centers. Health system performance, as measured by disability adjusted life expectancy (DALE), gross national investment (GNI) per capita and purchasing power all showed strong consistent correlations with complications, and significant independent associations with complication prevalence after controlling for HbA1c and hypertension. In conclusion, health system performance, social distribution of wealth and purchasing power may play important roles in explaining the geographic variation of diabetes complications.

Adolescent↗
PubMed1989

Economic considerations that influence health policy and research.

Cardiovascular conditions account for more medical costs than any other diagnostic category in the United States. Increasingly, economic constraints will shape policy related to health care and research. Hypertension is the most common cardiovascular condition, and despite low unit health care costs, the aggregate costs are considerable. However, the unit and aggregate costs of the complications of hypertension are fourfold greater and, in this economic perspective, aggressive approaches are warranted to prevent complications. Treatment and research strategies should be identified that could have considerable potential economic impact. Several strategies are suggested as a prospective guide to policy development. Economic considerations will be important and should be incorporated in the planning of hypertension care and research.

Antihypertensive Agents↗
PubMed2002

Sustainable development of wastewater treatment strategies for the food industries.

The sustainable development of environmental protection is a newly created philosophy. It means continuous development of better protection of the air, soil, water and resources, used from the industry, to be saved also for future generations. The globalization of the economy is another process, which interferes with environmental ideas, and an equilibrium with the socio-eco-sustainable development is wanted. The industry is subjected to big changes depending on economic development. Thus the treatment plants at the end of the pipe must be constructed with maximum flexibility. A removal of constructed devices, if not necessary, must be considered from the beginning as a possibility. Priority is given to integrated production processes solving wastewater problems directly by production devices. The treatment of the process wastewater streams separately will become more important. The end of the pipe solutions will be less complicated and more reliable. The reuse of valuable waste substances and treated water will reduce the total cost of the treatment plants substantially.

Agriculture↗
PubMed2003

Turn public problems to private account.

Many managers face increasing calls to invest corporate resources in charitable causes. How should executives balance a firm's very real economic imperative to maximize profitability with its hypothetical moral imperative to improve society? To provide one answer, the author draws on his experience as president of an economic-development company, IBEC. Viewing profit as "an essential discipline and measure of economic success" but not "the sole corporate goal," the company actively invested in social programs that met four criteria: they served a need of the local population; they required innovative approaches; they made sense on economic grounds; and they respected the social norms of the community. Such civic-minded efforts, the author argues in this prescient 1971 article, not only improve people's lives but also create the foundation for more affluent and dynamic markets--markets that ultimately produce greater profits for business. For example, one of IBEC's earliest ventures was directed toward solving Venezuela's problems in retail food marketing. Many important items were unavailable at the small stores where people shopped. So in 1949, working with local partners, IBEC opened a supermarket. Supermarkets soon changed the food-buying habits of the nation, and the initiative helped alter patterns of food distribution and created the reliable demand needed to establish a host of local suppliers. Return on IBEC's investment, and that of its local partners, was most satisfactory, the author reports. The road to meeting a public need-especially a major one--is rarely easy, the author says. But if management sizes up the need well, there is a good chance its new venture will survive under adversity.

Administrative Personnel↗
PubMed1993

Consequences of rapid fertility decline in the Republic of Korea: issues and solutions.

During the last 3 decades, efforts to deal with population problems in Korea have focused largely on reducing population growth. The national population control program has been a major means of achieving this goal. Between the early 1960s and 1990, evidence from a national survey indicates that the percent of current use of contraception rose from about 12% to 80% and the total fertility rate fell to 1.6. representing 1 of the most rapid fertility transitions in the developing world. In conjunction with this rapid reduction in fertility, mortality also improved significantly during this period. Thus, Korea has virtually completed the demographic transition from high birth and death rates to low birth and death rates during the same period. It is widely recognized that Korea has reached demographic maturity and has also achieved remarkable economic development at the same time. The world's demographic history shows that the demographic transition which almost every industrialized country has gone through from a predominantly rural, illiterate society with high birth and death rates, to a predominantly rural, illiterate society with high birth and death rates, to a predominantly urban, educated society with low birth and death rates usually takes well over a century, but in Korea, that process has taken only a few decades. On the other hand, the consequences of a rapid fertility decline bring about various demographic and social issues which we have to take into consideration for future socioeconomic development policy concerning the well-being of the Korean people. Some of issues for policy consideration can be broadly summarized as follows: 1) gradual imbalance of sex ratio at birth due to traditional son preference behavior; 2) latent effect of inevitable population aging and increasing dependency burden on behalf of the elderly for the public sector; 3) changes in family life cycle and rapid transformation form a large to a small family; 4) increasing demand for now social roles for women, supported by easing of child care burdens within households.

Asia↗
PubMedDate not supplied

Development and disadvantage: implications for the early years and beyond.

Links have long been made between literacy and economic development, and recent governments in the UK have put great emphasis on the teaching of literacy to raise educational standards. There is substantial evidence to show that spoken and written language share some processes in common and that the development of literacy is supported by the development of spoken language. Anecdotal evidence from early years practitioners suggests that many children coming into early years education, particularly those from disadvantaged socioeconomic backgrounds, may not have the spoken language skills needed to develop reading and writing. This preliminary study aimed to investigate the extent to which the spoken language skills of children reared in poverty are depressed in comparison with the general population, and in comparison with their general cognitive abilities. Two tests were administered to children in their first term at nursery school to measure their spoken language skills and cognitive abilities: CELF-PUK and BAS II. More than half of the children were found to be language-delayed, although girls' receptive language abilities were significantly better than those of boys. Participants' language skills were also significantly depressed in comparison with their cognitive abilities. Government initiatives to raise awareness of spoken language in the early years are discussed, and implications for the future role of speech and language therapists working in the pre-school sector are considered.

Age Factors↗
PubMed1990

Effects of agricultural development policies on migration in peninsular Malaysia.

State planning plays a central role in Malaysia's social and economic development. The government's rural development policies are designed to promote agricultural incomes and help counterbalance ethnic inequalities. The Federal Land Development Authority (FELDA) implements one of the internationally most successful land development and resettlement programs. In this article, we quantify the impact of FELDA settlements on local out-migration rates, linking macro and micro approaches and using data from the Malaysian Family Life Survey, national censuses, and other sources. A model of instantaneous migration rates specifies an individual's migration rate as a function of individual-level sociodemographic characteristics, the level of urbanization of the origin and destination, and the extent of rural development at the district of current residence. Our results show that in the late 1960s and early 1970s, the existence of rural development centers in a district reduced the levels of out-migration to pre-1965 levels.

Agriculture↗
PubMed2005

The new nutrition science: sustainability and development.

OBJECTIVE: To show that nutrition science is anchored in food systems and is influenced by the social, through the environmental to the cosmological, life's connections and rhythms. To indicate that an integrative approach is now becoming possible with advances in food technology, in the understanding of food choice and of human behaviour, and in a preparedness to recognise nutritional inputs in the full sweep of life-long well-being and health outcomes. METHOD: An analysis of the much broader understanding of nutritionally related diseases from an ecological perspective, with attention to economic development, beginning with poverty alleviation. Recognition that the biological dimension of nutrition science is undergoing a profound reappraisal; that technologies will allow us to change the course of nutritionally related diseases for the better; and that nutrition science will find partners in information technology and telecommunications, food technology and energy technology. CONCLUSION: A new generation of nutrition scientists can help build a new economy that supports development amongst communities, whether close or distant from each other. The opportunities for this kind of development to be realised between Asia, Latin America and Africa are considerable. At all times, however, nutrition scientists must uphold the paramount importance of good governance, conflict resolution and maternal literacy if their work is to achieve its growing potential.

Developing Countries↗
PubMed1998

Fertility and labour supply in Femina economica.

This paper sets out a formal framework for the biological-evolutionary study of human economic behaviour. Femina economica is a hypothetical parthenogenetic species with a simple economy. Individuals make decisions about labour supply and fertility subject to time and resource constraints. Labour is of differing types and a parent determines the type of her offspring's labour. Wages are determined as marginal productivities from an economy-wide production function. Three propositions are proved, of which the first shows that under very general conditions there exists a population genetic equilibrium, in which individuals' decisions are assumed to be under genetic control. The second shows that at a population genetic equilibrium, individuals have the same behaviour as they would at an economic equilibrium, in which individuals are assumed to maximise a common utility function. The third proposition shows that if the common utility function fulfils certain conditions, the attainment of an economic equilibrium brings about the same behaviour as a population genetic equilibrium. This suggests a way in which evolutionarily stable behaviour can be brought about without the necessity for changes in gene frequencies. Demographic implications include the possibility of interpreting in Darwinian terms the reductions in offspring number that occur in fertility transitions, and the weak or even negative correlation in economically developed societies between control of resources and offspring number. There are implications for economics of deriving utility maximisation from population genetics.

Biological Evolution↗
PubMedDate not supplied

Reform of the Chinese health care financing system.

The radical changes which have been taken place in the Chinese economy since the late 1970s have influenced the health sector and the health care financing system. A rapid increase in medical care costs in the last decade has placed a heavy financial burden on the government and enterprises and a vast majority of the rural population. The public service medical scheme for government employees and labor insurance for enterprise workers are facing a great challenge of cost containment through a series of reforms in the mechanisms of fund collection and management. In the meanwhile, the collapse of the cooperative medical care scheme in most rural areas has raised the issue of gaining access to basic health care for the rural population and in particular the poor. This paper provides a description, with some explanation, of how and why the health care financing system had been changed and experienced such a sharp increase in expenditure. In conclusion, how to develop and improve a financing system appropriate to the level of socio-economic development in China is addressed.

China↗
PubMed2006

Surgical practice in Hong Kong.

Surgery in Hong Kong has undergone a significant evolution over the past century. The quality of surgical care, medical education, surgical training and academic research has improved significantly through the joint efforts of the two universities, the government and the surgical colleges over these years. Surgical practice in Hong Kong continues to change also with the development of specialties/subspecialties, the changing pattern of disease and the development of new and effective treatments. Areas of clinical excellence in oesophageal cancer, hepatocellular carcinoma (HCC) and nasopharyngeal cancer (NPC) have gradually developed in these areas in Hong Kong. With the ongoing Westernisation and continued economic development in Hong Kong, some previously uncommon diseases will become more common. The surgical service in Hong Kong will need to continue to change to meet the new challenges in the future

Benchmarking↗
PubMed2002

Current status of coronary risk factors among rural Malays in Malaysia.

BACKGROUND: Coronary heart disease (CHD) is the leading cause of death in Malaysia, despite its status as a developing country. The rural population is thought to be at low risk. OBJECTIVE: To investigate the prevalence of risk factors and global risk profile among rural Malays in Malaysia. METHODS: We studied 609 rural Malay subjects (346 females, 263 males; age range 30-65 years). Blood pressure (BP), body mass index (BMI), waist-hip ratio (WHR), smoking habits and family history of premature CHD were documented. Fasting blood samples were analysed for serum lipids, lipoprotein (a), plasma glucose and fibrinogen. Oral glucose tolerance tests were performed using 75 g anhydrous glucose. RESULTS: The prevalence of hypercholesterolaemia for total cholesterol concentrations of > or = 5.2, > or =6.5 and > or =7.8 mmol/l were 67.3, 30.5 and 11.8% respectively. There was a high prevalence of low serum high-density lipoprotein cholesterol (13.1%), hypertension (30.3%), smokers (24.4%), diabetes (6.4%), impaired fasting glucose or glucose tolerance (13.9%), overweight or obesity (44.7%) and increased WHR (48.5%). Global risk assessment showed that 67.3% of the study population were at risk, with 15.9, 18.9 and 32.5% in the mild, moderate and high risk categories respectively. CONCLUSION: Prevalence of risk factors was high in the rural population. Global risk assessment showed a high-risk profile with two-thirds being at risk, and one-third being categorized into the high-risk group. Although rural communities were considered at low risk of developing CHD, this is changing fast, possibly due to the rapid socio-economic development, in addition to underlying genetic predisposition.

Adult↗
PubMed2004

[Nutrition and development].

Discussions on development and nutrition frequently have a double focus: one that considers nutritional status as a reflection of development, and another that admits that nutrition strongly influences the level and rhythm of development. The authors view nutrition as a decisive factor for adequate social and economic development, specifying the fact that nutritional interventions might contribute to significant improvements in individual classroom performance, productivity at the workplace, and resistance to infections. The implications of malnutrition for the economy are thus evident: either by limitations in income expectations, increased costs deriving from burdens assumed by the population to protect themselves, or considerable hidden social costs--absenteeism, work accidents, and rotation of employees. Given modernization and a competitive economy, there is an unquestionable need for nutrition to head the agenda of national priorities, thus promoting human resource development and the preservation of this human capital, one of the chief goals of a socially responsible economy.

English Abstract↗
PubMed1998

Application of geographical information systems to co-analysis of disease and economic resources: dengue and malaria in Thailand.

Two vector-borne communicable diseases, malaria and dengue, are among a number of diseases of particular importance in relation to economic development in Southeast Asia and thus need to be assessed in relation to economic parameters in the region. Geographical Information Systems (GIS) provide one means of comparing disease and resource data versus time and place, to facilitate rapid visualization by planners and administrators. Given that Thailand is a global epicenter of multidrug resistant falciparum malaria and of dengue hemorrhagic fever, both of which are mosquito-borne, application of GIS methods to these two diseases gives opportunity for comparison of resource needs and allocation in relation to disease epidemiologic patterns. This study examined per capita gross provincial product (GPPpc) and health care resources in relation to geographic distribution of malaria and dengue in Thailand. The two diseases vary greatly in overall seasonal patterns and in relation to provincial economic status, and present differing demands on resource utilization: planned integration of control of malaria and dengue could utilize such analyses in relation to resource sharing and consideration of allocative efficiency. The concentration of malaria (and to a lesser extent dengue) along international border areas underscores the desirability of multi-country coordination of disease management and control programs. Because socio-economic and disease data are collected by quite different means and in different time frames, there are some limitations to the dynamic interpolation of these two broad data sets, but useful inferences can be drawn from this approach for application to overall planning, at both national and multi-country levels.

Dengue↗
PubMed1999

Economic impact of delaying or preventing AIDS in persons with HIV.

OBJECTIVES: To investigate how preventing or delaying the development of acquired immune deficiency syndrome (AIDS) [or other severe conditions related to the human immunodeficiency virus (HIV)] through antiretroviral therapy affects the lifetime cost of HIV/AIDS care, and to compare the cost of therapy with the potential savings in HIV/AIDS-related end-of-life care. METHODS: The analysis utilized a previously developed economic model of HIV/AIDS-related medical care costs under various disease progression scenarios to compare the costs and benefits of antiretroviral therapy. RESULTS: The analysis suggests that: (1) recent projections of long-term medical care cost savings due to highly effective protease inhibitor combination therapies are probably illusory; (2) it makes relatively little difference to the overall long-term cost of HIV/AIDS care whether combination antiretroviral therapy completely prevents or just substantially delays progression to AIDS; and (3) although combination therapy is not likely to save economic resources in the long run, it nevertheless can be highly cost effective. CONCLUSIONS: The health-related benefits of antiretroviral therapy are not free, but appear to be worth the cost.

Acquired Immunodeficiency Syndrome↗