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PubMed2006

[Management qualifications for academic surgeons in the future: what can we learn from business administration?].

Health is a fundamental resource for social and economic development. Greater human development implies that people live longer and enjoy good health for a greater number of years. Healthcare systems should adapt to the new challenges posed by health: a sharp increase in population aging, the demand for more appropriate and transparent management, increased patient expectations, rising costs, and the emergence of ever more challenging economic contexts. At the vanguard of surgical development, surgical units in university hospitals play a fundamental role in the future of surgery and are therefore responsible for coping efficiently with these changes. To do this, effective surgical leaders are required. However, this poses the problem of how these future surgical leaders should be trained so that their training can be controlled and proactively influenced in advance. The present article reviews the arguments and need for management training among general surgeons, as well as knowledge of this process and its results. To maintain first-class healthcare and provide the most advanced medical education and biomedical research, modern surgical units in university hospitals will require effective surgical leaders. To train these modern leaders, business management programs are essential, both in undergraduate education and in specialized surgical training.

Delivery of Health Care↗
PubMed1963

The effects of trypanosomiasis on rural economy with special reference to the Sudan, Bechuanaland and West Africa.

Trypanosomiasis, both of humans and of livestock, is one of the most important factors restricting economic development in Africa today. The present paper outlines how this disease is limiting agricultural, veterinary and forestry development in the Sudan, Bechuanaland and West Africa.The present tsetse-fly distribution is reviewed. Glossina palpalis and G. morsitans occur in the south Sudan and G. morsitans in the Ngamiland district of Bechuanaland; G. morsitans, G. palpalis and G. tachinoides are the most important species in West Africa.These tsetse flies have altered the cattle distribution in all three regions and, in addition to causing widespread disease, have created local overstocking problems in the tsetse-free grazing areas, and have enforced nomadism on breeding herds and economic loss in slaughter cattle along the trade cattle routes in West Africa.Human trypanosomiasis is not now such an urgent problem and public health measures have led to its control in all three areas.Increased agricultural development, which can be a successful and economic method of reclaiming land from tsetse flies, must be intensified in all three areas.Forest conservation policy comes into conflict with tsetse control measures only in West Africa.Detailed tsetse-fly surveys and research, on which future plans can be firmly based, are now urgently required.

Africa↗
PubMed2005

"Harnessing genomics to improve health in Africa" - an executive course to support genomics policy.

BACKGROUND: Africa in the twenty-first century is faced with a heavy burden of disease, combined with ill-equipped medical systems and underdeveloped technological capacity. A major challenge for the international community is to bring scientific and technological advances like genomics to bear on the health priorities of poorer countries. The New Partnership for Africa's Development has identified science and technology as a key platform for Africa's renewal. Recognizing the timeliness of this issue, the African Centre for Technology Studies and the University of Toronto Joint Centre for Bioethics co-organized a course on Genomics and Public Health Policy in Nairobi, Kenya, the first of a series of similar courses to take place in the developing world. This article presents the findings and recommendations that emerged from this process, recommendations which suggest that a regional approach to developing sound science and technology policies is the key to harnessing genome-related biotechnology to improve health and contribute to human development in Africa. METHODS: The objectives of the course were to familiarize participants with the current status and implications of genomics for health in Africa; to provide frameworks for analyzing and debating the policy and ethical questions; and to begin developing a network across different sectors by sharing perspectives and building relationships. To achieve these goals the course brought together a diverse group of stakeholders from academic research centres, the media, non-governmental, voluntary and legal organizations to stimulate multi-sectoral debate around issues of policy. Topics included scientific advances in genomics innovation systems and business models, international regulatory frameworks, as well as ethical and legal issues. RESULTS: Seven main recommendations emerged: establish a network for sustained dialogue among participants; identify champions among politicians; use the New Plan for African Development (NEPAD) as entry point onto political agenda; commission an African capacity survey in genomics-related R&D to determine areas of strength; undertake a detailed study of R&D models with demonstrated success in the developing world, i.e. China, India, Cuba, Brazil; establish seven regional research centres of excellence; and, create sustainable financing mechanisms. A concrete outcome of this intensive five-day course was the establishment of the African Genome Policy Forum, a multi-stakeholder forum to foster further discussion on policy. CONCLUSION: With African leaders engaged in the New Partnership for Africa's Development, science and technology is well poised to play a valuable role in Africa's renewal, by contributing to economic development and to improved health. Africa's first course on Genomics and Public Health Policy aspired to contribute to the effort to bring this issue to the forefront of the policy debate, focusing on genomics through the lens of public health. The process that has led to this course has served as a model for three subsequent courses (in India, Venezuela and Oman), and the establishment of similar regional networks on genomics and policy, which could form the basis for inter-regional dialogue in the future.

Editorial↗
PubMed1992

History of prostheses and orthoses in Japan.

Until the first contact with European civilization in 1543, prostheses and orthoses were not seen in Japanese medical history. Some physicians and surgeons who studied medicine in the Dutch language understood about prostheses and orthoses before the opening of the country in 1868. From 1868 to the end of World War II (1945), prostheses and orthoses were influenced by German orthopaedic surgery. From the latter half of the 1960s the research and development of these have been advanced, because of the establishment of a domestic rehabilitation system, international cultural exchange and economic development.

History, 16th Century↗
PubMedDate not supplied

[Underdevelopment and role of health assistance. The case of Equatorial Guinea].

The health-care problems of Equatorial Guinea and its health-care resources are analyzed to put them into the context of aid to developing nations, and to especially consider, the impact of Spanish Technological Cooperation, in particular. The parallel between goals of economic development and the development of health-care is so great in Equatorial Guinea that not even the structural change programs patronized by the International Monetary Fund have any effect on health-care expenses. The considerable uncertainty regarding the most suitable development strategy for Equatorial Guinea makes investments in human resources (health-care, education and self-sufficiency in food production) one of the most indisputable measures taken. The role of foreign aid, specifically that of Spain in Equatorial Guinea, has been considerable and is bound to increase, as it contributes effectively to development and can result in external benefits for the donor country.

Delivery of Health Care↗
PubMed1979

Past and current contraceptive use in Pakistan.

Despite a vigorous national family planning program and such innovations as the Continuous Motivation System, there has been little change in contraceptive use in Pakistan in recent years. Data from the 1968-69 National Impact Survey and the 1975 World Fertility Survey for Pakistan show that, while use rates increased by a small amount in urban areas, the rates in rural areas seem to have declined. Even in urban areas contraceptive use is low in comparison with other developing countries that began family planning programs around the same time. Although this is probably due to differences in economic development, further investigation of program structure and inputs is recommended.

Adolescent↗
PubMed2003

Environmental effect of vegetation restoration on degraded ecosystem in low subtropical China.

The environmental effect of degraded ecosystem's vegetation restoration in low subtropical China was studied. Results indicated that the vegetation recovery on degraded lands significantly ameliorates surrounding environment, increases species diversity, improves soil structure, raises soil fertility, enhances productivity, and promotes regional agricultural production and social economic development dramatically. Through the combining engineering and biological measures, the restoration of degraded ecosystem in low subtropical area is possible and economical. The restoration experience in Xiaoliang, Wuhua and other sites are valuable for other degraded subtropical area was introduced.

China↗
PubMed1993

Factors influencing infant mortality in Vietnam.

Selected determinants of overall infant mortality in Vietnam were examined using data from the 1988 Vietnam Demographic and Health Survey, and factors underlying neonatal and post-neonatal mortality were also compared. Effects of community development characteristics, including health care, were studied by logistic regression analysis in a subsample of rural children from the 1990 Vietnam Accessibility of Contraceptives Survey. Infant neonatal and post-neonatal mortality rates showed comparable distributions by birth order, maternal age, pregnancy intervals, mother's education and urban-rural residence. Rates were highest among first order births, births after an interval of less than 12 months, births to illiterate mothers and to those aged under 21 or over 35 years of age. Logistic regression analysis showed that the most significant predictor of infant mortality was residence in a province where overall infant mortality was over 40 per 1000 live births. In the rural subsample, availability of public transport was the most persistent community development predictor of infant mortality. Reasons for the low infant mortality rates in Vietnam compared to countries with similar levels of economic development are discussed.

Adolescent↗
PubMed1985

How nonprofit organizations can develop comprehensive in-home support services by utilizing various funding streams.

Home-chore service delivery can provide nonprofit organizations with opportunities for service, employment, training, and economic development. This article describes the ways that such organizations can fund and develop home-chore programs. It examines the five major funding sources and the opportunities for combining program funds to promote comprehensive care. It then discusses issues to consider in competing for contract bids with proprietary providers. Marketing strategies are outlined for each funding source, including which services to offer and how to project a favorable agency image. This section places special emphasis on ways to tap the often overlooked but largest potential client population, the private pay sector. Finally, there are guidelines and projections for preparing budgets.

Aged↗
PubMed2005

Economic justification for a public school of pharmacy: lessons for Nevada.

There is a nationally recognized shortage of pharmacists in the United States that is more pronounced in the West. This shortage will worsen with the rapid growth and aging of the population. Demand for traditional pharmaceutical care services has grown faster in the last decade than predicted and is projected to outpace the entry of pharmacists into the workforce. The growth of direct patient care roles for pharmacists, together with the increasing need for pharmacist services in the management of health care, threatens to overpower the present capacity of pharmaceutical education. Healthcare officials and consumers alike are becoming increasingly concerned about the pressure on pharmacist services leading to decreased access to pharmaceutical care and an increase in the frequency of medication errors both having a major impact on the health of patients. While the impact of the pharmacist shortage on the quality of pharmaceutical care has been the subject of recent concern, the role of pharmacists in economic development has not been adequately addressed. In this review, we examine the impact of the shortage of pharmacists and apply economic principals to the impact created by the addition to a state economy of a public school of pharmacy. We apply this analysis to the proposed addition of a public school of pharmacy in Nevada, the fastest growing state in the nation, which currently has a single, private pharmacy school.

Arizona↗
PubMed1993

Geographic peculiarities of endometrial and cervical cancer incidence in five continents (review).

The review of references and data on endometrial and cervical cancer incidence in five continents (1970, 1976, 1982, 1987) are presented. The increase in cervical cancer rates in the developing countries of Asia, Africa and Latin America has been recorded. The hormonedependent tumours (endometrial, breast cancer) prevail in the economically developed countries of Europe and North America. They have shown a tendency to increase since the end of the 70's. The possible causes of peculiarities in oncogynecological incidence have been discussed.

Africa↗
PubMed1995

Traffic-related mortality in industrialized and less developed countries.

Road traffic-related mortality has traditionally been regarded as a problem primarily of industrialized countries. There is, however, growing evidence of a strong negative relationship between economic development and exposure-adjusted traffic-related death rates. Cross-sectional data on road traffic-related deaths in 1990 were obtained from 83 countries. The relationship between such mortality and a number of independent variables was examined at the individual country level by means of multiple regression techniques. These were also used to elucidate factors associated with variations in age, sex, and case-fatality patterns of road traffic mortality. Countries were grouped according to region and socioeconomic features, and the mortality data were summarized by these groups. The gross national product per capita was positively correlated with traffic-related mortality/100,000 population/year (P = 0.01), but negatively correlated with traffic deaths/1000 registered vehicles (P < 0.0001). Increasing population density was associated with a proportionately greater number of traffic-related deaths in the young and the elderly (P = 0.036). Increasing GNP per capita and increased proportional spending on health care were associated with decreasing case-fatality rates among traffic-accident victims (P = 0.02 and 0.017, respectively). Middle-income countries appear to have, on average, the largest road-traffic mortality burden. After adjusting for motor vehicle numbers, however, the poorest countries show the highest road traffic-related mortality rates. Many industrialized countries would appear to have introduced interventions that reduce the incidence of road traffic injury, and improve the survival of those injured. A major public health challenge is to utilize this experience to avoid the predicted increase in traffic-related mortality in less developed countries.

Accidents, Traffic↗
PubMed1977

Some remarks on the economic and political development of health care in the Federal Republic of Germany.

The economic and political development of health care in the Federal Republic of Germany is analyzed within the framework of overall social development. This will be shown describing the main components of the health care system: outpatient care, inpatient care, the dispensing of medicines, and statutory health insurance. The functions of the state and the influence of the pressure groups, i.e. the medical professional associations, are examined. Finally, an assessment of the present situation is made.

Delivery of Health Care↗
PubMed1982

Issues in the evaluation of nutrition interventions.

Malnutrition in developing countries is essentially a problem of poverty and low food consumption. Thus, its alleviation rests in integrating nutrition interventions with socio-economic development measures. With this orientation, evaluation is becoming increasingly necessary. However, the methodology available for assessing nutritional status places unreasonable demands on the human and financial resources of any programme. There is also a serious lack of knowledge of the effect of malnutrition on the physical capacity and mental functioning and on the relationship between malnutrition and income. Evaluation may, with advantage, be built into the framework of the intervention project design, and be introduced at the appropriate time when impact is likely to be detectable. Of concern are such operational aspects as the relation of evaluators to operation staff, the involvement of project participants and the management of evaluation ata. In addition, the political and ethical implications of evaluating nutrition interventions need to be kept in focus in order to maximize the value of evaluation efforts.

Agriculture↗
PubMed2001

A system dynamics approach for regional environmental planning and management: a study for the Lake Erhai Basin.

In recent years, water-quality deterioration associated with rapid socio-economic development in the Lake Erhai Basin, China, has acquired more and more attention from the public and the government. An effective planning for the basin's environmental management system is desired for sustainable regional development. In this study, an environmental system dynamics model, named ErhaiSD, is developed for supporting this planning task. The ErhaiSD consists of dynamic simulation models that explicitly consider information feedback that governs interactions in the system. Such models are capable of synthesizing component-level knowledge into system behaviour simulation at an integrated level. This capability is very useful in analyzing and recommending policy decisions. For the study case, interactions among a umber of system components within a time frame of 15 years are examined dynamically. Four planning alternatives are considered. The base run is based on an assumption that the existing pattern of human activities will prevail in the entire planning horizon, and the other alternatives are based on previous planning studies. The contributions of various nonpoint pollution sources to the lake's eutrophication problems, and the effects of industrial activities and wastewater treatment processes on pollution problems in the Xier River are analyzed through the developed modeling system. The exercise draws attention to the implications of different alternatives to the system's environmental and socio-economic objectives. The modeling results are directly useful for simulating and evaluating a variety of decision actions and their dynamic consequences, and answering questions such as 'What should I do?', 'What if I do?' and 'What are the expected consequences?'.

Agriculture↗
PubMed1991

Aging and disability in China: cultural issues in measurement and interpretation.

Aging is no longer an issue of concern only to industrialized countries. Recent estimates project that by the year 2000 there will be 590 million people aged 60 or older worldwide. Of these 590 million approximately 61% will be living in lesser developed countries. Thus, these countries will shortly face critical decisions concerning the impact of these aging populations on state plans for economic development. China, the country with the largest anticipated number of elderly in the world, provides an instructive case of how one developing country is attempting to balance the needs of the elderly with those of the nation as a whole. In particular the rapid aging of the Chinese population has prompted official concern about the financial implications of providing health care to increasing numbers of disabled or frail elderly. This paper reports the efforts of one study to determine the extent of disability and frailty among the urban elderly and the strategies they and their family members have developed to cope with it. The research was conducted between June 1987 and January 1988 in two neighborhoods of Canton, the capital of Guangdong Province. Two hundred households, each containing at least one member 70 years of age or older, were randomly selected from household registration lists. In each household a 1-2 hr interview was conducted with the elder (or, in the case of those too disabled to participate, a proxy) on the following topics: personal background, proximity and contact with kin, household composition and organization, health and functionality, use of medical services, work history, income sources, daily activities, and attitudes regarding intergenerational relations. The paper is divided into five parts addressing the following topics: (1) China and research on aging, (2) comparative data--problematic aspects, (3) methodological issues to consider when investigating disability, (4) the findings of the study, and (5) the significance of ideological, environmental, and political factors in mediating the experience of age-associated disability in China.

Aged↗
PubMed2005

Research agendas in global emergency medicine.

As the global culture moves forward into the 21st century with increasing interaction of populations through direct contact and electronic interchange, those citizens of our planet who have not benefited from the material gains that have been realized in the "mature economy" countries will increasingly seek equity on all levels, beginning with the most fundamental aspect of health care. There is a need to develop a capacity for treatment of urgent and emergent health conditions globally, a need that will only increase with advancing global economic development.

Emergency Medical Services↗
PubMed2006

Country development and the association between parity and overweight.

INTRODUCTION: Parity is associated with overweight and obesity in developed countries and has been related to maternal depletion in poor developing countries. However, the literature from developing countries is limited and may not represent current stages of development. METHODS: We analyzed data from 50 Demographic and Reproductive Health Surveys conducted between 1992 and 2003. We examined the association between parity (proxied by number of live births) and overweight (body mass index (BMI)> or =25 kg/m(2)) in relation to level of country wealth and development. RESULTS: The odds ratio (OR) for overweight comparing women with at least four live births to women with one live birth was >1.0 in 38 of the 50 countries studied. The median OR was >1.0 in all regions studied and highest in North Africa/West Asia, where all countries had OR >1.0. Country wealth and development were both positively associated with the ORs. CONCLUSIONS: The importance of parity as a predictor of overweight increases with national economic development and wealth. Policy implications might include the development and implementation of programs to prevent excessive gestational weight gain and promote postpartum weight loss via dietary change and physical activity, concomitant with exclusive breastfeeding.

Adolescent↗