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[[Women's empowerment and population issues]].

Prospects for controlling the growth of the world's population are reviewed. "The key to the stabilization of the world population is advancing gender equality and equity and the empowerment of women and ensuring women's ability to control their own fertility.... As the [1994] Cairo Conference has taught us, the most important thing to do is to provide women and men with equal rights and responsibilities in the entire course of life, particularly in health, education, production and reproduction." (SUMMARY IN ENG)

Demography↗

Health-care technology transfer: expert and information systems for developing countries.

Computer-based technologies such as information systems and expert systems have an undoubted contribution to health-care development in developing countries. This paper addresses the appropriateness of these technologies for developing countries, the criteria to be used in selection of the technology to be transferred, and the need for a systematic approach to evaluation. A conceptual model for assessing transferability so as to achieve an effective transfer, has been introduced. This requires not only an attempt to amplify the role of information and expert systems in health-care improvement and for socio-economic development, but the analysis of prior experience in transferring these technologies to developing countries. Following this approach, and using operational research techniques such as the Analytic Hierarchy Process, a subjective assessment model has been described that can systematically guide decision-making about computer-based health-care technology to be transferred to developing countries.

Developing Countries↗

Assessing the ecological security of the Tibetan plateau: methodology and a case study for Lhaze County.

A system for assessing the ecological security of Lhaze County in China's Tibetan Autonomous Region was developed using a pressure-state-response model and the analytic hierarchy process. We then used this model to comprehensively evaluate the status of ecological security in Lhaze County. Our results showed that the ecological environment in Lhaze County has deteriorated from an 'early stages of damage status' in the 1980s to 'moderately damaged status' today. This deterioration has become a major barrier to local economic development and social advancement. Natural and social aspects related to the population explosion, resource exploitation, and climate change that led to this ecological deterioration are discussed. Furthermore, we have suggested proposals for improving the ecological environment that include controlling population growth and enhancing the system of laws that protect the environment, upgrading 3 882.6 ha of low-yield farmland, planting 2 425.8, 548.8, and 1 207.4 ha of shelter belts for farmland protection, soil and water conservation, and fuelwood, respectively, and seeding 2 358.1 ha of artificial grassland. In the meantime, we propose strengthening the controls that limit soil and water loss, and optimizing industrial sectors that aspire to achieve high-efficiency, ecologically responsible agriculture.

China↗

New federalism and health care policy: states and the old questions.

The New Federalism that evolved under the Reagan administration tends to grant states more discretion in the implementation of health care programs. It thereby rekindles old concerns about the commitment, capacity, and progressivity of the states. This paper reviews recent policy developments and reconsiders state performance from the vantage point of the mid-1980s. While hard evidence remains elusive, a plausible case exists that any gap between the states and Washington on commitment, capacity, and progressivity has diminished. State administrative capacity in particular has probably increased. The continued presence of substantial variation among the states needs to be underscored, however. Moreover, the relentless imperative of economic development, or migration, theory sets severe limits on how far states can go in adopting redistributive measures to assure adequate medical care for the poor. Given current federal laws, the most optimistic, plausible scenario envisions the rise of a technical politics of efficiency in the states. In spite of state limitations, health policy reformers need to pay increased attention to their potential role.

Costs and Cost Analysis↗

Militarism and mortality. An international analysis of arms spending and infant death rates.

Examination of data from 141 countries showed that infant mortality rates for 1979 were positively correlated with the proportion of gross national product devoted to military spending (r = 0.23, p less than 0.01) and negatively correlated with indicators of economic development, health resources, and social spending. In a multivariate analysis controlling for per caput gross national product, arms spending remained a significant positive predictor of infant mortality rate (p less than 0.0001), while the proportion of the population with access to clean water, the number of teachers per head, and caloric consumption per head were negative predictors. The multivariate model accounted for much of the observed variance in infant mortality rate (R2 = 0.78, p less than 0.0001), and showed good fit to similar data for the year 1972 (R2 = 0.80, p less than 0.0001). The model was also predictive of infant mortality rates in subgroup analysis of underdeveloped, middle developed, and developed nations. Analysis of time trends confirmed that an increase in military spending presages a poor record of improvement in infant mortality rate. These findings support the hypothesis that arms spending is causally related to infant mortality.

Capital Expenditures↗

Global overview of malaria.

Malaria continues to be one of the main public health problems in the world, especially in the majority of African countries. It particularly affects young children, young adults engaged in economic development activities, pregnant women and international itinerant groups of population, moving into malaria endemic areas. Malaria epidemics became a regular feature in many parts of the world, including the highlands of Africa, being associated with the warming of the climate, disruption of health services and large scale uncontrolled population movement as a result of social disruption and civil wars. Further proliferation of drug resistance is closely related to massive population movements, inadequate health services, improper use of antimalarial drugs, limited resources and operational difficulties in implementing malaria control activities. The economic impact of malaria is felt by various social groups of the society particularly by the poorest countries of the world and among populations living under the most difficult conditions. To overcome the malaria challenge, there is a need for concerted efforts by the health services, the private sector, the communities themselves, including the international community. Much could be achieved through the research and development (the use of insecticide-impregnated materials) and disease management (the use of artemisinin and its derivatives in areas with multi-drug resistance) will facilitate the achievement of the global goal of malaria control-to eliminate mortality and to reduce morbidity due to malaria.

Adult↗

Urban nutritional problems of Korea.

Rapid economic development resulted in urbanization of Korea, since 1960s. Seoul is the center of politics, finance, education and culture of Korea. Mostly young people have migrated to large cities, such as Seoul and Pusan. For instance, the population in Seoul city was 2.5 million in 1960 but increased to 10 million in 1990. Presently, total population of Seoul and Pusan, second largest city, composed of approximately 50% of whole national population. The economic distribution among urban people became extremely uneven creating a large gap between low and high income group. As a consequence, both under and over nutritional problems coexist. According to the national nutrition survey data, animal food, such as meat, fish and dairy products have been consumed about 6 times more, and cereal consumption was far less in higher income group. In terms of nutrients intake, 28% of total caloric intake comes from lipids and 15-17% of total caloric intake from protein. This was found in higher income group, while low income group consumed more than 80% of total caloric intake from carbohydrate. The trends of major causes of death in Korea have changed. The degenerative diseases, cerebral disorder, high blood pressure became leading cause of death in recent years. Malignant neoplasm and diabetes followed second leading cause of death in Korea. Undernutrition and nutritional insufficiencies, anemia and low growth rate continue to exist among low income group. According to the annual death rate by age group, the age between 34-54 was the highest in the world.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Physician migration: donor country impact.

Physician migration from the developing to developed region of a country or the world occurs for reasons of financial, social, and job satisfaction. It is an old phenomenon that produces many disadvantages for the donor region or nation. The difficulties include inequities with the provision of health services, financial loss, loss of educated families, potential employers, and role models and diminished resources with which to conduct medical education. Staff for undergraduate and postgraduate education is depleted. The critical mass for research and development becomes difficult to achieve or maintain, and these disadvantages are not compensated for adequately by increased contacts, the introduction of new ideas, or financial inflow to the donor region or country. The political will of governments and international organizations regarding treaties about the ethics of physician recruitment is called into question by discrepancies between the text of agreements and the ground realities. Amelioration of this situation requires economic development and imaginative schemes by the donors and, ideally, ethical considerations from recipient governments. At the very least, adequate compensation should be made to the donor country for the gain obtained by the host country.

Education, Medical↗

Health condition of Siberian population (medical ecological analysis).

OBJECTIVES: The aim of the investigation is to show, with the help of various scientific approaches, the Siberian population's state of health for the last years. METHOD: On the basis of results of a large cycle of population investigations of people in different zones of Siberia--shift workers, inhabitants of ecologically adverse regions, schoolchildren in sensitive periods of development--we discovered disorders of adaptive processes that are accompanied by a decrease of mental stability, readjustment of physiological regulation mechanisms and exhaustion of functional reserves of the organism. RESULTS AND CONCLUSIONS: The significant changes registered everywhere of the condition of health of the adult and children population in the centres of ecological risk and trouble call more and more urgently for considering the condition of health an economic category, and the quality of health of the population a limiting factor of the strategy of social-economic development of the territories of Siberia.

Ecology↗

The food industry and provincial economies.

This paper discusses the significance of the food industry for the Zhejiang provincial economy and for provincial economies generally. It is suggested that the strong ties between the food industry and provincial economies in China means that the food industry can be a key influence in the economic development of regional China. Moreover, the geographically diffuse nature of the food industry in China gives the industry a strategic significance in countering regional inequality within and between provinces, a by-product of China's rapid growth over the past 25 years. For these reasons, change in the food industry, whether it has its origins in the introduction of western fast foods, or in environmental, technological or economic trends, not only assumes significance for the health of the Chinese people (as other papers presented to the International Cuisine and Health Workshop at Hangzhou have pointed out), but also for the wealth of the nation and the way that wealth is distributed.

China↗

Damage loss assessment and control of the cereal leaf beetle (Coleoptera: Chrysomelidae) in winter wheat.

Cereal leaf beetle, Oulema melanopus (L.), invaded northern Alabama and Georgia more than a decade ago and since has become an economic pest of winter wheat and other cereal crops in the southeastern United States. A series of trials was conducted beginning in 1995 to determine optimal rate and timing of applications of selected foliar insecticides for managing cereal leaf beetle in soft red winter wheat. These trials, cage studies with larvae, and a manual defoliation experiment were used to provide information on cereal leafbeetle yield loss relationships and to develop economic decision rules for cereal leaf beetle in soft red winter wheat. Malathion, methomyl, carbaryl, and spinosad effectively controlled larval infestations when treatments were applied after most eggs had hatched. Encapsulated endotoxin of Bacillus thuringiensis, methyl parathion, and disulfoton applied at the lowest labeled rates were not effective treatments. Organophosphate insecticides generally were not effective when applied before most eggs had hatched. The most effective treatments were the low rates of lambda cyhalothrin when applied early while adults were still laying eggs and before or near 50% egg hatch. These early applications applied at or before spike emergence virtually eliminated cereal leaf beetle injury. The manual defoliation study demonstrated that defoliation before spike emergence has greater impact on grain yield and yield components than defoliation after spike emergence. Furthermore, flag leaf defoliation causes more damage than injury to lower leaves. Grain test weight and kernel weight were not affected by larval injury in most trials. Regression of larval numbers and yield losses calculated a yield loss of 12.65% or 459 kg/ha per larva per stem, which at current application costs suggested an economic threshold of 0.4 larvae per stem during the spike emergence to anthesis stages.

Animals↗

8-year clinical experience in cerebral palsy.

The changes in frequency and distribution of the clinical types of cerebral palsy (CP) were evaluated in 1873 CP cases admitted to the Department of Pediatric Neurology between 1982 and 1989. The observed panorama of CP was unlike the situation in developed countries. The majority of the cases were term-born and perinatal risk factors were noted to play the predominant role in the etiology of these cases. On the other hand, the most common type of CP was spastic quadriplegia where as spastic diplegia cases were less commonly encountered. These differences led us to conclude that the clinical panorama of CP might be an indicator of socio-economic development.

Age Factors↗

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

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.

Community Mental Health Services↗