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PubMed1987

Overurbanization reconceptualized: a political economy of the world-system approach.

"After many years of relative neglect, the issue of 'overurbanization' in Third World countries has recently received renewed attention in the social science literature. Adopting a political economy of the world-system perspective on urbanization and development, this article critiques the theoretical adequacy of the overurbanization thesis. Conceptualizing a causal relationship between spatio-demographic imbalances (labelled 'over-urbanization') and relatively skewed and stagnant economic development is midleading. Both urban patterns and development trajectories are distorted by the international dependency of Third World nations in the world economy. The general argument is illustrated by discussing the role that the so-called 'urban surplus labor' of the 'informal sector' plays in surplus extraction under peripheral capitalism."

Demography↗
PubMedDate not supplied

Bahia-Carolina Program in Environmental and Occupational Health: A North-South partnership for workplace and environmental justice.

The Bahia-Carolina Program in Environmental and Occupational Health is an interdisciplinary collaborative program in research and training linking the Institute for Collective Health (ISC), the Federal University of Bahia, Brazil, and the School of Public Health, University of North Carolina at Chapel Hill. An important goal of this Fogarty Center-funded project is to improve workplace and environmental conditions and the well-being of the general population, particularly those workers in the informal sector. Major accomplishments include training taking place in the United States, training in Brazil, and support of Brazilian institutions. Brazilians studying in the United States have researched occupational risk factors for non-Hodgkin's lymphoma, the effectiveness of an environmental sanitation program, the health of refinery workers, and statistical methods for multilevel analysis, among other topics. The program also emphasizes the opportunity for U.S. faculty and students to learn from Brazilian colleagues. Challenges encountered in the collaboration process are described.

Brazil↗
PubMedDate not supplied

Use of a national reporting system for occupational injuries in Costa Rica.

Occupational injury surveillance in developing countries may be hindered by the lack of health data infrastructure as well the large numbers of informal-sector workers. The goal of this study was to elucidate the scope of occupational injury in the Monteverde district of Costa Rica using data collected through the national workers social security system. A list of occupational injuries occurring in the district reported to the National Insurance Institute (INS) central office between 1998 and 2002 was taken to the regional INS office, and the original injury reports for the cases were pulled. Specific data on the injuries were collected. There were 184 injuries reported during the five year period. Occupations with the highest number of injuries included production, building and grounds maintenance, and agricultural/forestry/fishing. Descriptive data showed that prevention efforts in this rural region should target food manufacturing, hotels, and construction.

Accidents, Occupational↗
PubMed1991

Taking charge: death control as an emergent women's issue.

Advances in medical technology in recent decades have produced an array of life-sustaining technologies which can delay the moment of death for almost everyone, making the timing and circumstances of death more a matter of deliberate choice than ever before in human history. Continuing proliferation of such technologies, their escalating social and economic costs, a growing population of older people, and the feminization of old age make right-to-die concerns ever more compelling. This paper points out how such issues are particularly salient for aged women as consumers of long-term care, both in the formal and informal sectors. The dual dilemmas of "premature" versus "delayed" death are also explored in each context. Finally, the implications of social change are interpreted in light of feminist health care goals.

Aged↗
PubMed1991

Caregivers as comptrollers: women and long-term care and cost containment.

The emphasis on cost containment that was the hallmark of the Reagan Administration and the shifting of the burden for long-term care onto the informal sector have had a particularly negative impact on women. Women through caregiving are used to help control the public cost of long-term care. This unwritten policy is unlikely to be successful because of a number of factors: (1) the economic condition of women; (2) the lack of available and affordable community services; and (3) the types of social relationships we now have.

Aged↗
PubMed2003

[Under registration of occupational accidents in São Paulo, Brazil, 1997].

OBJECTIVES: To estimate the number of occupational accidents that occurred in a certain municipality during a specific period of time as well as the extent of sub-registration. METHODS: The study sample was comprised of 4.782 households within the municipality of Botucatu, São Paulo occupied by a total 17,219 inhabitants on the 1st of July, 1997. In each household, an adult inhabitant was interviewed in order to identify the occurrence of occupational accidents in the three months preceding the interview. When such occurrences were identified, the injured workers were interviewed. The Cochran formula was utilized to calculate the confidence interval. RESULTS: Seventy-six individuals confirmed that they had suffered occupational accidents during these three months. In 1997, there were approximately 1,810 occupational accidents in Botucatu, according to our estimates, and the incidence of work related injuries in the population was approximately 4.1% (CI 95% 3.0%-5.3%). Thirty-nine (51.3%, CI 95% 41.1%61.6%) of the above 76 workers were not covered by the Social Security System. Consequently, their injuries were not reported for there was no legally binding obligation to fill out and emit the official registration form - Comunicação de Acidente do Trabalho (CAT) [the work injury report]. Included among the latter are civil servants and informal sector workers, such as self-employed, casual workers and others. Although the remaining 37 workers (48.7%) were covered by the Social Security System and emission of the work injury report was obligatory, 20 of the cases (54.1% CI 95% 39.4%-68.7%) had not been registered. A greater proportion of cases of sub-registration were found among those workers employed in micro, small and medium sized businesses than among those working in large firms. Only 22.4% (CI 13.8%-30.9%) of the occupational accidents reported in this study were registered by the Social Security System. CONCLUSIONS: Research findings confirm that analyses based on the number of officially registered workplace accidents are limited. It highlights the importance of utilizing other sources of data, besides the registration form for occupational accidents used currently by the Social Security System, Comunicação de Acidente do Trabalho or CAT, in order to elaborate official statistics on occupational accidents.

Accidents, Occupational↗
PubMed2001

The global expansion of precarious employment, work disorganization, and consequences for occupational health: placing the debate in a comparative historical context.

Mounting research evidence suggests that the shift to contingent work arrangements in industrialized countries is having serious adverse effects on the health of workers, both directly and indirectly (by undermining regulatory and other protections). The authors place this research, and the issues surrounding it, in a comparative historical context. Extensive use of precarious employment is not essentially new. It was a characteristic feature of most if not all industrialized societies in the 19th and early 20th centuries. Though the two phases are not identical, historical comparisons are instructive for understanding recent experiences and ways of addressing them. The authors also make comparisons with the developing world, where the informal sector typically accounts for over half the workforce. Such comparisons are instructive in indicating the consequences of a shift to more precarious patterns of employment and disorganized work settings. There is also good evidence that precarious employment is expanding in the developing world. The growing precarious employment in both industrialized and developing countries is interconnected, and the authors identify a number of the mechanisms affecting workers' health.

Commerce↗
PubMed2006

Approaches to occupational health based on participatory methodology in small workplaces.

An intervention based on the methodology developed by the International Labour Office, the Work Improvement in Small Enterprises (WISE) was carried out to improve work condition of small-scale enterprises and the informal sector in the Philippines, Thailand and Japan. Through the evaluation of the efficacy of the approaches based on participatory methodology, it is concluded that the method is an efficient measure to improve work condition in small workplaces. It is also pointed out that the activities of supporting experts such as introduction of the methodology and evaluation of the activity are necessary. The important roles of the experts are 1) to encourage managers and workers to sustain the activities for work improvement, 2) to analyse the effectiveness and problems of the implemented improvements, 3) to give appropriate suggestions for the further improvement, and 4) to get materials for demonstrating the effectiveness of WISE activities on improving work conditions and productivity to other managers and workers who have not participated in the activity.

Cooperative Behavior↗
PubMedDate not supplied

Occupational health in the Philippines.

The practice of occupational health and safety (OHS) in the Philippines is shaped by both success and failures. Government initiatives have achieved specific goals, particularly in providing better access by local industries to technical services and manpower development. However, the ability to sustain these achievements has been constrained by lack of adequate resources, both financial and human. Large-scale industrial establishments have better success in the implementation of OHS programs in their organizations. Small- and medium-scale enterprises suffer from limited resources to invest in measures for the health and safety of workers. Similarly, the government has little influence on the health and safety conditions migrant workers experience in another nation. The informal sector is the most deprived in terms of access to OHS measures. The deprivation may be alleviated by economic solutions, as their existence is a result of economic situations. Occupational health development in the Philippines is progressing and will be strengthened by better regulation, by increasing awareness among all sector workers of the importance of OHS, and by adequately building up the capacity of government and vital human resources.

Government Agencies↗
PubMed1988

Returning migrant characteristics and labor market demand in Greece.

Immigrants who repatriate bring with them modern work skills which many observers in labor exporting regions describe as a great contribution to the mother country. Using data from 2 samples of Greek repatriates as well as projections of industrial labor force demands in Greece for the 1980s, this article challenges this concept. The authors find that the uneven regional development and stunted industrial growth which pushed these workers abroad are also responsible for the narrowly limited employment options which they face once they repatriate. For the urban repatriate, the market is limited to unemployment, the urban informal sector and scattered jobs, while for the rural repatriate, small-scale agriculture, multiple job holdings and unemployment are the only viable options.

Demography↗
PubMedDate not supplied

Social security reform in Central and Eastern Europe: variations on a Latin American theme.

After Chile reformed its social security system in 1981, several other Latin American countries and certain Central and Eastern European (CEE) countries implemented the Chilean model, with some variations: either a single- or multitier system, or with a period of transition to take care of those in the labor force at the time of the change. The single-tier version consists of individual accounts in pension fund management companies. Multi-tier systems retain some form of public program and add mandatory individual accounts. Most of the CEE countries did not want to incur the high transition costs associated with the Chilean model. The switch to a market economy had already strained their economies. Also, the countries' desire to adopt the European Union's Euro as their currency--a move that required a specific debt ceiling--limited the amount of additional debt they could incur. This article describes the CEE reforms and makes some comparisons with the Latin American experience. Most of the CEE countries have chosen a mixed system and have restructured the pay-as-you-go (PAYGO) tier, while the Latin American countries have both single- and multi-tier systems. Some CEE countries have set up notional defined contribution (NDC) schemes for the PAYGO tier in which each insured person has a hypothetical account made up of all contributions during his or her working life. Survivors and disability programs in CEE have remained in the public tier, but in most of the Latin American programs the insured must purchase a separate insurance policy. Issues common to both regions include: Administrative costs are high and competition is keen, which has led to consolidation and mergers among the companies and a large market share controlled by a few companies. Benefits are proportionately lower for women than for men. A large, informal sector is not covered by social security. This sector is apparently much larger in Latin America than in the CEE countries. Issues that are unique to some of the CEE countries include: Individual accounts in Hungary and Poland have proved more attractive than originally anticipated. As a result, contributions to the public PAYGO system in Hungary and Poland fell short of expectations. In several countries, laws setting up the programs were enacted without all the details of providing benefits. For example, in some countries laws must now be drawn up for establishment of annuities because they do not yet exist. Setting up a coherent pension policy has been difficult in some countries because of frequent and significant changes in government. This situation has affected the progress of reform in various stages of development. In general, a definitive assessment of individual accounts in these countries will not be possible until a cohort of retirees has spent most of its career under the new system.

Aged↗
PubMed2003

Privacy and research involving humans.

Human research ethics committees in Australia are required to consider compliance with privacy law as an element of the ethics of research. Recent legislation has introduced federal private sector privacy protection, as well as privacy protection at State and Territory levels. In Victoria, which is used as an example in this article, State privacy legislation covers public sector information and health records. This article considers the implications for research involving human participants and for ethics committees of the new privacy regimes. Although privacy law is a potential barrier to research about humans, the need for exceptions has been dealt with effectively in the context of medical or health research. However, privacy law and its chilling effect could potentially be a serious impediment to some forms of non-health-related research, such as social and socio-legal research.

Australia↗
PubMed2003

Transport and land-use policies in Delhi.

Current transportation policies in mega-cities worldwide lead to major threats to health through traffic injuries, air pollution, noise, reduction in physical activities, and adverse impact on urban quality of life. In addition, a large section of the population in cities in low-income countries has to live in informal-sector, substandard housing. Many transportation policies fail to take enough account of their impacts on poverty and social exclusion, and they neglect the access and transportation demands of the more economically disadvantaged groups of society, who rely mostly on public transportation, walking, and cycling. Delhi, the capital city of India, is an interesting case because failure to consider the broad spectrum of health effects that may result from transport and land-use policies and investments has resulted in decisions that penalize the least affluent groups of the population and make it more difficult for them to get to jobs, education, health care, amenities, and services.

Accidents, Traffic↗
PubMed2005

The excretion rates of stress hormones under mental work.

The aim of the study was to assess stress on the basis of the excretion rates of stress hormones in occupational groups under mental stress. The investigation includes 293 persons, working in power engineering, education, public health and information sector. The stress hormones adrenaline, noradrenaline and 11-oxycorticosteroids (11-OCS) were followed during the working day using spectrofluorimetric methods. Very high excretion rates of adrenaline, noradrenaline and/or 11-OCS were found with leading radio editors, responsible engineers and operators in nuclear power station (NPS), teachers in secondary schools, designing engineers. In conclusion our data indicate high stress in occupational groups working under high psychological demands, high responsibility, making important managing decisions, low job control and are discussed with regard to the health risk.

11-Hydroxycorticosteroids↗
PubMed2005

[Prostatic biopsy technique in the Centre region].

UNLABELLED: Prostate cancer is the most frequent cancer and second cause of cancer mortality in men. The objective of this study was to analyse the prostatic biopsy technique and to verify its conformity with the reference technique of the Centre region. MATERIAL AND METHOD: This study concerned first-line biopsies performed and analysed between 01/01/2001 and 31/03/2001 by all pathologists of the Centre region. We analysed the anaesthesia used to perform these biopsies, whether or not the patient was hospitalized, the needle diameter, the use of ultrasound or finger guidance, the operator's specialization and whether he/she worked in the private or public sector, the number of biopsies, the histology request form and the antibiotic prophylaxis used. RESULTS: Six hundred and twelve reports were sent by laboratories at the request of the regional health insurance fund. There were 562 first-line biopsies, which represented 93% of all biopsies studied Biopsy was performed as an outpatient procedure, the recommended modality, in only 36% of cases; in 10% of cases, hospitalization was justified by a particular clinical context. 11% of biopsies were not ultrasound-guided, particularly in the private sector. Information about histological type, Gleason grade, tumour volume, number of cores invaded and extension to the periprostatic space was present in 46% of cases. CONCLUSIONS: Only 40% of biopsies performed during the first quarter of 2001 complied with recognized quality criteria: ultrasound guidance, as an outpatient procedure or justified hospitalization, without anaesthesia or with local anaesthesia. Improvement of clinical practice probably requires a phase of discussions and negotiations between professionals and authorities to determine a reasonable fee allowing an objective choice adapted to the patient's state of health. The quality of the histological report is not satisfactory at the present time. A standard report was presented by the Réseau Regional de Cancérologie du Centre (Centre Regional Oncology Network) but has not been adopted by all professionals; further discussions are required to develop a simplified grid comprising essential information, especially as the quality of these reports determines treatment decisions.

Ambulatory Care↗
PubMed2006

Ubiquitous computing in shared-care environments.

In light of future challenges, such as growing numbers of elderly, increase in chronic diseases, insufficient health care budgets and problems with staff recruitment for the health-care sector, information and communication technology (ICT) becomes a possible means to meet these challenges. Organizational changes such as the decentralization of the health-care system lead to a shift from in-hospital to both advanced and basic home health care. Advanced medical technologies provide solutions for distant home care in form of specialist consultations and home monitoring. Furthermore, the shift towards home health care will increase mobile work and the establishment of shared care teams which require ICT-based solutions that support ubiquitous information access and cooperative work. Clinical documentation and decision support systems are the main ICT-based solutions of interest in the context of ubiquitous computing for shared care environments. This paper therefore describes the prerequisites for clinical documentation and decision support at the point of care, the impact of mobility on the documentation process, and how the introduction of ICT-based solutions will influence organizations and people. Furthermore, the role of dentistry in shared-care environments is discussed and illustrated in the form of a future scenario.

Computer Systems↗
PubMed1988

Self-help in primary care: preliminary findings of a study in Liverpool.

Self-help groups are an important, but often neglected, resource in primary care. This paper reports the preliminary findings of a study of the origins and natural history of self-help groups in Liverpool, and considers the role for general practitioners in mobilizing resources to facilitate community participation in health through this diverse, and informal, sector of the health care system.

England↗
PubMed1995

[Work and health--new challenges for public health research and practice].

In a period of transition from industrial to post-industrial society with its focus on the service and information sector the nature of work is changing as well as the impact of work on human health. This paper describes leading concepts which were developed in social sciences to better account for this impact, especially so the so called job strain model. Moreover, it gives a selective, but representative review of recent empirical findings based on these concepts with coronary risk and disease as main outcome criteria. Finally, the paper discusses practical implications with regard to public health: preventive measures which aim at structural rather than individual intervention. The main focus of these measures is on work organisation and manpower policy.

Coronary Disease↗