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PubMed1981

Computing the level and distribution of gains from fertility reduction.

"This paper describes and illustrates new procedures for measuring monetary gains from fertility reduction that can be applied to macromodels of population and development. A previously developed method for calculating the total monetary gain from averted births is reviewed. A new technique for distributing gains between birth-averting households and society at large is explained....A technique for evaluating alternative fertility reduction programs is described. Each of the methods is applied to a macromodel estimated from a cross section of countries."

Birth Rate↗
PubMed1986

A measurement scale for the parental underinvestment concept.

"The concept of parental underinvestment was used by Scrimshaw (1978) to explain infant and childhood mortality where a biological explanation was lacking. This report describes an underinvestment scale developed and tested in the Philippines. No previous scale had been developed to test the underinvestment concept. Reliability and validity of the scale are reported along with recommendations for improvement of the scale and an expansion of the parental underinvestment concept to explain outcomes other than mortality."

Adolescent↗
PubMed2000

Modeling the epidemiology and economics of directly observed therapy in Baltimore.

SETTING: From 1958 to 1978, Baltimore maintained one of the highest pulmonary tuberculosis (TB) rates in the US. But, from 1978 to 1992 its TB rate declined by 64.3% and its ranking for TB fell from second highest among large US cites to twenty-eighth. This TB trend coincided with the implementation of an aggressive directly observed therapy (DOT) program by Baltimore's Health Department. OBJECTIVES: We used modeling to estimate the range of TB cases prevented in Baltimore under DOT. Case estimates equal the difference between the observed number of TB cases in Baltimore versus the expected number if Baltimore's TB trend was replaced by the TB trend for the US (low estimate) or the TB trend for all US cities with over 250,000 residents (high estimate). Economic savings are estimated. RESULTS: Without DOT we estimate there would have been between 1,577 (53.6%) and 2,233 (75.9%) more TB cases in Baltimore, costing $18.8 million to $27.1 million. Cases prevented and expenditures saved increased with increased DOT participation. CONCLUSION: Our model predicts that Baltimore's TB decline accompanying DOT resulted in health care savings equal to twice the city's total TB control budget for this period. These results are most plausibly due to DOT, since it was the only major change in Baltimore's TB control program, and rising TB risk factors-AIDS, injection drug use, poverty-in a city where TB had been epidemic should have triggered a TB increase as in comparable US cities, rather than the observed decline. As national TB rates continue to decline it will be important to identify ways to capture and reinvest these savings to support effective TB control programs.

Antitubercular Agents↗
PubMed1994

Modelling the dynamics and economics of health in individual dairy herds: future tasks for the veterinarian in practice and in research.

Collaboration with practicing veterinarians was established in a research project and has resulted in several epidemiologic tools to assist them in their work. Simultaneously, the research group obtained continuous access to valid and precise data and obtained first-hand knowledge about real-life problems for the dairy farmer and the practicing veterinarian. The veterinarian was able to supply detailed information concerning managerial routines applied on the farm. Epidemiologic analyses of the collected data produced input for herd-specific modelling of herd dynamic and economic effects of relevant production alternatives by means of a dynamic, stochastic, and mechanistic simulation model. The relevance of this approach as a research methodology is discussed.

Animal Husbandry↗
PubMed1999

Ovariectomized hamster: a potential model of postmenopausal hypercholesterolemia.

A suitable and economical animal model of ovarian hormone deficiency can greatly enhance the understanding of postmenopausal-elevated risk of coronary heart disease. The male Golden Syrian hamster is a well-established small animal model of hypercholesterolemia, but the effect of ovariectomy on lipid profile in the female hamster is unclear. The objective of this study was to determine whether ovariectomized hamsters develop hypercholesterolemia and experience changes in body fat distribution consistent with changes observed in postmenopausal women. Twenty-two 90-day-old female Golden Syrian hamsters were divided into two groups and were either ovariectomized or sham-operated and given free access to a standard cholesterol-free laboratory diet for 65 days. Ovariectomized hamsters had significantly (P < 0.05) elevated serum total cholesterol concentrations (16.6%) as well as abdominal fat mass (56%; P< 0.01) despite equal food intake compared with the sham-operated group. In contrast, the mean intestinal weight and in vivo rate of sterol biosynthesis were significantly (P < 0.002 and P = 0.01, respectively) lower in the ovariectomized compared with the sham-operated group. In vivo rates of hepatic sterol biosynthesis were directionally lower (P = 0.1) in the ovariectomized group. No significant differences were observed in final body weight, serum triglycerides, or liver total cholesterol and lipids between the two groups. In conclusion, ovariectomized hamsters undergo changes in serum cholesterol and fat distribution similar to those experienced by postmenopausal women, and thus may serve as an appropriate model for postmenopausal hypercholesterolemia.

Journal Article↗
PubMed1987

A demographic-economic explanation of political stability: Mauritius as a microcosm.

"This paper examines current models of economic and political development--social modernization theory, political and economic characteristics of stable regimes, and cross country analysis of political stability--and tests them on the Indian Ocean Island of Mauritius. The analysis continues with a causal explanation for political stability in Mauritius' recent history, derived from an examination of economic policies and demographic patterns. Political change in Mauritius over the past sixty years seems to be explained best by a model for political stability which integrates specific economic and demographic factors. The model, applicable to development in other third world nations, revises Malthus' conclusion that population and economic conditions move in an oscillatory relationship and replaces it with a more comprehensive theory, suggesting that political stability is a function of both economic development and a repeating cyclical relationship between economics and population."

Africa↗
PubMed1995

Living on the margin: a salutogenic model for socio-economic differentials in health.

Research into health inequalities shows that socio-economic position (SEP) is strongly associated with differentials in health. Yet at present there is no adequate model to explain the causal link between the social and the biological variables: in particular why the association between SEP and health is found in all societies; and why inequalities are not simply a reflection of poverty causing sickness, but are also seen among the wealthiest classes in the wealthiest societies. In this paper we propose a model which brings together many diverse strands of research, and helps to explain how stratification by socio-economic position may be seen in terms of differentials in the margin of resources. Resource differentials lead to stratified health outcomes owing to the differential capacity of individuals and groups to realise 'universal' psychological aspirations of a broadly 'health promoting' nature. The margin model builds upon a previously described salutogenic theory of health. On average, the relative size of the margin will predict differential health outcome. This prediction is empirically testable and opens up a new agenda for research on health differentials; it also provides a framework for understanding, planning and evaluating health promotion.

Health Policy↗