SEARCH · Search PubMed
Results for “Economic Development”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Gender training: creating change.
Explore the source record for details and available documents.
Influenza vaccination in 22 developed countries: an update to 1995.
This study expands and updates through 1995 our earlier report on influenza vaccine use in 18 developed countries. Five of the six countries with high levels of vaccine use in 1992 (> or = 130 doses/1000 population) showed little change or slight declines over the subsequent 3 years. The exception was the United States, where a new federal program for vaccination reimbursement for the elderly helped to increase vaccine distribution from 144 to 239 doses/1000 population. The six countries with medium levels of vaccine use in 1992 (76-96 doses/1000 population) increased to > or = 100 doses/1000 population by 1995. Among the six low-use countries in 1992 (< or = 65 doses/1000 population), only Finland showed substantial improvement (96 doses/1000 population) in 1995. Four new countries were added to the study. In Germany, vaccine use increased to 80 doses/1000 population in 1995, but in Ireland it remained at a low level (48 doses/1000 population). In Korea, vaccine use increased from 17 to 95 doses/ 1000 population during the period 1987-1995. In Japan, very high levels of vaccine use (approximately 280 doses/1000 population) in the early 1980s were associated with vaccination programs for school children. However, vaccine use fell precipitously when these programs were discontinued, and only 2 and 8 doses/1000 population were used in 1994 and 1995, respectively. In all 22 countries, higher levels of vaccine use were associated with vaccination reimbursement programs under national or social health insurance and were not correlated with different levels of economic development. Excluding Japan, in 1995 there was still a greater than fourfold difference between the highest and lowest levels of vaccine use among the other 21 countries in the study. Given its well established clinical effectiveness and cost-effectiveness, none of these countries has yet achieved the full benefits of its programs for influenza vaccination.
The family today: sociological highlights on an embattled institution.
Explore the source record for details and available documents.
[Epidemiological survey of mental illnesses in the people aged 15 and older in Zhejiang Province, China].
OBJECTIVE: To describe the current prevalence and distribution of all types of mental disorders in Zhejiang Province and use this data to develop a provincial mental health plan. METHODS: Stratified multi-stage cluster randomization was used to identify 14 counties (cities), 70 townships (urban districts), 140 villages (urban neighborhoods) and 15,000 subjects > or = 15 years of age. Psychiatric nurses used an expanded version of the General Health Questionnaire (GHQ) to identify subgroups of subjects at high, moderate and low risk of having a mental disorder, then psychiatrists determined their diagnoses by administering a structured psychiatric examination (SCID) that employs American diagnostic criteria for mental disorders (DSM-IV) to 100% of high-risk, 40% of moderate-risk and 10% of low-risk subjects. RESULTS: 14 639 subjects completed the screening and 4,788 completed the psychiatric examination. The adjusted overall current rate of mental disorders was 17.3% (95% CI = 16.0%-18.7%), which dropped to 13.4% (12.2%-14.7%) if the non-specific (NOS) disorders were excluded. The most common diagnostic groups were affective disorders (8.6%, 7.9%-9.5%), anxiety disorders (4.3%, 3.6%-5.1%), and substance use disorders (3.0%, 2.4%-3.8%). The most common specific disorders were major depressive disorder (4.3%, 3.7%-4.9%), alcohol use disorder (2.9%, 2.3%-3.7%), dysthymia (1.6%, 1.3%-1.9%) and specific phobias (1.2%, 0.8%-1.8%). The overall prevalence was higher in rural than in urban areas (RR = 1.23, 95% CI = 1.11-1.37) and slightly higher in women than in men (RR = 1.11, 1.00-1.22). CONCLUSIONS: Mental disorders seriously affect the social and economic development of Zhejiang Province; they are a major public health problem that urgently needs to be addressed. To do this, it is necessary to develop and implement a comprehensive province-wide mental health plan and regularly evaluate its effectiveness.
Influences of mother's work, childhood place of residence, and exposure to media on breast-feeding patterns: experience of Nigeria and Uganda.
This study uses data from the Nigerian Demographic and Health Survey collected in 1990 and the Ugandan Demographic and Health Survey collected in 1995 to examine the implications of mother's work, childhood place of residence, and exposure to the media for breast-feeding patterns (exclusivity and intensity) in Nigeria and Uganda. Nigeria and Uganda present an interesting contrast because Nigeria is more modernized and economically developed than Uganda, thus providing a good indication of the influence of modernization on breast-feeding patterns. Mother's work status is defined by considering whether mothers earned cash from work and took their children to work, hence emphasizing the compatibility of work with child care. Work least compatible with child care had a negative effect on breast-feeding intensity in Nigeria. The negative effect of mother's work on exclusive breast-feeding (that is, if the mothers used formula or milk instead) observed for some working mothers in Nigeria and Uganda was partly confounded by urban residence, exposure to media, and other socioeconomic factors. Mother's work did not have a negative effect on breast-feeding intensity in Uganda. The relationship between mother's work, urban residence, media exposure, and breast-feeding practice seems to be stronger in Nigeria than Uganda.
Status of national research bioethics committees in the WHO African region.
BACKGROUND: The Regional Committee for Africa of the World Health Organization (WHO) in 2001 expressed concern that some health-related studies undertaken in the Region were not subjected to any form of ethics review. In 2003, the study reported in this paper was conducted to determine which Member country did not have a national research ethics committee (REC) with a view to guiding the WHO Regional Office in developing practical strategies for supporting those countries. METHODS: This is a descriptive study. The questionnaire was prepared and sent by diplomatic pouch to all the 46 Member States in the WHO African Region, through the WHO country representatives, for facilitation and follow up. The data were entered in Excel spreadsheet and subsequently exported to STATA for analysis. A Chi-Squared test (chi2) for independence was undertaken to test the relationship between presence/absence of Research Ethics Committee (REC) and selected individual socioeconomic and health variables. RESULTS: The main findings were as follows: the response rate was 61% (28/46); 64% (18/28) confirmed the existence of RECs; 36% (10/28) of the respondent countries did not have a REC (although 80% of them reported that they had in place an ad hoc ethical review mechanism); 85% (22/26) of the countries that responded to this question indicated that ethical approval of research proposals was, in principle, required; and although 59% of the countries that had a REC expected it to meet every month, only 44% of them reported that the REC actually met on a monthly basis. In the Chi-Squared test, only the average population in the group of countries with a REC was statistically different (at 5% level of significance) from that of the group of countries without a REC. CONCLUSION: In the current era of globalized biomedical research, good ethics stewardship demands that every country, irrespective of its level of economic development, should have in place a functional research ethics review system in order to protect the dignity, integrity and safety of its citizens who participate in research.
Women in public life.
Explore the source record for details and available documents.
The economic and demographic restructuring of nonmetropolitan counties in the Mountain West.
"The purpose of this paper is to examine the fluctuating economic and demographic landscapes within nonmetro Mountain West counties [of the United States], describe relationships between the economic restructuring and shifting demographic patterns, and to discuss the potential significance of these transformations for the Mountain West nonmetro region. We begin by articulating a conceptual framework linking economic restructuring (development) and population change due to migration. The remainder of the paper empirically examines these linkages. A concluding section summarizes our findings and provides suggestions for future research."
[Fifty years of research on tuberculosis. Lessons I have learnt during 50 years and topics to be investigated in the future].
I have engaged in the research on tuberculosis for 50 years, and lessons I have learnt during this period could be summarized in the following ten topics. First is great research achievements by our predecessors on the establishment of so-called primary infection theory on the pathogenesis of TB, planning of TB control principles based on the theory and development of new technologies used for TB control, such as mass miniature X-ray examination and BCG vaccination in 1920s and 1930s. TB control law was enforced in 1951, and the modern TB programme was initiated. Second, the field is a treasure house of interesting data. Several interesting data on TB soon after the World War II in Tokyo and a rural area were collected and analyzed from the mass health examination. Third, looking at the increase of tuberculin positivity with age, it was found that the tuberculin negativity decreased as the exponential function of age, and the current concept of the annual risk of TB infection was already developed in late 1940s. It was 18.1% in male and 11.6% in female in Tokyo in late 1940s. Based on this concept, age specific TB mortality was analyzed by the type of TB, and the rates of miliary TB and TB meningitis were similar to the rate of newly infected to the total population, while the rate of all forms could be divided into early and late death as shown in Fig. 1. Fourth, I suffered from TB by myself from 1951 to 1953, receiving first thoracoplasty in two stages under local anaesthesia, then right upper lobectomy and segmentectomy of superior segment of right lower lobe. From this experience, I learnt a lot about the psychology and suffering of TB patients. Fifth, the importance of recognition of real magnitude of the problem in such a disease as TB in which many TB cases did not aware of their disease. The answer to this was the first TB prevalence survey in 1953 using stratified random sampling method, and based on the results of the survey, the mass health examination originally focussed on youth was expanded to the total adult population of Japan. Sixth, TB could be reduced rapidly by applying appropriately planned control programme. In big enterprises, the application of intensive case-finding programme brought about the rapid decline of severe TB cases, contributed to the increase of the productivity of the enterprises, thus to the rapid increase of GDP of whole Japan, and the growing spiral between the improvement of health and the economic development was formed by successful TB control. In addition to the mass health examination, BCG vaccination and spread of appropriate treatment in the original TB control law, the registration and case management system and the more extensive application of hospitalization for infectious cases were introduced in early 1960s. Observing the proportion of TB care expenditure to the national medical expenditure, it was 28% in 1954, and it dropped down to 0.4% in recently as shown in Fig. 2. The decline of TB in Japan during 1950s and 1960s was one of fastest in the world. Seventh, there had been marked differences in the prevalence of TB as well as the coverage and quality of TB programmes in several areas of Japan though it was often said that Japan is homogeneous country. To know the real status in various areas of Japan, a chart to express graphically the magnitude of TB and coverage and quality of TB programmes was developed (Fig. 3), and it was finally refined to the current form. Eighth difficulty in changing existing programmes, and we are grateful for kind cooperation of Niigata Prefecture for making several new attempts. Ninth, it has been needed to observe TB problems from global standpoint, and it was actually done through participation to the bilateral cooperation projects on TB control and conducting the international training courses sponsored by JICA. Tenth, TB is a pertinacious disease. As shown in Fig. (ABSTRACT TRUNCATED)
Chronic non-communicable diseases.
Chronic non-communicable diseases (NCD) account for almost 60% of global mortality, and 80% of deaths from NCD occur in low- and middle-income countries. One quarter of these deaths--almost 9 million in 2005--are in men and women aged <60 years. Taken together, NCD represent globally the single largest cause of mortality in people of working age, and their incidences in younger adults are substantially higher in the poor countries of the world than in the rich. The major causes of NCD-attributable mortality are cardiovascular disease (30% of total global mortality), cancers (13%), chronic respiratory disease (7%) and diabetes (2%). These conditions share a small number of behavioural risk factors, which include a diet high in saturated fat and low in fresh fruit and vegetables, physical inactivity, tobacco smoking, and alcohol excess. In low- and middle-income countries such risk factors tend to be concentrated in urban areas and their prevalences are increasing as a result of rapid urbanization and the increasing globalisation of the food, tobacco and alcohol industries. Because NCD have a major impact on men and women of working age and their elderly dependents, they result in lost income, lost opportunities for investment, and overall lower levels of economic development. Reductions in the incidences of many NCD and their complications are, however, already possible. Up to 80% of all cases of cardiovascular disease or type-2 diabetes and 40% of all cases of cancer, for example, are probably preventable based on current knowledge. In addition, highly cost-effective measures exist for the prevention of some of the complications of established cardiovascular disease and diabetes. Achieving these gains will require a broad range of integrated, population-based interventions as well as measures focused on the individuals at high risk. At present, the international-assistance community provides scant resources for the control of NCD in poor countries, partly, at least, because NCD continue to be wrongly perceived as predominantly diseases of the better off. As urbanization continues apace and populations age, investment in the prevention and control of NCD in low-and middle-income countries can no longer be ignored.
Introduction. Review of the six expert group meetings.
Explore the source record for details and available documents.
[Time trend of mortality rates of cerebrovascular diseases in Hong Kong].
OBJECTIVE: To describe the time trend of mortality rates of cerebrovascular diseases (CVD) in Hong Kong for the period of 1976 to 1995, and to compare them with those in the more developed countries around the world. METHODS: Mortality rates of CVD were standardized directly using world standard population in 1961. Annual percent changes of mortality rates of CVD were estimated with a non-linear regression. Birth-cohort analysis was carried out at an interval of five-year of age to compare their age-specific mortality rates of CVD in different birth cohorts. Time trend of cause-specific mortality rates of CVD both in males and females was fitted with a simple linear regression model. RESULTS: Considerable downward trend of CVD mortality was observed during the past twenty years. Mortality rates among men and women decreased by 50.96% and 37.85% in 1995, as compared to those in 1976, respectively. Although in general, a greater trend in CVD mortality was observed during the last 10 years, as compared with that in the previous 10 years, an annual increase in CVD mortality of 1.34% was found among males aged 35 to 44 years during the latter 10 years. CVD mortality for both males and females decreased steadily by 1% per year. CVD mortality for females will catch up with that for males by the year of 2013, if such a trend continues. Birth-cohort analysis showed that those born more recently at the same age-group had lower mortality of CVD (except for those born after 1955). Data from hospital admission showed that improvement in the treatment for CVD could have contributed partly to the decrease in its mortality. CONCLUSION: Time trend of mortality of CVD in Hong Kong was similar to that in many other economically developed areas around the world.
Exporting labor: the impact of expatriate workers on the home country.
The economic impact of emigration on the source country is analyzed through a literature review and a discussion of costs, benefits, and public policy implications. It is noted that "information collected from different sources and settings is needed for cross-validation of assessments and conclusions. Second....the cost/benefit analysis of emigration should be undertaken on a case by case basis. Third...these costs and benefits must be assessed in a long-term framework that considers the socio-economic conditions and the goals of the country....Fourth, effective governmental policies...need to recognize that emigrants generally are highly motivated people [who] are adept at overcoming legal or other obstacles in their path." (SUMMARY IN FRE AND SPA)
[Hundred years' psychiatry in Korea (1899-1999)].
The western medical knowledges of the human anatomy and physiology including knowledges of central nervous system have probably been introduced into Korea by Prince Sohyŏn Seja in 1645. The authentic education for the western medicine at the governmental and private medical schools, however, originated from 1899 and the education of mental disease was included in curriculum of Tai-Han-uiwon, the governmental medical school before 1910. In 1913 the first department of psychiatry (Department of Mental Disease) was established at the Chongdokbu-uiwon, the clinic of the Japanese colonial government, the former Korean governmental hospital which has later developed to the Kyŏngs ŏng Imperial University Hospital. On the other hand, there was in Severance Hospital Medical College, one Australian missionary psychiatrist McLaren, who has served at Paton Memorial Hospital in Jinju, Korea from 1911, taught neurology and psychiatry from 1913 at Severance Hospital Medical College, established psychiatry ward in 1923 at the Hospital, conducted the ward in humanistic way until 1940. It was the German psychiatry which the Japanese psychiatrists have brought to the Korean peninsula and it remained as major trends of psychiatry in Korea during the Japanese occupation between 1911 and 1945. The academic levels of Kyŏngsŏng Imperial University in psychiatry as well as the quality of mental care seemed to be almost equivocal to the psychiatry in Japan. However, psychiatrists scope of social psychiatric issues and of the research interests seemed to be somewhat narrow. Due to the political discrimination for the Korean students, the Koreans had less opportunity for the promotion at the university than Japanese residents in Korea. In 1945, after the end of the Pacific War only about 11 Korean psychiatrists were left in Korea, who organized Korean Neuropsychiatric Association. The Department of Neuropsychiatry of Seoul National University (former Department of Neurology and Psychiatry, Kyŏngsŏng Imperial University) was the center for psychiatry training. The Korean War (1950-1953) enabled the interchanges between. Korean and American military psychiatrist, and motivated great change in Korean psychiatry from biologic oriented German descriptive psychiatry to the American dynamic psychobiological psychiatry. The German educational clinical systems were completely displaced by the American system, when internship and residency training system was conducted since 1958. However, there were always attempts to integrate old traditional Korean wisdoms into the modern psychiatry and to introduce European approaches and knowledges in psychiatry. With the rapid industrialization and economic development of the country since the late 1960s and the prevailing social defensive attitudes towards mentally ill patients of the leaders of the military regimes the increase of private asylums appeared where many chronically ill mental patients were kept without adequate treatment. The reform of asylums in the mid 1980s was gradually proceeded by the government leading consequently to the increase of huge mental hospitals in the land. With the democratization of the political situation as well as the social welfare policy of the government in the 1990s and with the steady stimulation elicited by some NGOs Mental Health Act was enacted in 1995 and the community mental health centers were increasingly set up in several districts. In concern with research activities in psychiatry remarkable development in social cultural as well as biological fields are recognized especially since in the 1970s academic societies for the subspecialities of psychiatry have been organized which cover the various schools of psychotherapy, social psychiatry as well as many subspecialities of biological psychiatry. The number of training hospitals have been increased as the result, the number of psychiatry specialists was increased from 93 in 1956 to 1593 in 1999. KNPA (Korean Neuropsychiatric Association) internal and international activities has been expanded. Question is however, the quality of services and the quality of academic achievement. Gradually, the voice was raised to focus more on the quality of research and training activities.
Expert Group Meeting on Population and Women.
Explore the source record for details and available documents.
[Education and training for tuberculosis in medical schools and in hospitals].
The recent decrease of the number of tuberculosis patients in Japan, by the economical development and the establishment of standard regimen with INH, RFP, SM/EB and PZA, have brought decrease of concern to tuberculosis not only in the masses but also in the medical personnel, and the worsening of the medical economy by the advancing of the ages in the nations is forcing to close the tuberculosis wards. On the other hand, the recent situation of tuberculosis in Japan, such as the increase of HIV infection, the additional inflow of the foreign tuberculosis patients, the increase of tuberculosis patients in the younger population by the increase of mass-infection, and recent progress of the maldistributions of the tuberculosis patients realized the efforts of the education and training for tuberculosis to the medical students and medical personnel, even in the increase of items that they must learn. The Japanese Society for Tuberculosis set a Symposium "How Tuberculosis be Taught in Medical Education" in 1986. It will be worth to have Round Table Discussion concerning to the education and training for the tuberculosis, after 11 years. Doctor Sato from Nagoya City University reported as follows. To survey the actual condition of tuberculosis education before graduation, a nationwide medical school questionnaire survey was carried out. Answers were received from 80 institutions (100%). It was found that 58 institutions (72%) lacked tuberculosis ward. When the results from this survey, in the area of medical school lecture, were compared to the previous survey of 11 years ago, it showed a decrease in the time and frequency that tuberculosis covered during lecture. This tendency was clearly seen, with the exception of internal medicine, in surgery, in plastic surgery, in urology and in public health. Furthermore, medical schools lacking tuberculosis ward were found to have a lesser percentage of clinical lectures and bed-side teaching when compared to ones with tuberculosis ward. He concluded that in the medical school without tuberculosis ward, the tuberculosis education is virtually impossible, and it is necessary to carry out with hospitals that have tuberculosis ward. Doctor Honda from Sapporo Medical University reported that in the University Hospital, the Third Department of Internal Medicine holds 6 isolation sick-beds for tuberculosis (3 for men and 3 for women) which containing an exclusive day room and bath room, in 52 beds alloted to their department. They always give 2 or 3 lectures about tuberculosis to medical students and also give bed-side teaching using these beds. He concluded education on tuberculosis is necessary for the protection of doctor's delay, and the tuberculosis ward in the university is very useful in the education of tuberculosis to medical students, even the economical efficiency of these beds are low. Doctor Nakabayashi from Sapporo National Hospital reported that his hospital is a general hospital with 513 beds but has no tuberculosis-bed, and that this hospital is combined with Hokkaido Cancer Center and 91.7% of in-patients of pulmonary division are lung cancer and one or two residents are trained in pulmonary division by 6 months rotation. He also reported that in his hospital, 18 mycobacteria positive cases were treated through 1996, however the training for tuberculosis to residents are mainly by the differential diagnosis of tuberculosis with lung cancer through case conferences with staff doctors. Doctor Yosikawa from Daido Hospital reported as follows. In his hospital, tuberculosis-beds and other respiratory-beds are in the same nursing unit managed with the same standard for nursing, although tuberculosis-beds are separated from other respiratory-beds by door and have exclusive toilets and bath-room. The doctors could study general respiratory diseases and tuberculosis at the same time. Thirteen doctors have finished this training, and all of them could deepen their knowledge to tuberculosi
Hindrances to family planning program: findings from Banke, Nepal.
Reducing population growth through programs is a high priority for many developing countries. Why particularly in the rural regions of these countries, do these initiatives fail? Using a case study of a recent initiative in rural Nepal between 1998 and 2002 as an example, this opinion piece discusses possible reasons for such failure and recommends that a broader strategic approach is necessary, particularly in relation to empowering women in these communities. Banke district, Nepal, is mainly rural, consisting of 47 villages. Scarcity of family planning provisions is a dominant problem in most parts of the district. District Public Health Office (DPHO), the major family service provider lacks resources and technical capabilities. In recent years, non-government organizations (NGOs) have been collaborating and coordinating their efforts with DPHO in order to cover the larger section of the district population. A local NGO called Banke Mahila Arthick Swawlamban Sangathan (BMASS) provided family planning services in 5 of the 47 villages of Banke district, Nepal, from 1998 through 2002. Outreach activities and clinical services were the two major components of BMASS family planning program. Outreach activities included door-to-door/mass counseling, street drama, and condom distribution. Clinical services that included counseling, testing, temporary sterilization, and referrals for permanent sterilization were provided through a centrally located static clinic and mobile clinics. BMASS family planning program had almost no impact in the target villages. There was no significant increase in contraceptive use, people's motivation to limit fertility, and number of people preferring a smaller family size. The contraceptive prevalence rate increased by less than 2% after 2 years of family planning program intervention. More than 80% of the family planning clients were reported to have discontinued contraceptive use within six months. The mean age of women at the time of first child delivery (16.2 years), total fertility rate (six children per woman), and the birth intervals (13-18 months) were reported to be the same for both periods: before and two years after family planning program intervention. Further assessment of the local factors revealed that women's lack of control over fertility and higher number of desired children could have hindered the community's response to BMASS family planning program. In the target villages a woman's fertility is dependent upon the preference of husbands and in-laws. The women in general are not empowered to voice their opinion with regards to delaying fertility, spacing child-births, and limiting the number of children to be born to them. Higher number of desired children in the target villages is the outcome of low cost of child rearing and high benefits from the children. Children not only contribute significantly in household economy and provide old age security to their parents, but also consume less. To be effective, family planning programs need to be integrated into broader societal reforms that address rural economic development and the role of women in society.