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PubMed1996

Aging and political decision making on public pensions.

"In this paper decision making on public pensions in a representative democracy is modeled within the framework of the well-known two-overlapping-generations (OLG) general-equilibrium model with rational expectations. The model is used to analyze the effects of aging on the economy in general and on the evolution of public pension schemes in particular, where aging is interpreted as a combination of a decrease in the rate of population growth and an increase in the political influence of pensioners. Analytical results are derived for the long run as well as for the short run by the method of comparative statics and comparative dynamics respectively. It appears that an increase in transfers to the old is not guaranteed if due to aging their political power increases."

Age Factors↗
PubMed2005

[The remarkable rise in life expectancy and how it will affect medicine].

Life expectancy has increased at a steady pace in industrialized countries over the last 160 years. A slowdown is not evident: Since 1950 the number of people celebrating their 100th birthdays has at least doubled each decade. This increase in survival is the result of economic developments, social improvements and advances in medicine. Although the belief that old-age mortality is intractable remains widespread, life expectancy is not approaching a limit. Rather, the evidence suggests that ageing is plastic and that survival can be extended by various genetic changes and non-genetic interactions. Increases in life expectancy are largely attributed to improvements in old-age survival. It is a reasonable scenario that life expectancy will rise further in coming decades, supported by advances in the prevention, diagnosis and treatment of age-related diseases. If the trend continues, life expectancy in Germany will rise to over 90 years in the first half of this century. Many official forecasts, however, have assumed lower figures which can have severe consequences both for public and private decision making.

Aged↗
PubMed1999

[The evaluation of research performance in psychiatry. Potential and pitfalls of bibliometric analysis].

Recent scientific and economic developments have emphasized the need for objective and operationalized criteria for the evaluation of collective and individual research performance. In this context the present article discusses the possibilities and limitations of bibliometric analysis in the evaluation of psychiatric research. Taking into account recent scientometric knowledge, the potentials and pitfalls of the so called impact factor are critically discussed with respect to its usefulness in the evaluation of psychiatric research performance in Germany. A major criticism arises from the observation that the unreflecting use of the impact factor may overemphasize quantitative aspects to the disadvantage of qualitative aspects of research. This may however lead to unwanted distortions and misjudgements. The critical analysis of the current use of scientometric indices in the evaluation process emphasizes the need for alternative criteria, which should take into account disciplinary as well as national idiosyncrasis. Accordingly, the authors aim to induce and contribute to a discussion process within the scientific community, which may lead to a more appropriate evaluation of psychiatric research performance.

Bibliometrics↗
PubMed2001

Links between social class and common mental disorders in Northeast Brazil.

BACKGROUND: Social class is an important aspect of all societies. Social class differences in the prevalence of common mental disorder are likely to vary according to time, culture and stage of economic development. The present study aimed to investigate the intermediaries between social class and common mental disorder in a deprived area of Northeast Brazil. The Self Reporting Questionnaire (SRQ) was used to estimate the prevalence of common mental disorder. METHOD: A cross-sectional survey was conducted of 683 adults, aged 15 years and over, living in a random sample of private households in area II of Olinda, Recife Metropolitan Region, Pernambuco, Brazil. RESULTS: Poor education (odds ratio, OR 2.5, 95% CI 1.2-5.2; <5 years vs > or =11 years education) and low income (OR 2.4, 95% CI 1.0-5.6; < or =1/4 minimum wage vs >1 minimum wage) were independently associated with the prevalence of common mental disorder. Univariate associations with occupation, housing conditions and possession of household appliances could be understood in part by their association with poor education. CONCLUSIONS: Brazil has the second most unequal distribution of income in the world. Disparity in educational attainment could be one of the most important factors perpetuating social inequalities in psychiatric disorder in the country.

Adolescent↗
PubMed2005

Critically ill obstetric patients in an American and an Indian public hospital: comparison of case-mix, organ dysfunction, intensive care requirements, and outcomes.

OBJECTIVE: To compare case-mix, health care practices, and outcome in obstetric ICU admissions in inner-city teaching hospitals in economically developed and developing countries. DESIGN: Retrospective study. SETTING: Ben Taub General Hospital (BTGH), Houston, Texas, and King Edward Memorial Hospital (KEMH), Mumbai, India. PATIENTS: Women admitted during pregnancy or 6 weeks postpartum between 1992 and 2001. MEASUREMENTS AND RESULTS: Patients from BTGH (n=174) and KEMH (n=754) had comparable age, number of organs affected, incidence of medical disorders (30%), liver dysfunction, and thrombocytopenia. Fewer KEMH patients received prenatal care (27 vs 86%) and came to hospital within 24 h of onset of symptoms (60 vs 90%). They had higher APACHE II scores (median 16 vs 10), greater incidence of neurological (63 vs 36%), renal (50 vs 37%), and cardiovascular dysfunction (39 vs 29%). Severe malaria, viral hepatitis, cerebral venous thrombosis, and poisoning were common medical disorders. The BTGH group had higher incidence of respiratory dysfunction (59 vs 46%) and disseminated intravascular coagulation (40 vs 23%), placental anomalies, HELLP syndrome, chorioamnionitis, peripartum cardiomyopathy, puerperal sepsis, urinary infection, bacteremia, substance abuse, and asthma. More BTGH patients required mechanical ventilation and blood component therapy, whereas more KEMH patients needed dialysis. Of BTGH patients, 78.2% were delivered by cesarean section (vs 15.4%). Maternal (2.3 vs 25%) and fetal (13 vs 51%) mortality were lower in BTGH patients. CONCLUSIONS: There were marked differences in medical diseases, organ failure, and intensive care needs. Higher mortality in the Indian ICU may be due to difference in case mix, inadequate prenatal care, delay in reaching hospital, and greater severity of illness.

Adult↗
PubMed1998

Immigration, assimilation and growth.

"This paper analyzes the welfare effects of immigration and its subsequent effect on ethnic diversity in a model featuring human capital spillovers which depend on the degree of ethnic heterogeneity, variation rates of time preference across individuals and endogenous levels of immigration and assimilation. In the model, an increase in ethnic diversity reduces the spillovers effect for the majority. Nonetheless, immigration can be welfare improving for the majority ethnic group even if it increases the degree of diversity as long as it raises the average human capital level and/or growth rate by increasing the proportion of people with low rates of time preference."

Acculturation↗
PubMed2001

The incidence of hip fracture in four Asian countries: the Asian Osteoporosis Study (AOS).

The Asian Osteoporosis Study (AOS) is the first multicenter study to document and compare the incidence of hip fracture in four Asian countries. Hosital discharge data for the year 1997 were obtained for the Hong Kong SAR, Singapore, Malaysia and Thailand (Chiang Mai). The number of patients who were 50 years of age and older and who were discharged with a diagnosis of hip fracture (ICD9 820) was enumerated. The age-specific incidence rates were deduced and were directly adjusted to the US white population in 1989. The age-adjusted rates for men and women (per 100,000) are as follows: Hong Kong, 180 and 459; Singapore, 164 and 442; Malaysia, 88 and 218; Thailand, 114 and 289; compared with US White rates of 187 in men and 535 in women, published in 1989. We conclude that there is moderate variation in the incidence of hip fracture among Asian countries. The rates were highest in urbanized countries. With rapid economic development in Asia, hip fracture will prove to be a major public health challenge.

Aged↗
PubMed1997

Ecotoxicology for risk assessment in arid zones: some key issues.

In the hot arid zones of the world, ecotoxicological research is in statu nascendi. In these zones, the major sources of contamination by toxicants are: (1) plant protection and vector control in wet zones; (2) large-scale crop protection campaigns in dry and ephemeral wet zones; (3) refuse and obsolete pesticides in dry zones; and (4) mining. Economic development in many of these zones requires an adequate knowledge of certain basic principles, i.e., where extrapolating existing knowledge does not apply. The vulnerability of ecosystems to contaminants is closely related to water flow. In dry areas, species are susceptible to factors that interfere with the ecophysiological properties regulating water loss. Most hot arid areas are found at low latitudes where temperatures show striking extremes both in time and space. Living organisms are physiologically resistant and/or show adaptive behavior to these temperature extremes. Very little is known about the effects of toxicants on these key resistant and adaptive functions, although by extrapolation a few assumptions can be made. The effects of hyperthermia, for instance, can be aggravated by GSH depleting substances, and the temporary disabling effects characteristic of many pesticides may prove fatal under these circumstances. Most wet areas show a spatial concentration of both human activity and wildlife. In mesic zones, the contamination of water represents a health risk to both humans and other living organisms. The vast majority of aquatic communities are those inhabiting temporary pools and streams. Their populations are characterized by short reproductive cycles and/or long dormant stages. Toxicants affecting growth in these areas have been shown to have a deleterious effect. In a synthesis of existing knowledge the most prominent gaps are identified and priorities for further research are made.

Animals↗
PubMed2005

Land-use and land-cover change and farmer vulnerability in Xishuangbanna prefecture in southwestern China.

This study investigated land-use and land-cover change in three hamlets and two state rubber farms in the Nan-e watershed of the Xishuangbanna prefecture of Yunnan province in Southwestern China. The overall objective of the study was to understand how state policies affected land use and land cover and how changes in these variables affected farmer vulnerability to economic, social, and political events. Emphasis was placed on the cultivation of rubber (Hevea brasiliensis), promoted in southern Yunnan province since the 1950s as a means to meet the demands of rapid economic development. The study combined remote sensing analysis with secondary data and in-field interviews in order to understand the coupling between land-use and land-cover change and farmer vulnerability in light of the geographic, historical, and sociopolitical situation.

Agriculture↗
PubMed2005

Modeling change-pattern-value dynamics on land use: an integrated GIS and artificial neural networks approach.

The use of spatial methods to detect and characterize changes in land use has been attracting increasing attention from researchers. The objectives of this article were to formulate the dynamics of land use on the temporal and spatial dimensions from the perspectives of the Change-Pattern-Value (CPV) and driving mechanism, based on multitemporal remote sensing data and socioeconomic data. The Artificial Neural Networks were used to identify the factors driving changes in land use. The Pearl River Delta Region of southeast China, which was experiencing rapid economic growth and widespread land conversion, has been selected as the study region. The results show that from 1985 to 2000 in the study region (1) the most prominent characteristics of change in land use were the expansion of the urban land at the expense of farmland, forests, and grasslands, (2) the land-use pattern was being optimized during this period, (3) in an analysis of value, built-up land can yield a return of more than 30 times that of farmland, water area, and forests lands, and (4) rapid economic development, growth in population, and the development of an infrastructure were major driving factors behind ecological land loss and the nonecological land expansion.

Agriculture↗
PubMed2006

Toward integrated environmental management for challenges in water environmental protection of Lake Taihu basin in China.

Lake Taihu is the third largest freshwater lake in China. It serves many social, economic, and ecological purposes in the drainage basin. Unfortunately, the water has been heavily polluted due to rapid industrialization and urbanization during the last two decades. Notwithstanding great efforts made so far to improve the water quality, the environmental situation is still far from being optimistic. The basin and the lake are facing a range of severe environmental challenges: rapid socio-economic development continues to place great pressures on the environment, current pollution control projects have many problems from the viewpoint of effectiveness and efficiency of their implementations, and the non-point sources of pollution such as agricultural fields, for which control is more difficult than for industrial point sources, have become the main contributors to serious eutrophication of the lake. Considering the characteristics of the environmental challenges and problems confronting the basin and the lake, we focus on integrated environmental management (IEM) as a promising and effective approach to overcome these predicaments. Current practices and problems of environmental management in the basin are examined, and potential future developments are discussed. Three aspects of the IEM are emphasized: institutional cooperation, public participation, and internalization of environmental externalities. We think these are the most critical for not only the basin but also for the whole of China to achieve a sustainable society.

Agriculture↗
PubMed2006

Criteria for the assessment of sustainable water management.

Pressure on the world's water resources is increasing, restraining social and economic development in many countries, and threatening ecological values in others. In order to manage water resources in a more sustainable manner, new planning methodologies/processes for river basin management need to be developed. This study attempts to construct a set of useable normative criteria for the analysis and evaluation of such processes. The criteria were designed as a response to the lack of deductive approaches in the evaluation of methodologies and working procedures used in the context of river basin management, making it possible to highlight their potential for sustainable development. The criteria are based on the twin concepts of participation and integration. These concepts function as well-established dimensions of both sustainable development and sustainable river basin management, and they are of significant methodological relevance. A synthesis of the key aspects connected to the two concepts is undertaken, based on a broad literature review. Focus is laid on how in methodological terms, and in relation to regional water management, to achieve participation and integration in a decision-making or planning process. The criteria are concerned with how knowledge and values are integrated into the planning process and how commitment, legitimacy, or acceptance for the resulting plan is generated.

Planning Techniques↗
PubMed1999

FORUM: Bioregional Conflict Resolution: Rebuilding Community in Watershed Planning and Organizing.

/ Watershed-based planning has been held as a vanguard for integrated ecosystem management based on a collaborative process. Watershed managers, however, must contend with conflicts that run much deeper than interests for economic development versus sustaining ecosystem health. With data from a survey of members of watershed organizations, we characterize the valued-based conflicts that watershed managers are likely to face in planning. We propose that utilizing collaborative decision-making strategies is important, but successful long-term watershed planning requires rebuilding a community-based infrastructure that can support important social and bioregional networks and partnerships.KEY WORDS: Conflict resolution; Watershed planninghttp://link.springer-ny.com/link/service/journals/00267/bibs/24n1p1.html

Journal Article↗
PubMed2001

Prevalence of polyps and diverticulosis of the large bowel in the Cretan population. An autopsy study.

While a number of studies have been performed in the United States, northern Europe, and some other countries on the epidemiology of large bowel polyps and diverticulosis, information from southern Europe and especially Greece is very limited. Our autopsy study sought to determine the prevalence of large bowel polyps and diverticulosis in the population on Crete. Specimens of colon and rectum were obtained during forensic postmortem autopsies and examined for the presence of polypoid lesions and diverticulosis. Data were collected from a total of 502 autopsies (320 men, 182 women; median age 65 years (range 16-93). Polyps were found in 106 cases (21.1%). These were adenomas in 73 cases (14.5%), hyperplastic polyps in 25 (4.9%), and mucosal tags in 8 (1.5%). Diverticulosis of the large bowel was found in 115 (22.9%). The prevalence of adenomas and diverticulosis increased with advanced age. The prevalence of colonic diverticulosis in Crete is slightly lower than that which has been reported in most other studies in economically developed countries. The prevalence of colorectal adenomas in Crete is one of the lowest rates reported in Europe and is compatible to the known low incidence of colorectal cancer in Crete.

Adenoma↗
PubMed2000

Analysis of Japanese occupational health services for small-scale enterprises, in comparison with the recommendations of the Joint WHO/ILO Task Group.

OBJECTIVES: To evaluate Japanese occupational health services (OHSs) for small-scale enterprises (SSEs). METHODS: The current Japanese OHSs for SSEs were compared with 15 recommendations of the Joint WHO/ILO Task Group. The status of OHSs was analyzed using the published papers collected by means of a computerized literature search. Thirty-five papers were used in the analysis, which was first conducted by the four authors separately, followed by discussion among the authors. Evaluation was conducted by classifying the status of Japanese OHSs for SSEs into three classes (A: good, B: average, C: poor) based on comparison with each recommendation. RESULTS: Six issues were evaluated as "A": establishment of a national policy for the provision of OHSs for SSEs, occupational health and safety inspection for SSEs, legislation to ensure services for SSEs and provision of financial incentives, adoption of occupational health programs using multiple channels, training in occupational health issues, and establishment of national data collection and registration systems. Nine issues were evaluated as "B": provision of OHSs for all SSEs as a part of the "national Health for ALL" strategy, intervention combining economic development and OHSs, extension of OHSs to vulnerable groups, coverage of migrant and seasonal workers by OHSs, the establishment of a national collaborative and coordinative body on OHSs, control of transfer of hazardous technology, encouragement of applied research, employers' commitment and worker participation, and integration of OHSs with primary health care. None of them was evaluated as "C". CONCLUSIONS: Japanese OHSs for SSEs were fairly well established in terms of compliance with the recommendations of the Joint WHO/ILO Task Group, although evaluation may be somewhat subjective and rather qualitative.

Facility Regulation and Control↗
PubMed1997

Occupational health in Brazil.

Brazil is a recently industrialised country with marked contrasts in social and economic development. The availability of public/private services in its different regions also varies. Health indicators follow these trends. Occupational health is a vast new field, as in other developing countries. Occupational medicine is a required subject in graduation courses for physicians. Specialisation courses for university graduated professionals have more than 700 hours of lectures and train occupational health physicians, safety engineers and nursing staff. At the technical level, there are courses with up to 1300 hours for the training of safety inspectors. Until 1986 about 19,000 occupational health physicians, 18,000 safety engineers and 51,000 safety inspectors had been officially registered. Although in its infancy, postgraduation has attracted professionals at university level, through residence programmes as well as masters and doctors degrees, whereby at least a hundred good-quality research studies have been produced so far. Occupational health activities are controlled by law. Undertakings with higher risks and larger number of employees are required to hire specialised technical staff. In 1995 the Ministry of Labour demanded programmes of medical control of occupational health (PCMSO) for every worker as well as a programme of prevention of environmental hazards (PPRA). This was considered as a positive measure for the improvement of working conditions and health at work. Physicians specialising in occupational medicine are the professionals more often hired by the enterprises. Reference centres (CRSTs) for workers' health are connected to the State or City Health Secretariat primary health care units. They exist in more populated areas and are accepted by workers as the best way to accomplish the diagnosis of occupational diseases. There is important participation by the trade unions in the management of these reference centres. For 30 years now employers organisations have also kept specialised services for safety and occupational health. Although they are better equipped they are less well used by the workers than the CRSTs. At the federal level, activities concerned with occupational health are connected to three ministries: Labour, Health and Social Security. The Ministry of Labour enacts legislation on hygiene, safety and occupational medicine, performs inspections through its regional units and runs a number of research projects. The Ministry of Health provides medical care for workers injured or affected by occupational diseases and also has surveillance programmes for certain occupational diseases. The Ministry of Social Security provides rehabilitation and compensation for registered workers. In spite of a decrease in the number of accidents at work during the past 25 years, working conditions have not improved. Changes in the laws of social security in the 1970s discouraged registration and reporting of occupational injuries and diseases. In consequence death rates due to accidents increased. With the implementation of the CRSTs, the recorded incidence of occupational diseases has risen, not only because of improved diagnosis, but also because of stronger pressure from the unions and better organisation of public services and enterprises.

Accidents, Occupational↗