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PubMed1998

[The characteristics of the activities of epidemiological health institutions under the new economic conditions].

The article deals with the basic administrative directives issued by the RF government, Ministries of Health and Defence that regulate the paid medical services to be rendered by the SE units. It draws the SE units leaders' attention to the provision that at the first stage of work the most important is the certification of the unit's medical activities and obtaining a licence thereof. The paper also offers the list of basic documents compiled by the leading SE experts, lawyers and economists, focusing on the accounting procedures for contracted services. It is emphasised that the business-like organisation of work in a number of SE units has netted additional sums of money to solve the problems of material and equipment development and civilian personnel stimulation.

Health Care Reform↗
PubMed2001

Decreased attendance at routine health activities mediates deterioration in nutritional status of young African children under worsening socioeconomic conditions.

BACKGROUND: Economic crisis and sociopolitical instability are generally associated with worsening health and nutrition in developing countries. This study examines the role played by the attendance rate of young children at routine health activities in the deterioration of their nutritional status under adverse social and economic conditions. METHODS: Two nutritional cross-sectional surveys were carried out in two districts of Brazzaville, capital city of The Congo, in 1993 and 1996. They included respectively 2807 and 1695 randomly selected children 4--23 months old. The children's nutritional status was assessed by height-for-age in z-scores. Using embedded general linear regression models, explanatory variables (routine health activities index, socio-demographic context, household economic level, prenatal factors) were tested as potential mediators for the effect of the year of survey on child mean height-for-age. RESULTS: The routine health activities index declined sharply from 1993 to 1996. Its introduction in the regression model including all other explanatory variables led to a sharp decrease in the effect of the year on children's nutritional status, showing the important mediating effect of routine health activities. This result was encountered across all economic categories of households. Other explanatory variables showed more limited mediating effect. CONCLUSIONS: Attendance at preventive health activities should be fostered in African urban communities facing harsh socioeconomic situations to prevent further deterioration in the nutritional status of children.

Anthropometry↗
PubMed1988

Temporary vs. permanent migration: a decision theoretical approach.

"The decision problem of the guest worker as a target saver is considered. He plans to accumulate capital in the host country for investment in the home country after return migration. As the worker is supposed to be incompletely informed about the economic variables in the host country he might prolong his stay unexpectedly provided the economic conditions in the host country are unfavourable. Explicit conditions for the economic variables are given such that temporary migration turns into permanent migration."

Behavior↗
PubMed1999

[Happiness and background factors in community-dwelling older persons].

In order to maintain and improve mental health of elderly people living in the community, a cross sectional survey was conducted to elucidate their happiness and background factors. The subjects were elderly persons living in the community who were able to fill in the questionnaire themselves. The study employed the self-recording questionnaire forms used in Kahoku Longitudinal Aging Study by Matsubayashi et al. Happiness was assessed using a visual analogue scale. Out of 2,379 elderly persons who were able to fill in the questionnaire by themselves in 2,361 (99.2%) returned the questionnaire sheets. After removing inadequate responses, analysis was possible for 1,873 (78.7%) (860 men (average age 72.7 years) and 1,013 women (average age 72.8 years). Among those with greater happiness, the ratio of those living with others (p = 0.0051) was high as well as those with spouses (p = 0.0240), without a history of hypertension (p = 0.0096) and apoplexy (p = 0.0039), not receiving medication regularly (p = 0.0039), with regular habit of walking (p < 0.001), or with work (p < 0.001). As for the relationship between happiness and various scores, the higher the happiness scale became, the scores for ADL, information-related function, functional and emotional support network, healthy condition, appetite condition, sleep condition, memory condition, family relationships, friendship, economic condition became significantly higher (p < 0.001, respectively). On multiple regression analysis using the background factors for happiness as explanatory variables, factors such as functional support network (p < 0.001), emotional support network (p = 0.0254), healthy condition (p < 0.001), good memory condition (p = 0.0027), friendship (p < 0.001), good economic condition (p < 0.001) were significant independent contributing factors. As for the relation between SDS and happiness, the more serious the SDS score (higher score) became, the scores for the feeling of happiness became significantly smaller (p < 0.001). For amelioration of the happiness of elderly persons living in the community, attempts should be made to improve the background factors clarified by the present study by efficiently utilizing health, medical and welfare services.

Aged↗
PubMed1989

Macroeconomic conditions and alcohol-impaired driving.

Several distinct bodies of literature indicate that economic factors influence alcohol consumption and driving behavior, including: econometric studies of effects of income and price on drinking, studies of booming and depressed communities, studies of the effects of recession on mental health and studies of the effects of the business cycle on driving patterns. The core research questions of this study were: (1) Does the state of the economy affect the rate of fatal motor vehicle crashes involving drinking drivers? and (2) Is the relationship between the state of the economy and motor vehicle fatalities mediated by effects of economic conditions on amount of alcohol consumed and amount of driving? Data were collected on multiple indicators of economic conditions, alcohol consumption, vehicle miles traveled and rates per population of fatal crashes in the United States on a monthly basis from 1976 through 1985. Nonlinear time-series modeling methods were used to estimate both direct and indirect effects and both coincident and lagged relationships. Results showed that economic conditions significantly influence fatal crash rates both directly and via changes in aggregate amount of alcohol consumed and aggregate amount of driving. However, these interrelationships at multiple lags are complex and not yet fully understood.

Accidents, Traffic↗
PubMed1994

[Comparative study of quality of life in the elderly between in Kahoku and in Yaku].

A comparative community-based study of quality of life (QOL) in the elderly was carried out between two Japanese rural towns, Kahoku and Yaku.QOL, which included the subjective sense of health, appetite, sleep at night, mood, memory, family relationships, friendship, economic condition, life satisfaction and happiness was assessed using a visual analogue scale (VAS) as well a Geriatric depression Scale (GDS), a variety of neurobehavioral function tests, and a questionnaire about activity of daily living (ADL). Subjects were all the eligible elderly aged over 75 years in both communities. Inter-rater reproducibility in VSA was more reliable than that in GDS. Life satisfaction and a subjective sense of happiness highly correlated with mood, family relationships, friendship and economic condition. GDS and VAS significantly correlated with family relationships, active participation in a group and economic condition, however, they did not correlated with age. The subjective sense of happiness correlated with ADL and steadiness of walk as assessed by neurobehavioral function tests. Living style correlated with VAS in the male elderly, but not female. Each score in VAS for family relationships, friendship, economic condition, life satisfaction and subjective sense of happiness was significantly higher in the elderly in Yaku than in Kohoku. The diseases which elderly people wanted to avoid were dimentia cancer, stroke, and cardiovascular disease in that order. In conclusion, QOL in the elderly population was influenced by disease, neurobehavioral functions, especially walking function, gender difference, lifestyle as well as cultural environment.

Activities of Daily Living↗
PubMed2004

[Acute diarrhea: does mother's knowledge of the disease reduce admission of children under two years of age?].

OBJECTIVES: To analyze the relationship of mother's knowledge about signs of dehydration, causes and management of acute diarrhea with admission of children under two years of age with the disease. METHODS: A nested cross-sectional and case-control study was carried out with children who were admitted at the "Instituto Materno Infantil de Pernambuco" with acute diarrhea: and control children admitted with other diseases. Variables were: patient admission having or not acute diarrhea (dependent); social-economic condition, nutritional state; duration of breastfeeding; mother's knowledge about acute diarrhea and its management (independent). The Epi-info software, 6.0 was used for analysis. RESULTS: There was statistical association between patient admission with acute diarrhea and poor social-economic conditions (p = 0.01); malnutrition (p = 0.01); short time of breastfeeding (p = 0.01), lack of mother's knowledge about how to avoid dehydration (p = 0.05) and effectiveness of oral rehydration solutions (p = 0.02). There was no statistical association with knowledge about causes, signs of dehydration or management of acute diarrhea. CONCLUSIONS: The study disclosed association between admission of children under two years of age with acute diarrhea and poor social-economic conditions; short time of breastfeeding, malnutrition, mother's lack of knowledge on how to avoid dehydration and effectiveness of oral rehydration solutions. Data suggests that lack of mother's knowledge reflects poor social-economic conditions.

Acute Disease↗
PubMed1989

Malnutrition and child mortality: are socioeconomic factors important?

The influences of household economic condition, maternal education, sex, and nutritional status of children on mortality were examined using multivariate analytical techniques. Weights of around 1700 children aged 2 60 months in five villages of Matlab, Bangladesh, were taken during the first half of 1981. The children were followed for 18 months and their survival was recorded. The severely malnourished children had a risk of death nine times that of their counterparts with better nutritional status. Female children had a higher risk of death than the males. Mother's education and economic condition of household also showed negative relationships with the risk of death, but the effect of mother's education was modified by economic condition and sex of the children.

Bangladesh↗
PubMed2006

Do physicians always flee from HMOs? New results using dynamic panel estimation methods.

OBJECTIVE: To assess the impact of changes in relative health maintenance organization (HMO) penetration on changes in the physician-to-population ratio in California counties when changes in the economic conditions in California counties relative to the U.S. average are taken into account. DATA SOURCES: Data on physicians who practiced in California at any time from 1988 to 1998 were obtained from the AMA Masterfile. The analysis was restricted to active, patient care physicians, excluding medical residents. Data on other covariates in the model were obtained from the Bureau of Economic Analysis, InterStudy, the Area Resource File, and the California state government. Data were merged using county FIPS codes. STUDY DESIGN: Changes in the physician-to-population ratio in California counties include the effects of both intrastate migration and interstate migration. A reduced-form model was estimated using the Arellano-Bond dynamic panel estimator. Economic conditions in California relative to the U.S. were measured as the ratio of county-level real per capita income to national-level real per capita income. Relative HMO penetration in California was measured as the ratio of county-level HMO penetration to HMO penetration in the U.S. relative HMO penetration was instrumented using five identifying variables to address potential endogeneity. Omitted-variable bias was controlled for by first differencing the model. The model also incorporated eight other covariates that may be associated with the demand for physicians: the percentage of the population enrolled in Medicaid, beds in short-term hospitals per 100,000 population, the percentage of the population that is black, the percentage of the population that is Hispanic, the percentage of the population that is Asian, the percentage of the population that is below age 18, the percentage of the population that is aged 65 and older, and the percentage of the population that are new legal immigrants in a given year. All of the above variables were lagged one period. The lagged physician-to-population ratio was also included to control for the supply of physicians. Separate equations were estimated for primary care physicians and specialist physicians. PRINCIPAL FINDINGS: Changes in lagged relative HMO penetration are negatively associated with changes in specialist physicians per 100,000 population. However, this effect of HMO penetration is attenuated and at times reversed in areas where the magnitude of the difference in relative economic conditions is sufficiently large. We did not find any statistically significant effects for primary care physicians. CONCLUSIONS: Consistent with prior studies, we find that changes in physician supply are associated with changes in relative HMO penetration. Relative economic conditions are an important moderator of the effect of changes in relative HMO penetration on physician migration.

California↗
PubMedDate not supplied

An efficient enzymatic Baeyer-Villiger oxidation by engineered Escherichia coli cells under non-growing conditions.

Economical methods of supplying NADPH must be developed before biotransformations involving this cofactor can be considered for large-scale applications. We have studied the enzymatic Baeyer-Villiger oxidation of cyclohexanone as a model for this class of reactions and developed a simple approach that uses whole, non-growing Escherichia coli cells to provide high productivity (0.79 g epsilon-caprolactone/L/h = 18 micromol epsilon-caprolactone/min/g dcw) and an 88% yield. Glucose supplied the reducing equivalents for this process, and no exogenous cofactor was required. The volumetric productivity of non-growing cells was an order of magnitude greater than that achieved with growing cells of the same strain. Cells of an engineered E. coli strain that overexpresses Acinetobacter sp. cyclohexanone monooxygenase were grown under inducing conditions in rich medium until the entry to stationary phase; the subsequent cyclohexanone oxidation was carried out in minimal salts medium lacking a nitrogen source. After the biotransformation was complete, the lactone product was adsorbed to a solid support and recovered by washing with an organic solvent.

Caproates↗
PubMed2004

Decision tree analysis to evaluate dry cow strategies under UK conditions.

Economic decisions on animal health strategies address the cost-benefit aspect along with animal welfare and public health concerns. Decision tree analysis at an individual cow level highlighted that there is little economic difference between the use of either dry cow antibiotic or an internal teat sealant in preventing a new intramammary infection in a cow free of infection in all quarters of the mammary gland at drying off. However, a potential net loss of over ł20 per cow might occur if the uninfected cow was left untreated. The only economically viable option, for a cow with one or more quarters infected at drying off, is antibiotic treatment, although a loss might still be incurred depending on the pathogen concerned and the cure rates achievable. There was a net loss for cows with quarters infected with Corynebacterium spp. at drying off, for both the teat sealant and untreated groups (ł22 and ł48, respectively) with only antibiotic-treated cows showing a gain.

Animals↗
PubMed1996

Race/ethnicity, the social environment, and health.

International and national research has documented the relations between socio-economic conditions and health. Nonetheless, racial/ethnic group comparisons of health indices frequently are presented in the United States without stratifying or adjusting for socio-economic conditions that could affect interpretation of the data. This paper examines how racial/ethnic group identifiers have been used in past research. While some studies assume biologic differences; others presume that race/ethnicity is a proxy for socio-economic race factors. One consequence of these presumptions has been an underdevelopment of knowledge about racial/ethnic minority populations that could help shape public policies and preventive interventions to reduce disparities in health. Findings from studies that examine the influence of both race and social class on health are reviewed in an effort to clarify the state-of-knowledge. Although the findings vary for particular health indices, the studies provide considerable evidence that socio-economic conditions are a powerful, although not necessarily exclusive, explanatory variable for racial disparities in health. The findings are used as the basis for encouraging more theoretically grounded and methodologically rigorous research rather than avoiding an assessment of the influence of race/ethnicity on health.

Disease Susceptibility↗