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Recession blues. Coping with economic uncertainty.

Health care is faring better than most professions hard-hit by the recession, but the impacts are starting to filter into hospitals. New legislation aimed at reducing the cost of ancillary services threatens to hinder respiratory therapy expansion efforts and may force directors to cut personnel.

Diagnosis-Related Groups↗

Earnings-replacement rate of old-age benefits, 1965-75, selected countries.

This study is about the earnings-replacement rate of the old-age benefit for the average worker in manufacturing who had average earnings throughout his career. It updates previously published data for earlier years and compares the replacement rate of the combined social security and private pension benefits for selected countries, in an attempt to show what a more complete benefit package might be. The study also traces what has happened to the replacement rate during the decade beginning in the mid-1960's. In several countries the intent has been to raise social security benefits over a period of time to a level sufficient to permit a retired worker to maintain his previous standard of living. The study looks to see if such policies have succeeded in reaching these goals, especially in view of the economic turbulence--recession and inflation--during the 1970's.

Canada↗

Supply prices to increase slightly.

Expect hospital supply prices to increase by about 3 percent to 4 percent during 1991, says the new economic forecast from the Joint Purchasing Corp. (JPC), New York City. JPC's report may help reduce the uncertainty for those making supply price forecasts during the current recession. The Economic Forecast and Budget Impact Report presents economic information from industry analysts and publishes the data in a single volume. The JPC forecast can be used as a guide to help determine price changes; however, it's also important to consider changes in consumption, utilization, and quality when using the report, says JPC's president.

Equipment and Supplies, Hospital↗

The changing labour market position of Canadian immigrants.

"This paper uses pooled 1971, 1981, and 1986 Canadian census data to evaluate the extent to which (1) the earnings of Canadian immigrants at the time of immigration fall short of the earnings of comparable Canadian-born individuals, and (2) immigrants' earnings grow more rapidly over time than those of the Canadian born. Variations in the labour market assimilation of immigrants according to their gender and country of origin are also analysed. The results suggest that recent immigrant cohorts have had more difficulty being assimilated into the Canadian labour market than earlier ones, an apparent consequence of recent changes in Canadian immigration policy, labour market discrimination against visible minorities, and the prolonged recession of the early 1980s." (SUMMARY IN FRE)

Acculturation↗

Nutrition and socio-economic development in Southeast Asia.

While most Third World countries, particularly in Africa and Latin America, have experienced a deterioration in child welfare as a result of the severe economic downturn in the 1980s, Southeast Asia in general managed to sustain improvements in the situation of its children because it has maintained satisfactory rates of economic growth. However, there were exceptions within Southeast Asia. The Philippines, Vietnam, Dem. Kampuchea and Laos had unsatisfactory growth rates and, consequently, unsustained nutritional gains from the 1970s through the 1980s. Economic factors exerted a big impact on the Philippine nutrition situation, particularly on the dietary status of the households and the nutritional status of children. As a result of the economic dislocation occurring in the country, the nutritional gains of 1978-82 were not maintained in succeeding years. Unlike the case of Thailand, it has been estimated that the solution to nutritional problems in the Philippines is far from being achieved in the immediate future (Villavieja et al. 1989). On the other hand, the nutrition improvements in Thailand have been as remarkable as the economic growth over the last decade. Long-term investments in health, nutrition and other social services in Thailand (as well as in Indonesia) have paid off according to the assessment by the United Nations (1990). It appears, therefore, that the nutrition situation in developing countries is highly dependent on the economic situation, globally and nationally (Cornia et al. 1987), as well as on investment in social services. Adjustment policies should, therefore, consider their implications on distribution and poverty in order that they could positively contribute to the improvement of the nutrition of the people.

Asia, Southeastern↗

Primary care in Cuba: a public health approach.

Cuba's primary health care model is presented. Unlike ambulatory care services, which are but one component of primary care, Cuba's model is a comprehensive public health approach that meets the World Health Organization's definition of primary care. The history of the development of Cuba's model is presented, including an update on the innovative neighborhood/home clinics. Achievements in health outcomes as a result of Cuba's model and the consequences for women's health care are discussed. Examples are presented of the effects on health care delivery of the economic hardship that Cuba has experienced since 1991 as a result of the loss of 85% of its trade with the former Soviet Union and the intensified U.S. embargo. A critique of Cuba's model concludes the article.

Cuba↗

The Mikamo lecture. Role of higher nervous activity in sudden cardiac death.

The brain receives and catalogues myriads of information from within and without the organism. These inputs promote neural integration of bodily function through a multiplicity of cybernetic feedback loops. Higher nervous activity shapes the contours of perceived well-being and determines the course and progress of disease. Behavioral and neural factors play an important role in cardiovascular function and are especially relevant to the problem of sudden cardiac death (SCD). Clinical data attesting to the role of biobehavioral factors in SCD derive from a diversity of sources. It has long been known that bereavement increases the prevalence of cardiac fatality. Business failure rates are strongly related to increased mortality among persons aged 55 and over. Recession in economic activity, with increasing unemployment, is associated with augmented death rates from ischemic heart disease. In extensive surveys conducted among London civil servants, Rose and Marmot found not only the level but the type of employment to be a factor determining coronary heart disease mortality. Blue collar workers had a 3.6 times greater chance of dying from heart disease than an age-matched population in the higher ranks of civil service. A man's employment status was a stronger predictor of risk for dying from coronary heart disease than any of the usual risk factors, such as smoking, blood pressure, height-weight ratio, leisure time activities, glucose tolerance, or plasma cholesterol. Operation of behavioral factors is also suggested by the time of occurrence of sudden death. Among 3,983 men followed for more than 30 years, Rabkin and co-workers observed an excess proportion of fatalities on Mondays. No such pattern was noted for cancer mortality. Not only the day of the week but the time of day appears to be a factor. Muller and co-workers found a significant preponderance in the occurrence of myocardial infarction and sudden death from 6:00 AM to noon. They could not implicate operation of circadian rhythm, but suggested a role for augmented autonomic neural discharge associated with early morning activities following waking from sleep. The longitudinal epidemiologic studies of the Health Insurance Plan of New York (HIP) have indicated an important association between behavioral and psychologic factors and the prevalence of sudden cardiac death.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗