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PubMed1995

Cardiovascular risk factors in the former communist countries. Analysis of 40 European MONICA populations.

MONICA Project findings provide a unique opportunity to compare cardiovascular disease (CVD) risk factor levels in a large number of populations living in different political systems. 15 European communist populations had significantly higher age-standardized mortality for age groups 35-64 years from all causes, from CVD and stroke than 25 democratic MONICA populations. The prevalence of systolic and diastolic hypertension in males and females, prevalence of smoking in males and prevalence of overweight in females were significantly higher in communist MONICA populations. In these populations there was tendency to lower prevalence of hypercholesterolemia. In simple and multiple regression analysis hypertension and smoking prevalence had the highest relation with CVD mortality in men; hypertension and overweight prevalence had the highest relation with CVD mortality in women. The combination of 'classical' CVD risk factors could explain only part of differences observed. In communist Europe there was high consumption of spirits, low consumption of fruits and extremely low intake of citrus fruits. Instead of exaggerated anti-cholesterol propaganda emphasis should be given to the prevention of antioxidant deficiencies by the increase of fruit and vegetable consumption and to the decrease in salt, spirit and cigarette consumption in former communist countries.

Adult↗
PubMed1995

[Scientific change in times of political upheaval: Germany in the 20th century].

Until recently, the development of the modern sciences has usually been described as a continuous unfolding of constantly expanding and differentiating research institutions on the one hand, and the accumulation of more and better knowledge on the other. The changes that have occurred both in scientific institutions and in the direction and content of research in the course of revolutions or comparable political changes pose significant challenges to such accounts. I would like to propose an interactive approach to this issue. Instead of accepting a linear, deterministic model of scientific change as a result of political upheaval, I suggest that such political changes present an array of challenges to and possibilities for the interruption, redirection, reconstruction or effortful continuation of research. The central claim is that scientific development in times of political upheaval has proceeded in Germany primarily by means of increasing cooperation of scientists with the state, involving a process that I call the technologization of basic research. But this is not always a one-sided affair involving the subordination of science to practical politics or to ideology. Rather, I argue, what occurs is the mobilization or reconstruction of physical, institutional, financial cognitive and/or rhetorical resources. Such mobilizations can proceed in various directions: the state or agencies within it can mobilize scientists as resources in the interest of achieving certain political aims; scientists can convert themselves into such resources (or claim that they are doing so); or both things can happen at once. The approach is exemplified by examining continuities and changes in the situations of the sciences following the major turning points of 20th century German history, symbolized by the dates 1918, 1933, 1945 and 1990. Considered in particular are: scientific changes in Germany following the Nazi takeover and creative innovations by émigré scientists working in different cultural settings; the massive transfer of scientific resources after Nazi Germany's defeat and attempts to carry on and reconstruct science in the two postwar German states; and the massive reorganization of scientific institutions in eastern Germany after unification. The examples come primarily from biology and experimental psychology, but physical sciences and particular branches of technology are considered as well.

Germany↗
PubMed2003

[Prevention of sudden infant death in Germany].

In Germany there are several committed which however haven't got together yet in order to set up a systematic health education campaign. So far the knowledge of other professional fields like that of graphic designers, specialists of communication and public health scientists hasn't been sufficiently used to familiarize nearly all pregnant women, parents, grandparents and babysitters with those known medical subject matters. Hopefully paediatricians, gynaecologists, children's nurses, midwives, breast-feeding consultants, paediatric preventive assistants, consultants for pregnant women who smoke and mothers in general will soon start to get going an effective lasting and possibly nationwide preventive campaign which will be supported by the competent social ministries and financing authorities, self-help groups, graphic designers, specialists for communication and public health scientists. The aim should be to reduce the amount of sudden infant death cases to or even below the level of The Netherlands (minimum figure in 2002: 0.11 SID cases per 1.000 live births). Already in 1972-15 years before the beginning of the Dutch preventive campaign--in former East Germany a ministerial instruction had advised mothers not to let infants sleep on prone position. Historically, the promotion of infants sleeping on prone position seems to have been a tragic break of tradition in the western world in between 1970 and 1990, as infants had been put to sleep almost only on their back during the past centuries. If we compare East and West Germany concerning the influence on the ways of looking after infants since the 1960th of the last century it has become clear that the advice of medical authorities mainly effects the way of nursing regardless of the political system. More and more, paediatricians, gynaecologists, midwives and children's nurses should become aware of this responsibility.

Cross-Sectional Studies↗
PubMed2000

[Personality, cognitive ability and health in East and West Germany: results of an interdisciplinary longitudinal study of aging].

The goal of the Interdisciplinary Longitudinal Study of Aging (ILSE) is to assess healthy and satisfying aging in middle adulthood and later life. In addition, this study compares adults from eastern and western Germany. The data for this study were collected between late 1993 and early 1996 as part of the first measurement point of the ILSE. Five-hundred and one participants from the Leipzig region were compared with 500 participants from the Heidelberg area on four specific dimensions: personality, cognitive functioning, subjective well-being, and health. Age differences were obtained for neuroticism, extraversion, openness, and agreeableness. Differences were also obtained in cognitive functioning and health. Regional differences between eastern and western Germany were obtained in the personality dimensions neuroticism, openness and conscientiousness, as well as in subjective well-being. Significant age by region interactions were obtained for openness and some of the cognitive measures, as well as for the physicians' health ratings of the participants, suggesting selective historical effects. The results are discussed with respect to functional abilities and levels of satisfaction in midlife, as well as with respect to regional differences that might be due to prior political system differences in the east and west.

Adult↗
PubMed2006

New constitutionalism and the social reproduction of caring institutions.

This essay analyzes neo-liberal economic agreements and legal and political frameworks or what has been called the "new constitutionalism," a governance framework that empowers market forces to reshape economic and social development worldwide. The article highlights some consequences of new constitutionalism for caring institutions specifically, and for what feminists call social reproduction more generally: the biological reproduction of the species; the reproduction of labor power; and the reproduction of social institutions and processes associated with the creation and maintenance of communities. New constitutional governance frameworks fundamentally reshape conditions under which the care of human beings takes place. Caring institutions once governed by enabling professions geared to universal care are now determined increasingly by market values and private forces, and driven directly by the profit motive. This is one of the reasons why neo-liberalism is increasingly contested in both the North and the global South.

Commerce↗
PubMed1988

The advantages and disadvantages of subspecialization.

Writing as a subspecialist I intend to show: (1) that subspecialization is as necessary in developing countries as it is in developed countries; (2) that there are universal principles of human nature likely to govern the process of subspecialization, independently of a country's political system or health care policies; and (3) that the pyramidal system of tertiary referrals to subspecialists is threatening to price doctors out of many people's reach.

Delivery of Health Care↗
PubMed1991

Forum for debate.

Explore the source record for details and available documents.

Cost Allocation↗
PubMed1986

The assessment of medical technologist. Examples from Switzerland.

The need for assessment of new medical technologies has recently become evident in many countries, especially for the people responsible for health care policy. There are multiple reasons for making evaluation: rising costs in health care, medical efficacy, safety, as well as social and political issues. Each stage of life of a diagnostic, therapeutic or preventive technology, from its emergence to obsolescence, can be assessed by an appropriate procedure. In Switzerland, a country with decentralized health care as well as political systems, the assessment is made by various institutions. Evaluative aspects are included in some National Research Foundation programs. Most work, however, is done by the division of medical techniques at the Swiss Hospital Institute. The panel of experts has recently prepared a report on magnetic resonance imaging (MRI). As a result of the initial evaluation, the need for this new technology in this country, and the number and sites of MRI systems for the next few years were established. The capital, running and unitary costs of this diagnostic procedure were estimated. The report will be of aid to the people planning investments and dealing with questions of reimbursement and other issues of health care policy. The methods of epidemiology, biostatistics, sociology and health economics used by the institutes of social and preventive medicine are very helpful in the procedures of technology assessment.

Government Agencies↗
PubMed1990

Health care technology in Australia and New Zealand: contrasts and cooperation.

Australia and New Zealand are neighbouring countries with similarities due to their settlement by Europeans, but with major differences in their economies, populations, geography and political systems. These differences have led to contrasting approaches to the introduction and control of health care technologies. New Zealand has historically had greater success in limiting the use of health technologies which have often been adopted more widely and rapidly in Australia. Recent initiatives in health technology assessment have involved participation by both countries, giving the potential for a joint approach to policy formulation on use of some medical devices and procedures.

Australia↗