WorldWideScience

Sample records for high resource countries

  1. Functioning and disability in people living with spinal cord injury in high- and low-resourced countries: a comparative analysis of 14 countries.

    Science.gov (United States)

    Reinhardt, Jan D; Mansmann, Ulrich; Fellinghauer, Bernd A G; Strobl, Ralf; Grill, Eva; von Elm, Erik; Stucki, Gerold

    2011-06-01

    We examined whether persons with spinal cord injury (SCI) from countries with differential resources and resource distribution differ in the level and structure of functioning and disability. We analysed cross-sectional data of 1,048 persons with SCI from 14 countries based on the International Classification of Functioning, Disability and Health (ICF). We used penalized logistic regression to identify ICF categories distinguishing lower- and higher-resourced countries. Hierarchical linear models were employed to predict the number of problems in functioning. The association structure of ICF categories was compared between higher- and lower-resourced countries using graphical models. A total of 96 ICF categories separated lower- and higher-resourced countries. Differences were not univocal. Lower resources and unequal distribution were predictive of more functional problems in persons with higher age or tetraplegia. In the graphical models, few associations between ICF categories persisted across countries. Higher-resourced countries do not score higher in all ICF categories. Countries' economic resources and their distribution are significant predictors of disability in vulnerable groups such as tetraplegics and the elderly. Functioning is multi-dimensional and structures of association suggest that country-specific pathways towards disability exist.

  2. The global cancer divide: Relationships between national healthcare resources and cancer outcomes in high-income vs. middle- and low-income countries

    Directory of Open Access Journals (Sweden)

    Ali Batouli

    2014-06-01

    Conclusions: The analysis of this study suggested that cancer MIR is greater in middle/low-income countries. Furthermore, the WHO healthcare score was associated with improved cancer outcomes in middle/low-income countries while absolute levels of financial resources and infrastructure played a more important role in high-income countries.

  3. Natural Resources and FDI in GCC Countries

    OpenAIRE

    Mohamed Mahjoub Elheddad

    2016-01-01

    Natural resources are a blessing for some countries to attract FDI but cursed for others. Existing literature argues the suggestion that resource-rich countries attract less FDI because of resource (oil) price volatility. This study examines that natural resources discourage FDI in GCC countries (the FDI-Natural resources curse hypothesis), using panel data analysis for six oil dependent countries during 1980-2013 and applying several econometrics techniques. The main findings of this paper i...

  4. Natural Resources and FDI in GCC Countries

    Directory of Open Access Journals (Sweden)

    Mohamed Mahjoub Elheddad

    2016-08-01

    Full Text Available Natural resources are a blessing for some countries to attract FDI but cursed for others. Existing literature argues the suggestion that resource-rich countries attract less FDI because of resource (oil price volatility. This study examines that natural resources discourage FDI in GCC countries (the FDI-Natural resources curse hypothesis, using panel data analysis for six oil dependent countries during 1980-2013 and applying several econometrics techniques. The main findings of this paper is that natural resources measured by oil rents have a negative association with FDI inflows; this negative impact is robust even when other FDI determinates of FDI  are included. FDI inflows decreased between 0.15 and 0.92% when oil rents increased by 1%. In addition, the empirical results show that trade openness and labour force are the main factors that encourage FDI, while political instability and corruption deter FDI inflows into GCC countries.

  5. Acute Complications After High-Dose Chemotherapy and Stem-Cell Rescue in Pediatric Patients With High-Risk Neuroblastoma Treated in Countries With Different Resources

    Directory of Open Access Journals (Sweden)

    Mahmoud M. Elzembely

    2018-03-01

    Full Text Available Purpose: High-dose chemotherapy with autologous stem-cell rescue (SCR is a key component of high-risk neuroblastoma (HRNB therapy. Carboplatin, etoposide, and melphalan (CEM or busulfan and melphalan (Bu/Mel are the most evaluated, effective high-dose chemotherapy for HRNB on the basis of results from major cooperative group studies. Toxicity profiles vary between these regimens, and practice variation exists regarding the preferred high-dose therapy (HDT. We sought to evaluate the safety of HDT and autologous SCR for HRNB in a resource-limited country (Egypt compared with the resource-rich United States. Patients and Methods: We performed a retrospective comparative review of single CEM-based HDT/SCR outcomes through day 100 for HRNB at the Fred Hutchinson Cancer Research Center (FH in the United States (2005 to 2015 versus Bu/Mel-based HDT at El-Sheikh Zayed Specialized Hospital (SZ in Egypt (2009 to 2015. Results: Forty-four patients at FH and 77 patients at SZ were reviewed. Pretransplant hepatic comorbidities were significantly higher at SZ (29 of 77 v nine of 44; P = .05, with 19 of 77 patients at SZ having hepatitis infection. Engraftment was delayed after SZ-Bu/Mel therapy compared with FH-CEM therapy for neutrophils (median 12 days v 10 days, respectively; P < .001 and platelets (median 20 days v 18 days, respectively; P < .001. Sinusoidal obstruction syndrome occurred later, after SZ-Bu/Mel therapy (median 19 days v 7 days; P = .033, and four of eight cases were fatal (six of eight patients had underlying hepatitis infection, whereas three of three cases after FH-CEM therapy were moderately severe. Resource utilization associated with the number of days with fever, antibiotic use, and the number of transfusions administered was significantly higher after FH-CEM therapy than after SZ-Bu/Mel therapy. Conclusion: Use of autologous stem-cell transplantation is feasible in the context of a resource-limited country.

  6. Infection control practice in countries with limited resources

    Directory of Open Access Journals (Sweden)

    Alp Emine

    2011-10-01

    Full Text Available Abstract Nosocomial infections and their control are a world-wide challenge. The prevalence of nosocomial infections is generally higher in developing countries with limited resources than industrialized countries. In this paper we aimed to further explain the differences with regard to infection control challenges between Turkey, a country with "limited" resources, and the Netherlands, a country with "reasonable" resources. Infrastructure of hospitals, low compliance of hand hygiene, understaffing, overcrowding, heavy workload, misuse of personal protective equipments, late establishment of infection control programme are major problems in limited-resources countries. These problems cause high infection rates and spread of multi-drug resistant pathogens. To improve the control and prevention of infections in countries with limited resources, a multi-facet approach is needed.

  7. Transplantation in low resource countries

    Directory of Open Access Journals (Sweden)

    L. Faulkner

    2011-12-01

    Full Text Available Thalassemia major (TM is the most common deadly genetic disorder, a major cause of chronic non-infectious morbidity and financial burden in many low and middle-income regions. In these settings few children reach adulthood because proper long-term supportive care is seldom available. Bone marrow transplantation (BMT is the only available curative modality and it can be very successful and cost-effective for young children with low-risk features and a compatible related donor. However, in countries where TM is most prevalent, there is a dire shortage of BMT centers. The Cure2Children Foundation has supported a feasibility study evaluating safety, efficacy and costs of developing a new BMT center in an underserved lower-middle-income country with relatively untrained professionals within a structured collaboration and knowledge-transfer program. A total of 24 consecutive patients who underwent BMT in Pakistan between September 2008 and August 2010 are included in this prospective analysis, 17 from an established bone marrow transplant center, the National Institute for Blood Diseases in Karachi, Pakistan and the initial 7 BMTs from a start up unit in a government civil hospital, the Pakistan Institute of Medical Sciences Children’s Hospital in Islamabad. Patients were matched for age, nutritional status, growth, disease, disease status and post-BMT follow-up time. All patients had a matched-related sibling donor, were younger than 10 years of age at the time of transplantation, received the same conditioning regimen. All needy families could rely on a support program throughout the 8-month post-transplant period. The Cure2Children Foundation provided professional and financial support as well as a structured web-based data management and cooperation platform. At a median follow up of 19.6 months (range 8.7 to 31.5 actuarial thalassemia-free survival is 85.6% and 85.7% and overall survival 94.1% and 85.7% in the established and start-up center

  8. Energy resources in Arab countries: an overview

    Energy Technology Data Exchange (ETDEWEB)

    Al-Lababidi, M. Mukhtar [Organization of Arab Petroleum Exporting Countries, Technical Affairs Dept., Safat (Kuwait)

    1999-12-01

    The author examines the energy resources of Middle East and North African countries under the headings: oil (proven reserves, undiscovered potential recovery, improved recovery techniques, production capacities), natural gas (reserves, undiscovered potential gas recovery), shale oil and tar sand, coal, uranium, hydro, wind energy, solar energy and biomass. (UK)

  9. Pharmacovigilance in resource-limited countries.

    Science.gov (United States)

    Olsson, Sten; Pal, Shanthi N; Dodoo, Alex

    2015-01-01

    In the past 20 years, many low- and middle-income countries have created national pharmacovigilance (PV) systems and joined the WHO's global PV network. However, very few of them have fully functional systems. Scientific evidence on the local burden of medicine-related harm and their preventability is missing. Legislation and regulatory framework as well as financial support to build sustainable PV systems are needed. Public health programs need to integrate PV to monitor new vaccines and medicines introduced through these programs. Signal analysis should focus on high-burden preventable adverse drug problems. Increased involvement of healthcare professionals from public and private sectors, pharmaceutical companies, academic institutions and the public at large is necessary to assure a safe environment for drug therapy. WHO has a major role in supporting and coordinating these developments.

  10. Capital Flight and Transfer from Resource-Rich Developing Countries

    OpenAIRE

    Demachi, Kazue

    2013-01-01

    This paper analyzes the influence of international resource price movements on capital outflows from resource-rich developing countries (RRDCs) by distinguishing capital flight and capital transfers. The volume of capital flight and transfers are calculated and their determinants are analyzed using macro-panel data constituting 21 resource-rich developing countries from 1990 to 2011. Through the regression analysis, the linkage between capital flight and resource revenue as well as that betwe...

  11. Resource recovery and recycling in OECD countries

    Energy Technology Data Exchange (ETDEWEB)

    MacNeil, J.W.

    It was the importance of the economic issues relevant to resource recovery and re-use that prompted OECD to become involved in this general area, and the author proposes in this talk to describe the principal features of the three main approaches to waste management from an economic perspective. These approaches are reduction of waste generation (i.e. birth control) resource recovery and materials recycling or re-use (reincarnation). Most of OECD's work in this area to date has been on the third of these approaches with particular emphasis on the economics of recycling, so somewhat more attention will be devoted to it. Then some conclusions will be drawn concerning possible policy actions to encourage a rational approach to management of this resource.

  12. Cervical cancer screening and practice in low resource countries ...

    African Journals Online (AJOL)

    Key words: Cervical cancer screening; human papillomavirus, low resource countries; Nigeria; premalignant disease. ... has led to a significant decline in the incidence of cervical .... and malignant lesions as integration of the viral DNA into the.

  13. Infection control practice in countries with limited resources.

    NARCIS (Netherlands)

    Alp, E.; Leblebicioglu, H.; Doganay, M.; Voss, A.

    2011-01-01

    Nosocomial infections and their control are a world-wide challenge. The prevalence of nosocomial infections is generally higher in developing countries with limited resources than industrialized countries. In this paper we aimed to further explain the differences with regard to infection control

  14. Present status of uranium resource development in foreign countries, 1984

    International Nuclear Information System (INIS)

    1984-12-01

    The book of the same title as this one was published in 1983. Since then, the situation requiring the correction of the contents, such as the correction of uranium resource policy in various countries accompanying the change of uranium market condition and the change of uranium policy in Australia due to the political situation, has occurred, consequently, the revision has been made adding these new information. The confirmed resources of uranium and the resources of uranium to be added by estimation in the free world are tabulated. About each country, the organization and policy, the policy of exporting uranium and the present status of the export, the quantity of uranium resources, the production of uranium, the state of exploration and development and so on are reported. Japan has taken part in the development of uranium resources in Australia, Canada, Gabon, Zambia, Morocco, Guinea, Mali and so on. (Kako, I.)

  15. List of High risk countries

    International Development Research Centre (IDRC) Digital Library (Canada)

    Francine Sinzinkayo

    2013-07-26

    Higher Risk Countries and Territories. Reviewed regularly. Last update: July 26, 2013. Country/Territory. Note (1). Sources of Concern. Canadian. Law or. Policy. Knowledge of research setting. Ability to monitor research activities. (Note 2). Operational. Issues. (Note 3). Banking. Restrictions. (Note 4). Afghanistan. X. X.

  16. Pediatric Sepsis Guidelines: Summary for resource-limited countries

    Science.gov (United States)

    Khilnani, Praveen; Singhi, Sunit; Lodha, Rakesh; Santhanam, Indumathi; Sachdev, Anil; Chugh, Krishan; Jaishree, M.; Ranjit, Suchitra; Ramachandran, Bala; Ali, Uma; Udani, Soonu; Uttam, Rajiv; Deopujari, Satish

    2010-01-01

    Justification: Pediatric sepsis is a commonly encountered global issue. Existing guidelines for sepsis seem to be applicable to the developed countries, and only few articles are published regarding application of these guidelines in the developing countries, especially in resource-limited countries such as India and Africa. Process: An expert representative panel drawn from all over India, under aegis of Intensive Care Chapter of Indian Academy of Pediatrics (IAP) met to discuss and draw guidelines for clinical practice and feasibility of delivery of care in the early hours in pediatric patient with sepsis, keeping in view unique patient population and limited availability of equipment and resources. Discussion included issues such as sepsis definitions, rapid cardiopulmonary assessment, feasibility of early aggressive fluid therapy, inotropic support, corticosteriod therapy, early endotracheal intubation and use of positive end expiratory pressure/mechanical ventilation, initial empirical antibiotic therapy, glycemic control, and role of immunoglobulin, blood, and blood products. Objective: To achieve a reasonable evidence-based consensus on the basis of published literature and expert opinion to formulating clinical practice guidelines applicable to resource-limited countries such as India. Recommendations: Pediatric sepsis guidelines are presented in text and flow chart format keeping resource limitations in mind for countries such as India and Africa. Levels of evidence are indicated wherever applicable. It is anticipated that once the guidelines are used and outcomes data evaluated, further modifications will be necessary. It is planned to periodically review and revise these guidelines every 3–5 years as new body of evidence accumulates. PMID:20606908

  17. Present status of development of uranium resources in foreign countries

    International Nuclear Information System (INIS)

    1983-10-01

    The book with the same title as this was published in 1981. Thereafter, the necessity to correct the contents arose, such as the remarkable change in uranium market condition and the change of uranium resource policy in Australia accompanying the change of regime, accordingly, the revision was carried out by adding more new information. As the main sources of the information collected in this book, 25 materials are shown. The confirmed resources of uranium in the free world as of the beginning of 1981 amounted to 2,293,000 t U, and the estimated additional resources were 2,720,000 t U. The political system and uranium policy, the present status of uranium export, the quantity of resources and the estimated amount of deposits, the uranium production and the status of uranium exploration and development of 25 foreign countries are reported. Japan has carried out uranium development activities in Australia, Canada, Niger, Gabon, Zambia and so on. (Kako, I.)

  18. and high-income countries

    African Journals Online (AJOL)

    opperwjj

    sociodemographic, health risk behaviour and social-legal correlates among university students ... no national seatbelt law or a law that does not apply to all occupants, poor attitudes towards ..... inconsistently used seatbelts than female students, while in some other countries (China, ..... and Exercise, 35, 1381–1395. Cunill ...

  19. Ruminant production systems in developing countries: Resource utilization

    International Nuclear Information System (INIS)

    Devendra, C.

    1989-01-01

    Ruminant production systems are discussed with specific reference to the resource utilization required to support them. Particular focus is placed on the main production resources (animals and feeds) and their underutilization. The ruminant animals include buffaloes, cattle, goats, sheep and camels. With the exception of cattle and sheep, their numbers in developing countries account for between 94 and 100% of total world population. Their biological attributes, including inherent characteristics, feeding behaviour and metabolism, are summarized. The extent and availability of feed resources are considered; resources include permanent pastures, crop residues, agroindustrial by-products and non-conventional feeds. The prevailing ruminant production systems are classified into three main categories: extensive systems, systems incorporating arable cropping (roadside, communal and arable grazing systems; tethering and cut-and-carry feeding), and systems integrated with tree cropping. Their genesis and endurance with patterns of crop production and farming systems are discussed. Integrated systems, involving animals and tree crops, are potentially important. Prevailing ruminant production systems are unlikely to change in the foreseeable future, unless there are major shifts in resource use and the proposed new systems are demonstrably superior. Factors likely to influence future ruminant production systems are market requirements, available feed resources and growth in human populations. Two associated strategies for improvement are proposed: increased priority to buffaloes, goats, sheep and camels, consistent with their potential contribution to meat, milk and fibre supplies and draught power; and more complete utilization of the available feed ingredients and increased feed supplies

  20. Medical diagnosis in resource-poor tropical countries.

    Science.gov (United States)

    Ramos-Rincón, J M; Cuadros-González, J; Malmierca-Corral, E; de Górgolas-Hernández, M

    2015-01-01

    When working in healthcare centers in developing countries where diagnostic resources are limited, clinical skills are of considerable importance. This study presents the diagnostic tools available in resource-poor areas. Anamnesis and physical examination are key components for reaching a correct diagnosis. The laboratory has at its disposal hemograms, basic blood chemistry and urinalysis. The available basic microbiological tests are the study of fresh feces, smears for malaria, direct smears for bacilli in sputum and Gram staining of clinical exudates. Basic radiography of the chest, abdomen, bones and soft tissues are of considerable usefulness but are not available in all centers. Ultrasonography can be of considerable usefulness due to its simplicity and versatility. The diagnosis in low resource conditions should sharpen our clinical skills and should be supported by the use of additional basic tests. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  1. Resource nationalism and credit growth in FSU countries

    International Nuclear Information System (INIS)

    Kalyuzhnova, Yelena; Nygaard, Christian

    2009-01-01

    This paper analyses the connection between resource nationalism and financial sector intervention in the FSU countries. We consider recent financial development in the FSU and the special features of energy rich emerging economies (Russia and Kazakhstan, in particular) which are influencing recent credit expansions. We find that the hydrocarbon sector has boosted boosting domestic credits through a number of direct and indirect routes. Recent decline in oil prices may change government attitudes to a continued resource nationalist strategy. Sovereign wealth funds that were established in a majority of energy rich emerging economies may, to the extent that they enable the selection of winners in specific economic sectors, create path dependency or exacerbate longer term allocative inefficiency arising from the governance structure associated with resource nationalism.

  2. Resource nationalism and credit growth in FSU countries

    Energy Technology Data Exchange (ETDEWEB)

    Kalyuzhnova, Yelena; Nygaard, Christian [The Centre for Euro-Asian Studies, The University of Reading, Whiteknights, PO Box 218, Reading RG6 6AA (United Kingdom)

    2009-11-15

    This paper analyses the connection between resource nationalism and financial sector intervention in the FSU countries. We consider recent financial development in the FSU and the special features of energy rich emerging economies (Russia and Kazakhstan, in particular) which are influencing recent credit expansions. We find that the hydrocarbon sector has boosted boosting domestic credits through a number of direct and indirect routes. Recent decline in oil prices may change government attitudes to a continued resource nationalist strategy. Sovereign wealth funds that were established in a majority of energy rich emerging economies may, to the extent that they enable the selection of winners in specific economic sectors, create path dependency or exacerbate longer term allocative inefficiency arising from the governance structure associated with resource nationalism. (author)

  3. Germany, high-tech country

    International Nuclear Information System (INIS)

    Anon.

    1997-01-01

    The Nuclear Technology Conference organized annually by the Deutsches Atomforum (DAtF) e.V. and the Kerntechnische Gesellschaft (KTG) e.V. was held in Aachen on May 13-15, 1997. Approximately 1000 participants from seventeen countries met to exchange information with experts from industry, research, science, and politics. Unlike earlier events, this one was not disturbed by demonstrations. DAtF President Dr. Wilfried Steuer welcomed Joachim H. Witt, Chief Executive Officer of the city of Aachen, who expressed words of welcome on behalf of his city at the opening of the plenary day of the conference. Energy policy and global competition were the optics of the address by Dr. Norbert Lammert, Parliamentary Undersecretary of State with the German Federal Ministry of Economics. He advocated grasping the changes offered by expanding global markets by reforming the structures of the energy supply sector. The rank of nuclear power in European research policy was explained by Fabricio Caccia Dominioni as representative of the European Commission. The electricity utilities were represented by Dr. Dietmar Kuhnt, Chief Executive Officer of RWE AG, who spoke about the security of energy investments. A thoughtful analysis of Germany as an industrial location was presented by Professor Dr. Herbert Henzler of McKinsey and Company Inc. The President of the European Nuclear Society (ENS), Ger R. Kuepers, sketched the development of nuclear power in the Netherlands, combining national and European aspects and emphasizing, in particular, the important function of ENS. Uranium enrichment as an European project was subject of the report by Dr. Klaus Messer, Urenco Ltd. The General Manager of Tractabel Energy Engineering and Chairman of Belgatom, Guy Frederic, examined the economic viability of nuclear power, appealing to the audience to reduce capital costs by innovation without detracting from safety. (orig./DG) [de

  4. Fuel forests: a spreading energy resource in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Smith, N J.H.

    1981-09-01

    The fuel potential of forests, particularly in Third World countries, to raise the contribution of fuelwood to global energy resources is receiving positive notice in the incentive programs for forestry projects offered by lending institutions and actions taken by governments to arrest the loss of forest cover. Residential and industrial use of wood must be balanced by rigorous woodland protection and management to increase tree planting. The example of Korea's success in increasing fuelwood supplies illustrates the importance of public understanding and community involvement so that local environmental and cultural factors are considered and local leaders are involved. 56 references, 1 table. (DCK)

  5. Screening for genital tuberculosis in a limited resource country: case report

    OpenAIRE

    Namani, Sadie; Qehaja-Bu?aj, Emine; Namani, Diell?za

    2017-01-01

    Background Screening for benign or malignant process of pelvis in young females is a challenge for a physician in a limited resource country. Tuberculosis should be always considered in the differential diagnosis of a pelvic mass in countries with high prevalence of tuberculosis. Negative results of analysis of peritoneal fluid for acid-fast staining, late cultures, and unavailability of new diagnostics methods such as polymerase chain reaction and adenosine deaminase of the aspirated fluid f...

  6. Burden of diseases in poor resource countries: meeting the ...

    African Journals Online (AJOL)

    In Tanzania morbidity due to HIV/AIDS, tuberculosis and malaria leads to ... Key words: HIV/AIDS, malaria, tuberculosis, burden, poverty, research. Introduction ... children and women in particular, die without ever accessing ... 1990s in Tanzania show a mixed picture despite .... percent of the country is highly endemic for the.

  7. Energy needs, uses, and resources in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Palmedo, P.F.; Nathans, R.; Beardsworth, E.; Hale, S. Jr.

    1978-03-01

    The report identifies the energy needs, uses, and resources in the developing countries of the world and examines the energy options available to them for their continued social and economic growth. If traditional patterns of development are to continue, oil consumption in the non-OPEC LDCs will grow steadily to become comparable with current U.S. consumption between 2000 and 2020. Attempts to exploit indigenous hydrocarbon resources even in those LDCs with untapped reserves will be limited by shortages of capital and technical manpower. In the absence of major actions to replace noncommercial fuels or to increase the effectiveness with which they are used, a large fraction of the 3 to 4 billion LDC rural population in the year 2000 will not be able to raise their energy usage above subsistence levels. There is a wide variety of solutions to these problems, many of them emerging directly from the changed economics of energy. For example, most LDCs have not adequately explored and developed their own indigenous resources; in virtually all energy conversion and utilization processes there are opportunities for improvements in efficiency and substitution of renewable energy forms. In virtually all these areas there are opportunities for effective assistance activities.

  8. Designing equitable antiretroviral allocation strategies in resource-constrained countries.

    Directory of Open Access Journals (Sweden)

    David P Wilson

    2005-02-01

    Full Text Available Recently, a global commitment has been made to expand access to antiretrovirals (ARVs in the developing world. However, in many resource-constrained countries the number of individuals infected with HIV in need of treatment will far exceed the supply of ARVs, and only a limited number of health-care facilities (HCFs will be available for ARV distribution. Deciding how to allocate the limited supply of ARVs among HCFs will be extremely difficult. Resource allocation decisions can be made on the basis of many epidemiological, ethical, or preferential treatment priority criteria.Here we use operations research techniques, and we show how to determine the optimal strategy for allocating ARVs among HCFs in order to satisfy the equitable criterion that each individual infected with HIV has an equal chance of receiving ARVs. We present a novel spatial mathematical model that includes heterogeneity in treatment accessibility. We show how to use our theoretical framework, in conjunction with an equity objective function, to determine an optimal equitable allocation strategy (OEAS for ARVs in resource-constrained regions. Our equity objective function enables us to apply the egalitarian principle of equity with respect to access to health care. We use data from the detailed ARV rollout plan designed by the government of South Africa to determine an OEAS for the province of KwaZulu-Natal. We determine the OEAS for KwaZulu-Natal, and we then compare this OEAS with two other ARV allocation strategies: (i allocating ARVs only to Durban (the largest urban city in KwaZulu-Natal province and (ii allocating ARVs equally to all available HCFs. In addition, we compare the OEAS to the current allocation plan of the South African government (which is based upon allocating ARVs to 17 HCFs. We show that our OEAS significantly improves equity in treatment accessibility in comparison with these three ARV allocation strategies. We also quantify how the size of the

  9. The Role of Home Country Political Resources for Brazilian Multinational Companies

    Directory of Open Access Journals (Sweden)

    Karina Regina Vieira Bazuchi

    2013-10-01

    Full Text Available This paper aims to analyze the interactions between home country governments and Developing Country Multinational Companies (DMNCs. Drawing on evidence from the Brazilian political environment and Brazilian multinationals we investigate the mechanisms governments use to influence the internationalization process of domestic companies and firms’ political strategic responses to shape the political institutional environment in which they operate. We argue that foreign direct investment (FDI outflows from developing economies need to be explored given specific country level contextual factors, such as high levels of government involvement. Our main findings support this idea and indicate that home country governments use a series of formal and informal mechanisms in order to drive the international expansion of DMNCs in both the entry and consolidation phases. Moreover, DMNCs political behavior in the home country political environment accounts for an important part of their strategy to develop political resources and obtain above average returns from governmental benefits.

  10. How Emerging Market Resource-poor Firms Compete and Outcompete Advanced Country Resource-Rich Rivals

    DEFF Research Database (Denmark)

    Li, Xin

    2018-01-01

    Purpose: The purpose of this paper is to comment on Professor Ming-Jer Chen’s recent publication titled “Competitive dynamics: Eastern roots, Western growth” and present an asymmetry reversing perspective on the competitive dynamics between two nonobvious, invisible or indirect competitors, namely......, how emerging market resource-poor firms compete and outcompete advanced country resource-rich rivals. Design/methodology/approach: The author first identifies an important neglect in Professor Chen’s scholarship on competitive dynamics, i.e., the neglect of the ubiquity of the less visible competition...... position, and try to avoid any direct competition with the strong incumbents. They often tactically appear to pursue different paths of development from those of the strong incumbents by focusing on particular product categories and market segments. Doing so allows the resource-poor firms to win times...

  11. Paediatric Palliative Care in Resource-Poor Countries

    Directory of Open Access Journals (Sweden)

    Julia Downing

    2018-02-01

    Full Text Available There is a great need for paediatric palliative care (PPC services globally, but access to services is lacking in many parts of the world, particularly in resource-poor settings. Globally it is estimated that 21.6 million children need access to palliative care, with 8.2 needing specialist services. PC has been identified as important within the global health agenda e.g., within universal health coverage, and a recent Lancet commission report recognised the need for PPC. However, a variety of challenges have been identified to PPC development globally such as: access to treatment, access to medications such as oral morphine, opiophobia, a lack of trained health and social care professionals, a lack of PPC policies and a lack of awareness about PPC. These challenges can be overcome utilising a variety of strategies including advocacy and public awareness, education, access to medications, implementation and research. Examples will be discussed impacting on the provision of PPC in resource-poor settings. High-quality PPC service provision can be provided with resource-poor settings, and there is an urgent need to scale up affordable, accessible, and quality PPC services globally to ensure that all children needing palliative care can access it.

  12. Treatment of chancroid in resource-poor countries.

    Science.gov (United States)

    Annan, Naa Torshie; Lewis, David A

    2005-04-01

    Chancroid, formerly a major cause of the genital ulcer disease syndrome, remains an important cofactor in both the transmission and acquisition of HIV-1 infection. Those countries with the greatest burden of HIV also have some of the highest prevalence rates of chancroid worldwide. The diagnosis of chancroid, caused by the fastidious bacterium Haemophilus ducreyi, is both expensive and difficult in many resource-poor areas. These areas of the world use syndromic management to treat genital ulcers and such an approach has proven effective in reducing rates of bacterial genital ulcer diseases. There are currently inexpensive and effective single-dose therapies available to treat chancroid. Single-dose regimens, given at first presentation, improve compliance and reduce the risk of sexually transmitted infections. Bacterial resistance to several antimicrobial agents has increased over the years and remains a continued threat to effective antimicrobial therapy. Follow-up of cases, and partner notification and treatment is carried out to limit reinfection and onward transmission of chancroid. Patients with coexistent HIV may be particularly at risk of failing single-dose therapy and should therefore be reviewed wherever possible.

  13. Priority needs and wisdom strategy for blood transfusion safety in developing low-resource countries.

    Science.gov (United States)

    Abdelrazik, Abeer Mohamed; Ezzat Ahmed, Ghada M

    2016-02-01

    To evaluate the implementation of alternative safety measures that reduce the risk of transfusion transmissible infections as an affordable measure in low resource countries. It is still difficult in developing countries with limited resources to mandate nucleic acid testing due to its high cost. Although NAT reduces the window period of infection, the developing countries are still in need of an efficient and effective transfusion programme before implementing the complex high cost NAT. Two thousand eight hundred eighty sero-negative first-time and repeat donations from Fayoum University Hospital blood bank were individually analysed by NAT for HIV, HBV and HCV. Only discriminatory-positive NAT were classified comparing the non-remunerated and family replacement donations. Significant discriminatory-positive differences were observed for HBV NAT results, 2 remunerated donations compared to 0 non-remunerated sero-negative donations. The discriminatory positive differences were also significant for HCV NAT results, 4 remunerated donations compared to 1 non-remunerated sero-negative donation. No sero-negative, discriminatory-positive NAT HIV case was found. Seven out of 8 discriminatory positive cases were from first time donations. In order to ensure blood safety, the recruitment and retention of voluntary, non-remunerated repeat donors should be a major commitment for low resource countries in which NAT implementation is costly and not feasible. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. The ESTHER hospital partnership initiative: a powerful levy for building capacities to combat the HIV pandemic in low-resource countries

    OpenAIRE

    Raguin, Gilles

    2016-01-01

    Partnerships between hospitals in high income countries and low resource countries are uniquely capable of fulfilling the tripartite needs of care, training, and research required to address health care crises in low resource countries. Of particular interest, at a time when the EBOLA crisis highlights the weaknesses of health systems in resource-poor settings, the institutional resources and expertise of hospitals can also contribute to strengthening health systems with long-term sustainabil...

  15. Development and human resources in the Islamic world: a study of selected countries.

    Science.gov (United States)

    Duza, M B

    1987-01-01

    "The present paper attempts to provide an analytical profile of development and human resources in [12] selected [Islamic] countries." The countries--Bangladesh, Somalia, Pakistan, Indonesia, Egypt, Turkey, Malaysia, Algeria, Iraq, Saudi Arabia, Kuwait, and United Arab Emirates--vary in income levels from low to high and in population size from 1 million to 159 million. Using data from the World Bank and the Population Council, comparisons are made on the basis of mortality and fertility levels, family size, income, urbanization, labor force size and growth, education, nutrition, and health. Governmental policy changes and future directions are discussed. excerpt

  16. Human resource development in nuclear medicine in developing countries

    International Nuclear Information System (INIS)

    Gopinathan Nair, P.G.

    1998-01-01

    An organization, an enterprise or a movement is only as good as the people in it and these cannot be conceived without considering the people that make it, in other words its human resources (HR). The definition of HR includes the total knowledge, skills, creative abilities, talents and aptitudes of the work-force. Equally important it includes the values, attitudes and benefits of each of the individuals concerned. No development is possible without proper planning. HR planning is therefore a prerequisite for HRD in NM and no planning can be made without defining the objectives of Nuclear Medicine (NM) in developing countries (DC). It is also essential to forecast the future needs of NM in DC keeping in mind the stated objectives before laying out the strategies of the HRD. HRD in NM is best achieved when all the partners in the game play their part with commitment and sincerity of purpose. At the national level the partners are the government (ministries of health and education), professional bodies (national societies of NM) and academic bodies (colleges of NM physicians, physicists and technologists etc.). In the implementation of the HRD systems and processes, involvement of all the partners is essential for success. Creation of task forces to implement, monitor and evaluate HRD tools ensures the quality of these tools. The operation of some of these tools may have to be centralized, and others decentralized depending upon the exigencies of need, propriety and practicality. In summary, the aim of HRD should be to ensure the right people at the right time for the right job and in doing so nuclear medicine achieves its objectives and the individuals in the workforce realize their full potentials, and benefits in full

  17. Environmental and resource economics in South Africa: status quo and lessons for developing countries

    CSIR Research Space (South Africa)

    Nahman, Anton

    2009-09-01

    Full Text Available The paper reviews the potential contributions of environmental and resource economics (ERE) to the achievement of sustainable development in developing countries and highlights the limitations associated with applying ERE within a developing country...

  18. Hydrologic modeling for water resource assessment in a developing country: the Rwanda case study

    Science.gov (United States)

    Steve McNulty; Erika Cohen Mack; Ge Sun; Peter Caldwell

    2016-01-01

    Accurate water resources assessment using hydrologic models can be a challenge anywhere, but particularly for developing countries with limited financial and technical resources. Developing countries could most benefit from the water resource planning capabilities that hydrologic models can provide, but these countries are least likely to have the data needed to run ...

  19. Cervical cancer screening and practice in low resource countries ...

    African Journals Online (AJOL)

    While developed countries have recorded significant reduction in the incidence of cervical cancer owing to organizedscreening programs, treatment of premalignant cervical lesions, and follow‑up of treated cases, developing countries including Nigeria are yet to optimally utilize screening services due to lack of organized ...

  20. Risk management and nuclear human resources management in construction nuclear power plants in the Gulf Countries

    International Nuclear Information System (INIS)

    Saeed Hakami; Salim Almarmary

    2009-01-01

    The countries of the Gulf region have the capacity to rapidly expand their economic growth and gross domestic product (GDP). Also, one may observe that their growth rate is very high. To match this, they need a mix of energy sources for this economic growth. Nuclear power plants can have a significant role as a source of energy in the Gulf countries. Although, some of the Gulf countries signed contracts to construct nuclear power plants, they still require high a level of education as well as sufficient and adequate human resources in order to solve complex issues which may happen at nuclear power plants. The objective of this paper is to identify the complex issues that may arise at a nuclear site. Then the paper goes on to discuss how to evaluate these issues. Finally, the paper studies how to manage and control such complex issues in the work place. The advantage of highly educated people as well as sufficient and adequate human resource can increasingly protect and save human health and the natural environment from issues relating to the use of nuclear energy. There are vast theories, strategies and tools that have discussed in regards to human resources management in the nuclear industries. However, this paper chiefly provides a new risk management methodology. This methodology helps to highlight the risk factors and their consequences at nuclear sites. This paper is intended to decrease risks; to protect human health in the work place at nuclear power plants and save the environment within and beyond national borders and for future generations. It aims to increase safety from the use of nuclear energy, particularly in the Gulf countries.(Author)

  1. Housing Quality and Access to Material and Learning Resources within the Home Environment in Developing Countries

    Science.gov (United States)

    Bradley, Robert H.; Putnick, Diane L.

    2012-01-01

    This study examined home environment conditions (housing quality, material resources, formal and informal learning materials) and their relations with the Human Development Index (HDI) in 28 developing countries. Home environment conditions in these countries varied widely. The quality of housing and availability of material resources at home were…

  2. Natural resources - food nexus: food-related environmental footprints in the mediterranean countries.

    Science.gov (United States)

    Lacirignola, Cosimo; Capone, Roberto; Debs, Philipp; El Bilali, Hamid; Bottalico, Francesco

    2014-01-01

    Immediate action is required in the Mediterranean to address environmental degradation that is mainly driven by consumption patterns. Increasing stress on biological and social systems is put by unsustainable consumption patterns. Food consumption patterns are important drivers of environment degradation. The objective of this review paper is to explore natural resources-food nexus in the Mediterranean region by highlighting the environmental footprints of the current consumption and production patterns. Secondary data from different sources such as FAOSTAT, the World Bank, Water Footprint Network (WFN), and Global Footprint Network were used to analyze the situation in 21 Mediterranean countries. The region faces many environmental challenges, e.g., land degradation, water scarcity, environment pollution, biodiversity loss, and climate change. The current consumption patterns imply high ecological, carbon, and water footprints of consumption and unfavorable national virtual-water balances. Food Balance Sheets data show that the contribution of vegetal and animal-based food product groups to food supply is variable among the Mediterranean countries. This has implications also in terms of the WF of food supply, which was calculated for Bosnia, Egypt, Italy, Morocco, and Turkey. The WF of the current diet resulted lower than that of the proposed Mediterranean one in the case of Italy. There is a strong scientific evidence supporting assumption that it is so also for other Mediterranean countries. The Mediterranean is characterized by a high resource use intensity that is further exacerbated by food losses and waste (FLW). In fact, FLW implies the loss of precious resources (water, land, energy) and inputs (fertilizers). Therefore, it is crucial to increase adherence to the traditional Mediterranean diet and to reduce FLW in order to foster transition to more sustainable food consumption patterns thus reducing pressure on the scarce resources of the Mediterranean

  3. Diagnosis of primary ciliary dyskinesia: potential options for resource-limited countries

    Directory of Open Access Journals (Sweden)

    Nisreen Rumman

    2017-01-01

    Full Text Available Primary ciliary dyskinesia is a genetic disease of ciliary function leading to chronic upper and lower respiratory tract symptoms. The diagnosis is frequently overlooked because the symptoms are nonspecific and the knowledge about the disease in the primary care setting is poor. Additionally, none of the available tests is accurate enough to be used in isolation. These tests are expensive, and need sophisticated equipment and expertise to analyse and interpret results; diagnosis is therefore only available at highly specialised centres. The diagnosis is particularly challenging in countries with limited resources due to the lack of such costly equipment and expertise. In this review, we discuss the importance of early and accurate diagnosis especially for countries where the disease is clinically prevalent but diagnostic tests are lacking. We review the diagnostic tests available in specialised centres (nasal nitric oxide, high-speed video microscopy, transmission electron microscopy, immunofluorescence and genetics. We then consider modifications that might be considered in less well-resourced countries whilst maintaining acceptable accuracy.

  4. A kidney transplantation model in a low-resource country: an experience from Pakistan.

    Science.gov (United States)

    Rizvi, Syed Adibul Hasan; Naqvi, Syed Ali Anwar; Zafar, Mirza Naqi; Akhtar, Syed Fazal

    2013-05-01

    Pakistan is a low-resource country with a population of 185 million where expenditure on health is 1.3% of the gross national product. The estimated incidence of end-stage renal disease (ESRD) is 100 per million of the population. The paucity and high costs of renal replacement therapy render more than 90% of the ESRD population disenfranchised from replacement therapy. Our center, which is a government sector organization, established as an integrated dialysis and living related renal transplant program in the 1980s, where all services were provided free of cost to all patients with life-long follow-up care including medications. The model was based on a concept of community/government partnership where the contributions to funds vary between 40% and 60% for each partner. The model has been self sustaining for 25 years, with an annual budget of $28 million in 2010. Presently, over 600 patients are dialyzed each day and each week, 7-10 patients have received live related transplants. The overall 1- and 5-year graft survival rate of 3150 transplants is 92% and 85%, respectively. Free dialysis and transplantation established our institute as a focus of transplantation in the country. This model therefore allowed the institute to have a vital role in the campaign against transplant tourism and in the promulgation of the transplant law. It shows that in low-resource countries, specialized centers in the government sector can, with community support, provide high-quality ESRD care to the disenfranchised population.

  5. Screening for genital tuberculosis in a limited resource country: case report.

    Science.gov (United States)

    Namani, Sadie; Qehaja-Buçaj, Emine; Namani, Diellëza

    2017-02-07

    Screening for benign or malignant process of pelvis in young females is a challenge for a physician in a limited resource country. Tuberculosis should be always considered in the differential diagnosis of a pelvic mass in countries with high prevalence of tuberculosis. Negative results of analysis of peritoneal fluid for acid-fast staining, late cultures, and unavailability of new diagnostics methods such as polymerase chain reaction and adenosine deaminase of the aspirated fluid from peritoneal cavity can often result in invasive diagnostic procedures such as laparotomy. We report a case of a 24 year old Albanian unemployed female living in urban place in Kosovo who presented with abdominal pain, loss of appetite, fever, headache, a weight loss, nonproductive cough and menstrual irregularity for three weeks. In this example case, the patient with cystic mass in tubo-ovarial complex and elevated serum cancer antigen 125 levels was diagnosed for genital tuberculosis after performing laparotomy. Caseose mass found in left tubo-ovarial complex and histopathological examination of biopsied tissue were the fastest diagnostic tools for confirming pelvis TB. The Lowenstein-Jensen cultures were positive after six weeks and her family history was positive for tuberculosis. Young females with abdominopelvic mass, ascites, a positive family history for tuberculosis and high serum cancer antigen 125, should always raise suspicion of tuberculosis especially in a limited resource country. A laparoscopy combined with peritoneal biopsy should be performed to confirm the diagnosis as this could lead to a prevention of unnecessary laparotomies.

  6. Stillbirths : recall to action in high-income countries

    NARCIS (Netherlands)

    Flenady, Vicki; Wojcieszek, Aleena M.; Middleton, Philippa; Ellwood, David; Erwich, Jan Jaap; Coory, Michael; Khong, T. Yee; Silver, Robert M.; Smith, Gordon C. S.; Boyle, Frances M.; Lawn, Joy E.; Blencowe, Hannah; Leisher, Susannah Hopkins; Gross, Mechthild M.; Horey, Dell; Farrales, Lynn; Bloomfield, Frank; McCowan, Lesley; Brown, Stephanie J.; Joseph, K. S.; Zeitlin, Jennifer; Reinebrant, Hanna E.; Ravaldi, Claudia; Vannacci, Alfredo; Cassidy, Jillian; Cassidy, Paul; Farquhar, Cindy; Wallace, Euan; Siassakos, Dimitrios; Heazell, Alexander E. P.; Storey, Claire; Sadler, Lynn; Petersen, Scott; Froen, J. Frederik; Goldenberg, Robert L.

    2016-01-01

    Variation in stillbirth rates across high-income countries and large equity gaps within high-income countries persist. If all high-income countries achieved stillbirth rates equal to the best performing countries, 19 439 late gestation ( 28 weeks or more) stillbirths could have been avoided in 2015.

  7. Dynamic conservation of forest genetic resources in 33 European countries

    NARCIS (Netherlands)

    Lefevre, F.; Koskela, J.; Hubert, J.; Kraigher, H.; Longauer, R.; Olrik, D.C.; Vries, de S.M.G.

    2013-01-01

    Dynamic conservation of forest genetic resources (FGR) means maintaining the genetic diversity of trees within an evolutionary process and allowing generation turnover in the forest. We assessed the network of forests areas managed for the dynamic conservation of FGR (conservation units) across

  8. Intrahousehold bargaining and resource allocation in developing countries

    OpenAIRE

    Doss, Cheryl

    2013-01-01

    Many key development outcomes depend on women's ability to negotiate favorable intrahousehold allocations of resources. Yet it has been difficult to clearly identify which policies can increase women's bargaining power and result in better outcomes. This paper reviews both the analytical frameworks and the empirical evidence on the importance of women's bargaining power. It argues that the...

  9. Challenges in managing postpartum hemorrhage in resource-poor countries.

    Science.gov (United States)

    Karoshi, Mahantesh; Keith, Louis

    2009-06-01

    Managing postpartum hemorrhage depends in part on having a prepared mind, a complement of trained coworkers, and full access to modern therapies. The last 2 components are rare in resource-poor areas and their absence may be accentuated by climatic instability and lack of basic transportation. Greater use of the active management of third stage of labor and administration of misoprostol by nontrained birth attendants will provide beneficial reductions in hemorrhage rates in resource-poor areas. Additional improvements depend on increasing public awareness, facilitating existing nongovernmental organizations in their community-related, upgrading training of traditional birth attendants, and providing cell phone communication to workers in remote areas, in addition to providing better access to blood.

  10. Resource-conserving agriculture increases yields in developing countries.

    Science.gov (United States)

    Pretty, J N; Noble, A D; Bossio, D; Dixon, J; Hine, R E; Penning De Vries, F W T; Morison, J I L

    2006-02-15

    Despite great recent progress, hunger and poverty remain widespread and agriculturally driven environmental damage is widely prevalent. The idea of agricultural sustainability centers on the need to develop technologies and practices that do not have adverse effects on environmental goods and services, and that lead to improvements in food productivity. Here we show the extent to which 286 recent interventions in 57 poor countries covering 37 M ha (3% of the cultivated area in developing countries) have increased productivity on 12.6 M farms while improving the supply of critical environmental services. The average crop yield increase was 79% (geometric mean 64%). All crops showed water use efficiency gains, with the highest improvement in rainfed crops. Potential carbon sequestered amounted to an average of 0.35 t C ha(-1) y(-1). If a quarter of the total area under these farming systems adopted sustainability enhancing practices, we estimate global sequestration could be 0.1 Gt C y(-1). Of projects with pesticide data, 77% resulted in a decline in pesticide use by 71% while yields grew by 42%. Although it is uncertain whether these approaches can meet future food needs, there are grounds for cautious optimism, particularly as poor farm households benefit more from their adoption.

  11. Metal recycling - a renewable resource in Gulf Cooperative Countries region

    Energy Technology Data Exchange (ETDEWEB)

    Kassem, M.E. [Bahrain Univ. (Bahrain). Dept. of Chemical Engineering

    1995-12-01

    The exhaustion of natural resources and growing environmental awareness highlighted the necessity of metal recycling all over the world. The production/consumption activities in the GCC region do generate annually a huge amount of valuable ferrous and nonferrous metal scrap. This paper deals with the benefits of metal recycling to the GCC region in lights of energetic, environmental and economic points of view. (orig.) [Deutsch] Die abnehmenden Vorraete von Primaermetallen sowie das zunehmende Umweltbewusstsein machen das Metall-Recycling auf der ganzen Welt notwendig. Die Produktions- und Verbrauchsaktivitaeten in der GCC-Region erzeugen jaehrlich riesige Mengen von wertvollem eisen- und nicht eisenhaltigen Schrott. Dieser Beitrag befasst sich mit dem Energie-Verbrauch, dem Umweltschutz und der Wirtschaft des Recycling und stellt dessen Vorteile fuer die GCC-Region vor. (orig.)

  12. The new context for industrializing around natural resources: an opportunity for Latin America (and other resource rich countries)?

    OpenAIRE

    Carlota Perez

    2015-01-01

    This chapter argues that development is a moving target, and that windows of opportunity to both ‘catch up’ and ‘leap ahead’ present themselves at certain times and in specific regions due to technological revolutions and paradigm shifts. Having examined the historical precedents, it observes that the exploitation and processing of natural resources (NR), once seen as a ‘curse’ for developing nations, present such an opportunity for Latin America and other resource-rich countries at this stag...

  13. Assessment and Evaluation of National Human Resource Development System Competitiveness in Emerging Countries

    Science.gov (United States)

    Oh, HunSeok; Seo, DongIn; Kim, JuSeuk; Yoo, SangOk; Seong, HeeChang

    2015-01-01

    This study assessed and evaluated the competitiveness of national human resource development (NHRD) systems in emerging countries with potential for growth. The literature on emerging countries and NHRD systems was reviewed. The study developed a model mechanism with forty-one indices and nine sub-components for the NHRD system assessment in…

  14. Country report on human resource development in nuclear field

    International Nuclear Information System (INIS)

    Wanitsuksombut, Warapon; Noochpramool, Kovit

    2000-01-01

    The short-term plan is to promote utilization of the new research reactor in Thailand. The long-term plan is to gain public understanding and acceptance of nuclear technology. Since 1991, the office has conducted training and seminars in nuclear related field. The major training is in radiation protection, and training in nuclear reactor was at noticeably smaller portion. For ten years of training, 3,649 persons passed different radiation protection courses. Education programs in universities are outlined with the curriculums in the paper. It is clear that the manpower produced in nuclear field in Thailand is inadequate. Further more, most of them are working in limited areas in specific institutes, research laboratories, modern hospitals, and academic teaching. They seldom contact with the public. Hence communication to the public is lacking. After the training course for schoolteachers in our research reactor site, many of them appreciate new knowledge of nuclear technology. They became to realize that they had been involved with the nuclear technology before in their everyday well being. The urgent need is to arrange various suitable courses on research reactor utilization. In this effort, the exchange of information, equipment as well as teaching materials form developed institutes are necessary. The urgent need is a system of qualification for Radiation Protection Officer. By exchange of information and seminars, it may help the country to decide whether the harmonization and accreditation of training courses or the accredited examination is adopted. For long-term achievement, a regular seminar for schoolteacher should be formulated, and a program for social and economics curriculum in nuclear field should be initiated. (Tanaka, Y.)

  15. Comparative Analysis of OECD Member Countries' Competitive Advantage in National Human Resource Development System

    Science.gov (United States)

    Oh, Hunseok; Choi, Yeseul; Choi, Myungweon

    2013-01-01

    The purpose of this study was to assess, evaluate, and compare the competitive advantages of the human resource development systems of advanced countries. The Global Human Resource Development Index was utilized for this study, since it has been validated through an expert panel's content review and analytic hierarchy process. Using a sample of 34…

  16. BK Virus-Associated Nephropathy: Current Situation in a Resource-Limited Country.

    Science.gov (United States)

    Yooprasert, P; Rotjanapan, P

    Data on BK virus-associated nephropathy (BKVAN) and treatment strategy in a resource-limited country are scarce. This study aimed to evaluate epidemiology of BKVAN and its situation in Thailand. A retrospective analysis was conducted among adult kidney transplant recipients at Ramathibodi Hospital from October 2011 to September 2016. Patients' demographic data, information on kidney transplantation, immunosuppressive therapy, cytomegalovirus and BK virus infections, and allograft outcomes were retrieved and analyzed. This study included 623 kidney transplant recipients. Only 327 patients (52.49%) received BK virus infection screening, and 176 of 327 patients had allograft dysfunction as a trigger for screening. BKVAN was identified in 39 of 327 patients (11.93%). Deceased donor transplantation and cytomegalovirus infection were associated with a higher risk of BKVAN (odds ratio = 2.2, P = .024, 95% confidence intervals [1.1, 4.43], and odds ratio = 2.6, P = .006, 95% confidence intervals [1.29, 5.26], respectively). BKVAN patients were at significantly higher risk for allograft rejection (P < .001) and allograft failure (P = .036). At the end of the study, 4 graft losses were documented (12.12%). BKVAN was associated with high rate of allograft rejection and failure. However, surveillance of its complications has been underperformed at our facility. Implementing a formal practice guideline may improve allograft outcome in resource-limited countries. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Essential Medicines in a High Income Country: Essential to Whom?

    Science.gov (United States)

    Duong, Mai; Moles, Rebekah J; Chaar, Betty; Chen, Timothy F

    2015-01-01

    To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an "essential" medicine, and how the Essential Medicines List (EML) concept functions in a high income country context. In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach. Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain. This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach. The wide range of views of what stakeholders

  18. Essential Medicines in a High Income Country: Essential to Whom?

    Directory of Open Access Journals (Sweden)

    Mai Duong

    Full Text Available To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an "essential" medicine, and how the Essential Medicines List (EML concept functions in a high income country context.In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach.Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain.This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach. The wide range of views of

  19. Public sector refraction and spectacle dispensing in low-resource countries of the Western Pacific.

    Science.gov (United States)

    Ramke, Jacqueline; du Toit, Rènée; Palagyi, Anna; Williams, Carmel; Brian, Garry

    2008-05-01

    Given that uncorrected refractive error is a frequent cause of vision impairment, and that there is a high unmet need for spectacles, an appraisal of public sector arrangements for the correction of refractive error was conducted in eight Pacific Island countries. Mixed methods (questionnaire and semi-structured interviews) were used to collect information from eye care personnel (from Fiji, Papua New Guinea, Solomon Islands, Vanuatu, Cook Islands, Samoa, Tonga and Tuvalu) attending a regional eye health workshop in 2005. Fiji, Tonga and Vanuatu had Vision 2020 eye care plans that included refraction services, but not spectacle provision. There was wide variation in public sector spectacle dispensing services, but, except in Samoa, ready-made spectacles and a full cost recovery pricing strategy were the mainstay. There were no systems for the registration of personnel, nor guidelines for clinical or systems management. The refraction staff to population ratio varied considerably. Solomon Islands, Tuvalu and Vanuatu had the best coverage by services, either fixed or outreach. Most services had little promotional activity or community engagement. To be successful, it would seem that public sector refraction services should answer a real and perceived need, fit within prevailing policy and legislation, value, train, retain and equip employees, be well managed, be accessible and affordable, be responsive to consumers, and provide ongoing good quality outcomes. To this end, a checklist to aid the initiation and maintenance of refraction and spectacle systems in low-resource countries has been constructed.

  20. Technological Innovation and Developmental Strategies for Sustainable Management of Aquatic Resources in Developing Countries

    Science.gov (United States)

    Agboola, Julius Ibukun

    2014-12-01

    Sustainable use and allocation of aquatic resources including water resources require implementation of ecologically appropriate technologies, efficient and relevant to local needs. Despite the numerous international agreements and provisions on transfer of technology, this has not been successfully achieved in developing countries. While reviewing some challenges to technological innovations and developments (TID), this paper analyzes five TID strategic approaches centered on grassroots technology development and provision of localized capacity for sustainable aquatic resources management. Three case studies provide examples of successful implementation of these strategies. Success requires the provision of localized capacity to manage technology through knowledge empowerment in rural communities situated within a framework of clear national priorities for technology development.

  1. TOWARDS TO NEW ILLUSTRATION OF RESOURCE CURSE: FDI CHANNEL EMPIRICAL EVIDENCE FROM GULF COOPERATION COUNCIL (GCC COUNTRIES

    Directory of Open Access Journals (Sweden)

    Mohamed M. Elheddad

    2016-11-01

    Full Text Available This paper extends a high influential contribution by Poelhekke and Van der Ploeg (2013, on the new mechanism of natural resource curse which is FDI. Using panel data of FDI inflows (aggregate and disaggregate for six oil dependent countries (GCC during a period 1980-2013; our main findings are as follows. First, total FDI is negatively correlated with natural resources measured by oil prices constant 2000 in the long run and short term. This negative impact ranged between 0.21% and 0.41% if oil prices changed by one percent increase. Secondly, FDI in resource sector falls by around 0.44-0.47%, but non-resource FDI increased by about 0.21- 0.29% when the interaction term between oil revenues and initial oil prices (1980 increases by 1%. These results are robust even after including other FDI determinants.

  2. Turkey's High Temperature Geothermal Energy Resources and Electricity Production Potential

    Science.gov (United States)

    Bilgin, Ö.

    2012-04-01

    Turkey is in the first 7 countries in the world in terms of potential and applications. Geothermal energy which is an alternative energy resource has advantages such as low-cost, clean, safe and natural resource. Geothermal energy is defined as hot water and steam which is formed by heat that accumulated in various depths of the Earth's crust; with more than 20oC temperature and which contain more than fused minerals, various salts and gases than normal underground and ground water. It is divided into three groups as low, medium and high temperature. High-temperature fluid is used in electricity generation, low and medium temperature fluids are used in greenhouses, houses, airport runways, animal farms and places such as swimming pools heating. In this study high temperature geothermal fields in Turkey which is suitable for electricity production, properties and electricity production potential was investigated.

  3. Limited resources of genome sequencing in developing countries: Challenges and solutions

    Directory of Open Access Journals (Sweden)

    Mohamed Helmy

    2016-06-01

    Full Text Available The differences between countries in national income, growth, human development and many other factors are used to classify countries into developed and developing countries. There are several classification systems that use different sets of measures and criteria. The most common classifications are the United Nations (UN and the World Bank (WB systems. The UN classification system uses the UN Human Development Index (HDI, an indicator that uses statistic of life expectancy, education, and income per capita for countries' classification. While the WB system uses gross national income (GNI per capita that is calculated using the World Bank Atlas method. According to the UN and WB classification systems, there are 151 and 134 developing countries, respectively, with 89% overlap between the two systems. Developing countries have limited human development, and limited expenditure in education and research, among several other limitations. The biggest challenge facing genomic researchers and clinicians is limited resources. As a result, genomic tools, specifically genome sequencing technologies, which are rapidly becoming indispensable, are not widely available. In this report, we explore the current status of sequencing technologies in developing countries, describe the associated challenges and emphasize potential solutions.

  4. FOOD SECURITY SITUATION OF SELECTED HIGHLY DEVELOPED COUNTRIES AGAINST DEVELOPING COUNTRIES

    OpenAIRE

    Karolina Pawlak

    2016-01-01

    The aim of the paper is to present the food security situation in selected highly developed countries and to identify consumption disparities between them and developing countries. The research is based on the data from the United Nations Food and Agriculture Organization (FAO), the Statistical Office of the European Union (Eurostat), the United Nations Statistics Division, the Organisation for Economic Co-operation and Development (OECD), World Food Programme (WFP) and selected measures used...

  5. Comparative meta-analysis of tuberculosis contact investigation interventions in eleven high burden countries

    NARCIS (Netherlands)

    Blok, Lucie; Sahu, Suvanand; Creswell, Jacob; Alba, Sandra; Stevens, Robert; Bakker, Mirjam I.

    2015-01-01

    Screening of household contacts of tuberculosis (TB) patients is a recommended strategy to improve early case detection. While it has been widely implemented in low prevalence countries, the most optimal protocols for contact investigation in high prevalence, low resource settings is yet to be

  6. Paediatric cardiology programs in countries with limited resources: how to bridge the gap.

    Science.gov (United States)

    Sulafa, K M Ali

    2010-07-01

    Establishing paediatric cardiology service in a country with limited resources like Sudan is a challenging task. A paediatric cardiac team was formed then the services in different disciplines were gradually established. Echocardiography (echo) clinics were founded in tertiary and peripheral hospitals. Cardiac catheterization (cath) was established at the Sudan Heart Centre (SHC) in 2004 and over 400 procedures had been performed including interventional catheterization like pulmonary valve dilatation, patent ductus arteriosus and atrial septal defect device closure. Congenital heart surgery started in 2001, currently 200 cases are done each year including closed procedures as well as open heart procedures for patients weighing more than 8 kg. Cardiology-cardiac surgery as well as adult congenital heart disease meetings were held and contributed positively to the services. The cardiology-cardiac surgery scientific club meeting was founded as a forum for academic discussions. A fellowship program was established in 2004 and included seven candidates trained in paediatric cardiology and intensive care. Two training courses had been established: congenital heart disease echo and paediatric electrocardiogram interpretation. Links with regional and international cardiac centres had important roles in consolidating our program. Significant obstacles face our service due to the small number of trained personnel, high cost of procedures, the lack of regular supplies and lack of cardiac intensive care facilities for young infants. Bridging the huge gap needs extensive official as well as non-governmental efforts, training more staff, supporting families and collaboration with regional and international centres.

  7. Present and future nuclear power generation as a reflection of individual countries' resources and objectives

    International Nuclear Information System (INIS)

    Borg, I.Y.

    1987-01-01

    The nuclear reactor industry has been in a state of decline for more than a decade in most of the world. The reasons are numerous and often unique to the energy situation of individual countries. Two commonly cited issues influence decisions relating to construction of reactors: costs and the need, or lack thereof, for additional generating capacity. Public concern has ''politicized'' the nuclear industry in many non-communist countries, causing a profound effect on the economics of the option. The nuclear installations and future plans are reviewed on a country-by-country basis for 36 countries in the light of the resources and objectives of each. Because oil and gas for power production throughout the world are being phased out as much as possible, coal-fired generation currently tends to be the chosen alternative to nuclear power production. Exceptions occur in many of the less developed countries that collectively have a very limited operating experience with nuclear reactors. The Chernobyl accident in the USSR alarmed the public; however, national strategies and plans to build reactors have not changed markedly in the interim. Assuming that the next decade of nuclear power generation is uneventful, additional electrical demand would cause the nuclear power industry to experience a rejuvenation in Europe as well as in the US. 80 refs., 3 figs., 22 tabs

  8. Renewable energy resources and their role in the energy balance of the country

    International Nuclear Information System (INIS)

    Ivanov, P.; Trifonova, L.

    2001-01-01

    The role of the renewable energy sources in the energy production sector is discussed. The main features of solar, wind and biomass energy are reviewed. Studies for Bulgaria show a total solar radiation above 1600 kWh/m 2 for the Southern regions. The assessment of the solar resources, made by the DOE gives about 170 000 TWh/y for the whole territory. The economically advantageous resources for passive heating are 10.6 TWh till 2020. For the same period the utilization of 0.92 TWh solar energy is possible. Solar installations with surface about 14 000 m 2 are currently in operation. 54% of them are in the tourism sphere and only 8% are in industry (due to some economical difficulties about 44% of the industrial installations are shut down). On the base of processing of the data from more that 100 meteorological stations on the country territory, a spatial assessment of the resources has been done. For the whole territory the wind potential is estimated to about 15800 GW. Theoretical average annual wind resources at 10 km above the surface are 125 000 TWh. There are several areas with wind velocity 5-6 m/s which are suitable for wind energy production. The energy resources of biomass for the country are large - around 35.5 TWh. Under the programmes 'Country Study Project' and PHARE, different scenarii for the renewable energy source utilization till 2020 are developed. Estimation for the possibilities for wider application of the renewable sources in the market are done

  9. The practice of career development in the international human resource management of the European countries

    Directory of Open Access Journals (Sweden)

    Berber Nemanja

    2014-01-01

    Full Text Available The function very close to the training in the management of human resources is certainly the human resource development. Specifically, the employees acquire new knowledge, abilities and skills during the training process, but also gain new experiences through various business tasks during their working life, developing themselves both, in private life and in the professional sense. Human resource development is seen as the development of the expertise of people through organizational development and training of employees in order of improvement of the performances. In this paper authors explored the practice of carrier development in European countries. Research was based on data from international project, CRANET, in the period from 2008 to 2010. The authors presented data about the usage of techniques for evaluation of career development and investigated obtained results.

  10. Childbearing in adolescents aged 12-15 years in low resource countries: a neglected issue. New estimates from demographic and household surveys in 42 countries.

    Science.gov (United States)

    Neal, Sarah; Matthews, Zoë; Frost, Melanie; Fogstad, Helga; Camacho, Alma V; Laski, Laura

    2012-09-01

    There is strong evidence that the health risks associated with adolescent pregnancy are concentrated among the youngest girls (e.g. those under 16 years). Fertility rates in this age group have not previously been comprehensively estimated and published. By drawing data from 42 large, nationally representative household surveys in low resource countries carried out since 2003 this article presents estimates of age-specific birth rates for girls aged 12-15, and the percentage of girls who give birth at age 15 or younger. From these we estimate that approximately 2.5 million births occur to girls aged under 16 in low resource countries each year. The highest rates are found in Sub-Saharan Africa, where in Chad, Guinea, Mali, Mozambique, Niger and Sierra Leone more than 10% of girls become mothers before they are 16. Strategies to reduce these high levels are vital if we are to alleviate poor reproductive health. © 2012 The Authors  Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. Is Deindustrialization Causing High Unemployment in Affluent Countries? Evidence from 16 OECD Countries, 1970-2003

    Science.gov (United States)

    Kollmeyer, Christopher; Pichler, Florian

    2013-01-01

    This study assesses the possibility that deindustrialization has been contributing to the persistently high unemployment rates experienced by most affluent countries since the mid-1970s. Combining insights from Lilien's (1982) "sectoral shift" thesis and the literature on deindustrialization, the authors assert that the decades-long contraction of…

  12. How Can We Assess and Evaluate the Competitive Advantage of a Country's Human Resource Development System?

    Science.gov (United States)

    Oh, Hunseok; Ryu, Hyue-Hyun; Choi, Myungweon

    2013-01-01

    The purpose of this study was to develop an index to assess and evaluate the competitive advantage of a country's human resource development system. Based on an extensive literature review, a theoretical model of a human resource development system at the national level (named National Human Resource Development: NHRD) was constructed. The…

  13. Acute Kidney Injury Risk Assessment: Differences and Similarities Between Resource-Limited and Resource-Rich Countries

    Directory of Open Access Journals (Sweden)

    Kianoush Kashani

    2017-07-01

    Full Text Available The incidence of acute kidney injury (AKI among acutely ill patients is reportedly very high and has vexing consequences on patient outcomes and health care systems. The risks and impact of AKI differ between developed and developing countries. Among developing countries, AKI occurs in young individuals with no or limited comorbidities, and is usually due to environmental causes, including infectious diseases. Although several risk factors have been identified for AKI in different settings, there is limited information on how risk assessment can be used at population and patient levels to improve care in patients with AKI, particularly in developing countries where significant health disparities may exist. The Acute Disease Quality Initiative consensus conference work group addressed the issue of identifying risk factors for AKI and provided recommendations for developing individualized risk stratification strategies to improve care. We proposed a 5-dimension, evidence-based categorization of AKI risk that allows clinicians and investigators to study, define, and implement individualized risk assessment tools for the region or country where they practice. These dimensions include environmental, socioeconomic and cultural factors, processes of care, exposures, and the inherent risks of AKI. We provide examples of these risks and describe approaches for risk assessments in the developing world. We anticipate that these recommendations will be useful for health care providers to plan and execute interventions to limit the impact of AKI on society and each individual patient. Using a modified Delphi process, this group reached consensus regarding several aspects of AKI risk stratification.

  14. Modelling Oil‑Sector Dependency of Tax Revenues in a Resource Rich Country: Evidence from Azerbaijan

    Directory of Open Access Journals (Sweden)

    Akif Musayev

    2017-01-01

    Full Text Available Forecasting tax revenues is an important issue in budget planning. As a resource rich country, Azerbaijan’s budget revenues is severely depend on oil price and production levels. This study investigates oil sector dependency of state budget tax revenues in case of Azerbaijan by employing FMOLS, DOLS and CCR cointegration methods for the period of 2000Q1 – 2015Q2. Empirical results indicate statistically and economically significant positive long‑run impact of both oil related factors on tax revenues. Considering current fiscal challenges in the country, research findings are very useful for policy purposes and fills the gap in the literature by drawing mechanism of the association and estimating the relationship empirically.

  15. Leveraging HPC resources for High Energy Physics

    International Nuclear Information System (INIS)

    O'Brien, B; Washbrook, A; Walker, R

    2014-01-01

    High Performance Computing (HPC) supercomputers provide unprecedented computing power for a diverse range of scientific applications. The most powerful supercomputers now deliver petaflop peak performance with the expectation of 'exascale' technologies available in the next five years. More recent HPC facilities use x86-based architectures managed by Linux-based operating systems which could potentially allow unmodified HEP software to be run on supercomputers. There is now a renewed interest from both the LHC experiments and the HPC community to accommodate data analysis and event simulation production on HPC facilities. This study provides an outline of the challenges faced when incorporating HPC resources for HEP software by using the HECToR supercomputer as a demonstrator.

  16. First report on the state of the world's animal genetic resources. Views on biotechnology as expressed in country reports

    International Nuclear Information System (INIS)

    Cardellino, R.; Hoffmann, I.; Tempelman, K.A.

    2005-01-01

    As part of the country-driven strategy for the management of farm animal genetic resources, FAO invited 188 counties to participate in the First Report on the State of the World's Animal Genetic Resources, with 145 consenting. Their reports are an important source of information on the use of biotechnology, particularly biotechnical products and processes. This paper analyses information from country reports so far submitted, and is therefore preliminary. There is clearly a big gap in biotechnology applications between developed and developing countries, with artificial insemination the most common technology used in developing countries, although not everywhere. More complex techniques, such as embryo transfer (ET) and molecular tools, are even less frequent in developing countries. Most developing countries wish to expand ET and establish gene banks and cryoconservation techniques. There are very few examples in developing countries of livestock breeding programmes capable of incorporating molecular biotechnologies in livestock genetic improvement programmes. (author)

  17. Screening for neonatal deafness in resource-poor countries: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Olusanya BO

    2015-05-01

    Full Text Available Bolajoko O Olusanya Centre for Healthy Start Initiative, Ikoyi, Nigeria Abstract: Newborn or neonatal hearing screening (NHS is offered routinely in high-income countries as an essential and mandatory intervention for the early detection of infants with permanent congenital or early-onset hearing loss. However, NHS is rarely offered presently in the vast majority of low- and middle-income countries, which account for over 80% of the incidence and burden of permanent congenital or early-onset hearing loss worldwide. This review provides an overview of the current status of NHS programs in the most developmentally disadvantaged low-and middle-income countries with a per capita income of approximately US$6,000 or less against the backdrop of relevant recommendations for effective NHS programs. It highlights the key obstacles to the delivery and uptake of NHS services based on a review of available literature from the eligible countries. It proposes strategies for addressing these challenges and examines the crucial role of pediatricians and primary care physicians in providing leadership for the requisite multidisciplinary efforts to develop and promote effective NHS services in low- and middle-income countries. Keywords: early detection, intervention, newborn screening, early childhood development, developing countries

  18. FOOD SECURITY SITUATION OF SELECTED HIGHLY DEVELOPED COUNTRIES AGAINST DEVELOPING COUNTRIES

    Directory of Open Access Journals (Sweden)

    Karolina Pawlak

    2016-06-01

    Full Text Available The aim of the paper is to present the food security situation in selected highly developed countries and to identify consumption disparities between them and developing countries. The research is based on the data from the United Nations Food and Agriculture Organization (FAO, the Statistical Office of the European Union (Eurostat, the United Nations Statistics Division, the Organisation for Economic Co-operation and Development (OECD, World Food Programme (WFP and selected measures used by the Economist Intelligence Unit (EIU for the construction of the Global Food Security Index. It has been showed that to the greatest extent the problem of maintaining food security occur in developing countries which are characterised by low per capita income, while in developed countries the scale of hunger is marginal and it afflicts less than 1% of the population. On a regional scale the daily dietary energy supply is greater than the minimum dietary energy requirement in all regions of the world, but the extent to which the dietary needs are satisfied increases along with the increase in national income. In order to reduce the problem of hunger it is necessary to solve the problem of asymmetrical distribution of global income, e.g. by taking actions to accelerate the economic growth in less developed regions and increase the purchasing power of the population.

  19. Beyond Wage Bill Ceilings : The Impact of Government Fiscal and Human Resource Management Policies on the Health Workforce in Developing Countries, Background Country Study for Rwanda

    OpenAIRE

    World Bank

    2008-01-01

    One of the main explanations put forth on why access to health workers is so low in developing countries is that there are insufficient resources within the public sector to pay the wage bill - the salary and allowance payments - of an expanded health workforce. In turn, the lack of wage bill resources for the health sector is thought to be a direct result of restrictive macroeconomic poli...

  20. Biomedical laboratory science education: standardising teaching content in resource-limited countries

    Directory of Open Access Journals (Sweden)

    Wendy Arneson

    2013-06-01

    Full Text Available Background: There is a worldwide shortage of qualified laboratory personnel to provide adequate testing for the detection and monitoring of diseases. In an effort to increase laboratory capacity in developing countries, new skills have been introduced into laboratory services. Curriculum revision with a focus on good laboratory practice is an important aspect of supplying entry-level graduates with the competencies needed to meet the current needs. Objectives: Gaps in application and problem-solving competencies of newly graduated laboratory personnel were discovered in Ethiopia, Tanzania and Kenya. New medical laboratory teaching content was developed in Ethiopia, Tanzania and Kenya using national instructors, tutors, and experts and consulting medical laboratory educators from the United States of America (USA. Method: Workshops were held in Ethiopia to create standardised biomedical laboratory science (BMLS lessons based on recently-revised course objectives with an emphasis on application of skills. In Tanzania, course-module teaching guides with objectives were developed based on established competency outcomes and tasks. In Kenya, example interactive presentations and lesson plans were developed by the USA medical laboratory educators prior to the workshop to serve as resources and templates for the development of lessons within the country itself. Results: The new teaching materials were implemented and faculty, students and other stakeholders reported successful outcomes. Conclusions: These approaches to updating curricula may be helpful as biomedical laboratory schools in other countries address gaps in the competencies of entry-level graduates.

  1. EVALUATION OF FINANCIAL AUTONOMY PROCESS OF BINH THUAN PROVINCE IN TRAINING PUBLIC HUMAN RESOURCES IN FOREIGN COUNTRIES

    OpenAIRE

    NGUYEN THANH, NHAN

    2012-01-01

    This paper will discuss the financial autonomy in training public human resources in foreign countries in Binh Thuan province. The process of financial autonomy helps Binh Thuan province be proactive in dealing with its performances in many aspects, especially in training public human resources. Although central government has built many training policies, the training focuses on the fields that meet the general requirements of the whole country. This leads to the situation that the trained m...

  2. Using mobile electronic devices to deliver educational resources in developing countries.

    Science.gov (United States)

    Mazal, Jonathan Robert; Ludwig, Rebecca

    2015-01-01

    Developing countries have far fewer trained radiography professionals than developed countries, which exacerbates the limited access to imaging services. The lack of trained radiographers reflects, in part, limited availability of radiographer-specific educational resources. Historically, organizations that provided such resources in the developing world faced challenges related to the limited stock of current materials as well as expenses associated with shipping and delivery. Four mobile electronic devices (MEDs) were loaded with educational content (e-books, PDFs, and digital applications) spanning major radiography topics. The MEDs were distributed to 4 imaging departments in Ghana, India, Nepal, and Nigeria based on evidence of need for radiography-specific resources, as revealed by survey responses. A cost comparison of postal delivery vs digital delivery of educational content was performed. The effectiveness of delivering additional content via Wi-Fi transmission also was evaluated. Feedback was solicited on users' experience with the MEDs as a delivery tool for educational content. An initial average per e-book expense of $30.05, which included the cost of the device, was calculated for the MED delivery method compared with $15.56 for postal delivery of printed materials. The cost of the MED delivery method was reduced to an average of $10.05 for subsequent e-book deliveries. Additional content was successfully delivered via Wi-Fi transmission to all recipients during the 3-month follow-up period. Overall user feedback on the experience was positive, and ideas for enhancing the MED-based method were identified. Using MEDs to deliver radiography-specific educational content appears to be more cost effective than postal delivery of printed materials on a long-term basis. MEDs are more efficient for providing updates to educational materials. Customization of content to department needs, and using projector devices could enhance the usefulness of MEDs for

  3. Productive diversification in natural resource abundant countries : limitations, policies and the experience of Argentina in the 2000s

    NARCIS (Netherlands)

    L.A. Serino (Leandro)

    2009-01-01

    textabstractThe debate on the pattern of specialization in natural resource abundant countries has re-emerged as demand for raw materials and food products from the rapidly growing East Asian countries, speculation in financial markets, and changes in production techniques augmented the

  4. Republic of Ecuador Country Environmental Analysis : Environmental Quality and Natural Resource Management for Sustained Economic Growth and Poverty Alleviation

    OpenAIRE

    World Bank

    2007-01-01

    Ecuador is a country with exceptional natural resource and environmental advantages and challenges. It is strategically located and has considerable oil reserves in the interior and the coastal region. This document does not aim to describe the state of the environment in Ecuador. Rather, its main objective is to provide an analytical foundation to identify the country's institutional weak...

  5. Human Resource Management in Public Higher Education in the Tempus Partner Countries. A Tempus Study. Issue 10

    Science.gov (United States)

    Dubosc, Flora; Kelo, Maria

    2011-01-01

    The aim of this study is to give an overview of the ways in which human resources are managed in public higher education institutions in the Tempus Partner Countries. It is based on a survey addressed to individuals involved in Tempus projects and on information gathered at the level of the national authorities. In all the countries covered by the…

  6. Integrative Production Technology for High-Wage Countries

    CERN Document Server

    2012-01-01

    Industrial production in high-wage countries like Germany is still at risk. Yet, there are many counter-examples in which producing companies dominate their competitors by not only compensating for their specific disadvantages in terms of factor costs (e.g. wages, energy, duties and taxes) but rather by minimising waste using synchronising integrativity as well as by obtaining superior adaptivity on alternating conditions. In order to respond to the issue of economic sustainability of industrial production in high-wage countries, the leading production engineering and material research scientists of RWTH Aachen University together with renowned companies have established the Cluster of Excellence “Integrative Production Technology for High-Wage Countries”. This compendium comprises the cluster’s scientific results as well as a selection of business and technology cases, in which these results have been successfully implemented into industrial practice in close cooperation with more than 30 companies of ...

  7. Improving maternal and neonatal departments in high and low resource settings: the opinion of local health providers.

    Science.gov (United States)

    Trevisanuto, Daniele; Bavuusuren, Bayasgalantai; Wickramasinghe, Chandani S; Dharmaratne, Saminda M; Doglioni, Nicoletta; Giordan, Alessia; Zanardo, Vincenzo; Carlo, Waldemar A

    2011-10-01

    We compared local health caregivers' opinions regarding the priority areas for improving the maternal and neonatal departments in low and high resource countries. Personnel involved in maternal and neonatal care operating in level III, teaching hospitals in four countries (Sri Lanka, Mongolia, USA, and Italy) were asked to fill out an anonymous, written questionnaire. The questionnaire was completed by 1112 out of 1265 (87.9%) participants. "Personnel's education" was classified as the first most important intervention by health providers working in high (49.0%) as well as in low (29.9%) resource countries, respectively. Improvement in salary, equipment, internet access, and organizational protocols were considered as the most important interventions by a significantly larger percentage of personnel from low resource countries in comparison with those from high resource countries. Health providers from high resource countries considered organizational aspects (to define specific roles and responsibilities) as a priority more frequently than their colleagues from low resource countries. Although education of personnel was valued as the highest priority for improving maternal and neonatal departments there are substantial differences in priorities associated with the working setting. Local caregivers' opinion may contribute to better design interventions in settings with high or limited resources.

  8. 10 Best resources on… intersectionality with an emphasis on low- and middle-income countries.

    Science.gov (United States)

    Larson, Elizabeth; George, Asha; Morgan, Rosemary; Poteat, Tonia

    2016-10-01

    Intersectionality has emerged as an important framework for understanding and responding to health inequities by making visible the fluid and interconnected structures of power that create them. It promotes an understanding of the dynamic nature of the privileges and disadvantages that permeate health systems and affect health. It considers the interaction of different social stratifiers (e.g. 'race'/ethnicity, indigeneity, gender, class, sexuality, geography, age, disability/ability, migration status, religion) and the power structures that underpin them at multiple levels. In doing so, it is a departure from previous health inequalities research that looked at these forms of social stratification in isolation from one another or in an additive manner. Despite its potential use and long history in other disciplines, intersectionality is uncommonly used in health systems research in low- and middle-income countries (LMICs). To orient readers to intersectionality theory and research, we first define intersectionality and describe its role in public health, and then we review resources on intersectionality. We found that applications in public health mostly increased after 2009, with only 14 out of 86 articles focused on LMICs. To arrive at 10 best resources, we selected articles based on the proportion of the article that was devoted to intersectionality, the strength of the intersectionality analysis, and its relevance to LMICs. The first four resources explain intersectionality as a methodology. The subsequent six articles apply intersectionality to research in LMIC with quantitative and qualitative analysis. We provide examples from India, Swaziland, Uganda and Mexico. Topics for the studies range from HIV, violence and sexual abuse to immunization and the use of health entitlements. Through these 10 resources, we hope to spark interest and open a needed conversation on the importance and use of intersectional analysis in LMICs as part of understanding people

  9. Developing an appropriate digital hearing aid for low-resource countries: a case study.

    Science.gov (United States)

    Israsena, P; Isaradisaikul, S; Noymai, A; Boonyanukul, S; Hemakom, A; Chinnarat, C; Navacharoen, N; Lekagul, S

    2013-01-01

    This paper reviews the development process and discusses the key findings which resulted from our multidisciplinary research team's effort to develop an alternative digital hearing suitable for low-resource countries such as Thailand. A cost-effective, fully programmable digital hearing aid, with its specifications benchmarking against WHO's recommendations, was systematically designed, engineered, and tested. Clinically it had undergone a full clinical trial that employed the outcome measurement protocol adopted from the APHAB, the first time implemented in Thai language. Results indicated that using the hearing aid improves user's satisfaction in terms of ease of communication, background noises, and reverberation, with clear benefit after 3 and 6 months, confirming its efficacy. In terms of engineering, the hearing aid also proved to be robust, passing all the designated tests. As the technology has successfully been transferred to a local company for the production phase, we also discuss other challenges that may arise before the device can be introduced into the market.

  10. A survey on critical care resources and practices in low- and middle-income countries.

    Science.gov (United States)

    Vukoja, Marija; Riviello, Elisabeth; Gavrilovic, Srdjan; Adhikari, Neill K J; Kashyap, Rahul; Bhagwanjee, Satish; Gajic, Ognjen; Kilickaya, Oguz

    2014-09-01

    Timely and appropriate care is the key to achieving good outcomes in acutely ill patients, but the effectiveness of critical care may be limited in resource-limited settings. This study sought to understand how to implement best practices in intensive care units (ICU) in low- and middle-income countries (LMIC) and to develop a point-of-care training and decision-support tool. An internationally representative group of clinicians performed a 22-item capacity-and-needs assessment survey in a convenience sample of 13 ICU in Eastern Europe (4), Asia (4), Latin America (3), and Africa (2), between April and July 2012. Two ICU were from low-income, 2 from low-middle-income, and 9 from upper-middle-income countries. Clinician respondents were asked about bed capacity, patient characteristics, human resources, available medications and equipment, access to education, and processes of care. Thirteen clinicians from each of 13 hospitals (1 per ICU) responded. Surveyed hospitals had median of 560 (interquartile range [IQR]: 232, 1,200) beds. ICU had a median of 9 (IQR: 7, 12) beds and treated 40 (IQR: 20, 67) patients per month. Many ICU had ≥ 1 staff member with some formal critical care training (n = 9, 69%) or who completed Fundamental Critical Care Support (n = 7, 54%) or Advanced Cardiac Life Support (n = 9, 69%) courses. Only 2 ICU (15%) used any kind of checklists for acute resuscitation. Ten (77%) ICU listed lack of trained staff as the most important barrier to improving the care and outcomes of critically ill patients. In a convenience sample of 13 ICU from LMIC, specialty-trained staff and standardized processes of care such as checklists are frequently lacking. ICU needs-assessment evaluations should be expanded in LMIC as a global priority, with the goal of creating and evaluating context-appropriate checklists for ICU best practices. Copyright © 2014 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  11. Symposium on development and utilization of biomass energy resources in developing countries. Proceedings. V. 2: Country case studies

    International Nuclear Information System (INIS)

    1995-12-01

    The present publication presents the results of three UNIDO-sponsored case studies, each with a separate abstract, concerned with perspectives of development and utilisation of biomass energy resources in Brazil, Philippines and Romania. Emphasis is put on identifying regional biomass energy resources. Policies and strategies governing as well as barriers limiting the development and utilization of biomass energy are discussed. Innovative technologies as well as technology transfer related to biomass energy utilisation are dealt with, together with economic and environmental issues

  12. Potential of resource recovery in UASB/trickling filter systems treating domestic sewage in developing countries.

    Science.gov (United States)

    Bressani-Ribeiro, T; Brandt, E M F; Gutierrez, K G; Díaz, C A; Garcia, G B; Chernicharo, C A L

    2017-04-01

    This paper aims to present perspectives for energy (thermal and electric) and nutrient (N and S) recovery in domestic sewage treatment systems comprised of upflow anaerobic sludge blanket (UASB) reactors followed by sponge-bed trickling filters (SBTF) in developing countries. The resource recovery potential was characterized, taking into account 114 countries and a corresponding population of 968.9 million inhabitants living in the tropical world, which were grouped into three desired ranges in terms of cities' size. For each of these clusters, a technological arrangement flow-sheet was proposed, depending on their technical and economic viability from our best experience. Considering the population living in cities over 100, 000 inhabitants, the potential of energy and nutrient recovery via the sewage treatment scheme would be sufficient to generate electricity for approximately 3.2 million residents, as well as thermal energy for drying purposes that could result in a 24% volume reduction of sludge to be transported and disposed of in landfills. The results show that UASB/SBTF systems can play a very important role in the sanitation and environmental sector towards more sustainable sewage treatment plants.

  13. Global risk of pharmaceutical contamination from highly populated developing countries.

    Science.gov (United States)

    Rehman, Muhammad Saif Ur; Rashid, Naim; Ashfaq, Muhammad; Saif, Ameena; Ahmad, Nasir; Han, Jong-In

    2015-11-01

    Global pharmaceutical industry has relocated from the west to Asian countries to ensure competitive advantage. This industrial relocation has posed serious threats to the environment. The present study was carried out to assess the possible pharmaceutical contamination in the environment of emerging pharmaceutical manufacturing countries (Bangladesh, China, India and Pakistan). Although these countries have made tremendous progress in the pharmaceutical sector but most of their industrial units discharge wastewater into domestic sewage network without any treatment. The application of untreated wastewater (industrial and domestic) and biosolids (sewage sludge and manure) in agriculture causes the contamination of surface water, soil, groundwater, and the entire food web with pharmaceutical compounds (PCs), their metabolites and transformed products (TPs), and multidrug resistant microbes. This pharmaceutical contamination in Asian countries poses global risks via product export and international traveling. Several prospective research hypotheses including the development of new analytical methods to monitor these PCs/TPs and their metabolites, highly resistant microbial strains, and mixture toxicity as a consequence of pharmaceutical contamination in these emerging pharmaceutical exporters have also been proposed based on the available literature. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Assessment of human resources for health programme implementation in 15 Latin American and Caribbean countries.

    Science.gov (United States)

    Dal Poz, Mario Roberto; Sepulveda, Hernan Rodrigo; Costa Couto, Maria Helena; Godue, Charles; Padilla, Monica; Cameron, Rick; Vidaurre Franco, Thais de Andrade

    2015-04-28

    The health systems in the Americas region are characterized by fragmentation and segmentation, which constitute an important barrier to expanding coverage, achieving integrated primary health care, and reducing inefficiency and discontinuity of care. An assessment of the human resources for health (HRH) programmes that have been implemented at the country level was developed as part of the measurement of the 20 HRH regional goals for 2007-2015, adopted in 2007 by the Pan American Sanitary Conference (CSPA). The exercise was a combination of academic research and the development/application of an advocacy tool involving policy makers and stakeholders to influence the decision-making in the development, implementation, or change of HRH programmes while building evidence through a structured approach based on qualitative and quantitative information and the exchange and dissemination of best practices. This paper covers the methodological challenges, as well as a summary of the main findings of the study, which included 15 countries: Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama in the Central America, Dominican Republic in the Caribbean, Chile, Colombia, Ecuador and Peru in the Andean sub region, and Argentina, Paraguay, and Uruguay in the South Cone. Despite the different contexts, the results showed that the programmes evaluated faced common challenges, such as lack of political support and financial unsustainability. The evaluation process allowed the exchange and dissemination of practices, interventions, and programmes currently running in the region. A shared lesson was the importance of careful planning of the implementation of programmes and interventions. The similarities in the problems and challenges of HRH among the participating countries highlighted the need for a cooperation programme on the evaluation and assessment of implementation strategies in the Americas region.

  15. Possible transfer of traditional energy intensive industries towards developing countries. Offers of energy resource in the CIER [Comision de Integracion Electrica Regional] area in relation to this transfer

    International Nuclear Information System (INIS)

    Facchini Ferro, A.; D'Amado Campo, R.

    1989-01-01

    Due to the steep rise in oil prices in the early 1970s, South American countries became aware of the advisability of developing their abundant and renewable hydroelectric resources. The second energy crisis of 1979 pushed up oil prices still further and the consequences in the South American electricity sector included contractions in markets, overcapacity, and difficult financial circumstances. Increases in exports were seen as a way to reduce the burden of those countries' heavy debts and to improve economic conditions. To harmonize the interests of development of highly energy intensive industries in developed countries and the economic development of developing countries, the possibility of marketing energy as an industrial input should be considered. Evidence of the advantages that South American countries can offer to such industrial transfers is presented. These countries offer a source of plentiful hydropower from installations in operation, under construction, or projected as major developments. These installations are already largely interconnected through high- and extra-high-voltage power transmission networks. Technical information is given on the installed generating capacities, including thermal reserve plants; utilization levels; transmission line interconnections; and remaining renewable and non-renewable energy resources. Considerations regarding the political and financial implications of industrial transfers are discussed. 6 refs., 9 figs

  16. Joint Evaluation of the Wave and Offshore Wind Energy Resources in the Developing Countries

    Directory of Open Access Journals (Sweden)

    Eugen Rusu

    2017-11-01

    Full Text Available The objective of the present work is to assess the global wind and wave resources in the vicinity of some developing countries by evaluating 16-year of data (2001–2016, coming from the European Centre for Medium range Weather Forecast (ECMWF. Until now, not much work has been done to evaluate and use the renewable energy sources from these marine environments. This is because most of the attention was focused on more promising areas, such as the European coasts, which are more advanced in terms of technical and economical aspects. A general perspective of the current energy market from the selected target areas is first presented, indicating at the same time the progresses that have been reported in the field of the renewable energy. Besides the spatial and seasonal variations of the marine resources considered, the results also indicate the energy potential of these coastal environments as well as the performances of some offshore wind turbines, which may operate in these regions.

  17. Why do managers allocate resources to workplace health promotion programmes in countries with national health coverage?

    Science.gov (United States)

    Downey, Angela M; Sharp, David J

    2007-06-01

    There is extensive evidence that worksite health promotion (WHP) programmes reduce healthcare costs and improve employee productivity. In many countries, a large proportion of healthcare costs are borne by the state. While the full benefits of WHP are still created, they are shared between employers and the state, even though the employer bears the full (after-tax) cost. Employers therefore have a lower incentive to implement WHP activity. We know little about the beliefs of managers with decision responsibility for the approval and implementation of WHP programmes in this context. This article reports the results of a study of the attitudes of Canadian senior general managers (GMs) and human resource managers (HRMs) in the auto parts industry in Ontario, Canada towards the consequences of increasing discretionary spending on WHP, using Structural Equation Modelling and the Theory of Planned Behaviour. We identified factors that explain managers' intentions to increase discretionary spending on wellness programmes. While both senior GMs and HRMs are motivated primarily by their beliefs that WHP reduces indirect costs of health failure, GMs were also motivated by their moral responsibility towards employees (but surprisingly HRMs were not). Importantly, HRMs, who usually have responsibility for WHP, felt constrained by a lack of power to commit resources. Most importantly, we found no social expectation that organizations should provide WHP programmes. This has important implications in an environment where the adoption of WHP is very limited and cost containment within the healthcare system is paramount.

  18. Decision Support Systems for Water Resources Management in Developing Countries: Learning from Experiences in Africa

    Directory of Open Access Journals (Sweden)

    Carlo Giupponi

    2013-06-01

    Full Text Available Decision support system (DSS tools are rather popular in the literature on water resources management. The European Project “Splash” conducted a survey of the literature and of DSS implementation in developing countries with specific reference on Africa. Experts in the field were consulted through an ad hoc questionnaire and interviews. The results of the survey indicate that the exchange of experiences amongst projects with similar objectives or even the same case study is very limited, with a tendency towards restarting every time from scratch. As a consequence, it seems that DSS developments have produced only limited positive impacts. Most experts contacted shared either the frustration deriving from the limited impacts on intended end-users, who rarely used the tool after the project end, or in the case of ongoing projects, the preoccupation for future maintenance. Responses from the questionnaires indicate that priority efforts should not focus on developing the tools, but rather on improving the effectiveness and applicability of integrated water resource management legislative and planning frameworks, training and capacity building, networking and cooperation, harmonization of transnational data infrastructures and, very importantly, learning from past experiences and adopting enhanced protocols for DSS development.

  19. Clinical Neurophysiology Training in a Developing Country: Institutional Resources and Profiles.

    Science.gov (United States)

    Sámano, Arturo G; Ochoa Mena, José D; Padilla, Silvana P; Acevedo, Gerardo R; Orenday Barraza, José M; San-Juan, Daniel

    2018-05-01

    The purpose of this study was to describe the characteristics and preferences of clinical neurophysiology (CN) fellows, as well as the resources available for their training, in a developing country such as Mexico. An online survey (25 questions) was given to Mexican CN fellows from May to June 2017, covering their reasons for choosing the CN subspecialty, their activities, future plans, institutional resources, and administrative staff. Descriptive statistics were used. Total respondents: 20/22 (90%), 65% female from 7 CN centers (80% public and 20% private hospitals) in Mexico City. Seventy-five percent chose CN out of personal interest, and all were not unsatisfied with their academic program. Most plan to work in private practice (75%) and are interested in learning EEG (85%) and intraoperative monitoring (75%-85%). The highest-reported training time by CN area allocated by the programs was as follows: EEG (27%), electromyography (22%), and evoked potentials (16%). The average number of fellows per center was 4; 75% of the centers perform epilepsy surgery, of which 60% offer invasive intracranial studies for the evaluation of surgical candidates. Mexican CN fellows are satisfied with their choice and with the academic program. They are increasingly interested in intraoperative monitoring, which is not addressed in current Mexican CN Programs.

  20. Leadership Development of Rehabilitation Professionals in a Low-Resource Country: A Transformational Leadership, Project-Based Model.

    Science.gov (United States)

    Pascal, Maureen Romanow; Mann, Monika; Dunleavy, Kim; Chevan, Julia; Kirenga, Liliane; Nuhu, Assuman

    2017-01-01

    This paper presents an overview of the activities and outcomes of the Leadership Institute (LI), a short-term leadership development professional development course offered to physiotherapists in a low-resource country. Previous studies have provided examples of the benefits of such programs in medicine and nursing, but this has yet to be documented in the rehabilitation literature. The prototype of leadership development presented may provide guidance for similar trainings in other low-resource countries and offer the rehabilitation community an opportunity to build on the model to construct a research agenda around rehabilitation leadership development. The course used a constructivist approach to integrate participants' experiences, background, beliefs, and prior knowledge into the content. Transformational leadership development theory was emphasized with the generation of active learning projects, a key component of the training. Positive changes after the course included an increase in the number of community outreach activities completed by participants and increased involvement with their professional organization. Thirteen leadership projects were proposed and presented. The LI provided present and future leaders throughout Rwanda with exposure to transformative leadership concepts and offered them the opportunity to work together on projects that enhanced their profession and met the needs of underserved communities. Challenges included limited funding for physiotherapy positions allocated to hospitals in Rwanda, particularly in the rural areas. Participants experienced difficulties in carrying out leadership projects without additional funding to support them. While the emphasis on group projects to foster local advocacy and community education is highly recommended, the projects would benefit from a strong long-term mentorship program and further budgeting considerations. The LI can serve as a model to develop leadership skills and spur professional

  1. E-learning in medical education in resource constrained low- and middle-income countries.

    Science.gov (United States)

    Frehywot, Seble; Vovides, Yianna; Talib, Zohray; Mikhail, Nadia; Ross, Heather; Wohltjen, Hannah; Bedada, Selam; Korhumel, Kristine; Koumare, Abdel Karim; Scott, James

    2013-02-04

    In the face of severe faculty shortages in resource-constrained countries, medical schools look to e-learning for improved access to medical education. This paper summarizes the literature on e-learning in low- and middle-income countries (LMIC), and presents the spectrum of tools and strategies used. Researchers reviewed literature using terms related to e-learning and pre-service education of health professionals in LMIC. Search terms were connected using the Boolean Operators "AND" and "OR" to capture all relevant article suggestions. Using standard decision criteria, reviewers narrowed the article suggestions to a final 124 relevant articles. Of the relevant articles found, most referred to e-learning in Brazil (14 articles), India (14), Egypt (10) and South Africa (10). While e-learning has been used by a variety of health workers in LMICs, the majority (58%) reported on physician training, while 24% focused on nursing, pharmacy and dentistry training. Although reasons for investing in e-learning varied, expanded access to education was at the core of e-learning implementation which included providing supplementary tools to support faculty in their teaching, expanding the pool of faculty by connecting to partner and/or community teaching sites, and sharing of digital resources for use by students. E-learning in medical education takes many forms. Blended learning approaches were the most common methodology presented (49 articles) of which computer-assisted learning (CAL) comprised the majority (45 articles). Other approaches included simulations and the use of multimedia software (20 articles), web-based learning (14 articles), and eTutor/eMentor programs (3 articles). Of the 69 articles that evaluated the effectiveness of e-learning tools, 35 studies compared outcomes between e-learning and other approaches, while 34 studies qualitatively analyzed student and faculty attitudes toward e-learning modalities. E-learning in medical education is a means to an end

  2. E-learning in medical education in resource constrained low- and middle-income countries

    Science.gov (United States)

    2013-01-01

    Background In the face of severe faculty shortages in resource-constrained countries, medical schools look to e-learning for improved access to medical education. This paper summarizes the literature on e-learning in low- and middle-income countries (LMIC), and presents the spectrum of tools and strategies used. Methods Researchers reviewed literature using terms related to e-learning and pre-service education of health professionals in LMIC. Search terms were connected using the Boolean Operators “AND” and “OR” to capture all relevant article suggestions. Using standard decision criteria, reviewers narrowed the article suggestions to a final 124 relevant articles. Results Of the relevant articles found, most referred to e-learning in Brazil (14 articles), India (14), Egypt (10) and South Africa (10). While e-learning has been used by a variety of health workers in LMICs, the majority (58%) reported on physician training, while 24% focused on nursing, pharmacy and dentistry training. Although reasons for investing in e-learning varied, expanded access to education was at the core of e-learning implementation which included providing supplementary tools to support faculty in their teaching, expanding the pool of faculty by connecting to partner and/or community teaching sites, and sharing of digital resources for use by students. E-learning in medical education takes many forms. Blended learning approaches were the most common methodology presented (49 articles) of which computer-assisted learning (CAL) comprised the majority (45 articles). Other approaches included simulations and the use of multimedia software (20 articles), web-based learning (14 articles), and eTutor/eMentor programs (3 articles). Of the 69 articles that evaluated the effectiveness of e-learning tools, 35 studies compared outcomes between e-learning and other approaches, while 34 studies qualitatively analyzed student and faculty attitudes toward e-learning modalities. Conclusions E

  3. E-learning in medical education in resource constrained low- and middle-income countries

    Directory of Open Access Journals (Sweden)

    Frehywot Seble

    2013-02-01

    Full Text Available Abstract Background In the face of severe faculty shortages in resource-constrained countries, medical schools look to e-learning for improved access to medical education. This paper summarizes the literature on e-learning in low- and middle-income countries (LMIC, and presents the spectrum of tools and strategies used. Methods Researchers reviewed literature using terms related to e-learning and pre-service education of health professionals in LMIC. Search terms were connected using the Boolean Operators “AND” and “OR” to capture all relevant article suggestions. Using standard decision criteria, reviewers narrowed the article suggestions to a final 124 relevant articles. Results Of the relevant articles found, most referred to e-learning in Brazil (14 articles, India (14, Egypt (10 and South Africa (10. While e-learning has been used by a variety of health workers in LMICs, the majority (58% reported on physician training, while 24% focused on nursing, pharmacy and dentistry training. Although reasons for investing in e-learning varied, expanded access to education was at the core of e-learning implementation which included providing supplementary tools to support faculty in their teaching, expanding the pool of faculty by connecting to partner and/or community teaching sites, and sharing of digital resources for use by students. E-learning in medical education takes many forms. Blended learning approaches were the most common methodology presented (49 articles of which computer-assisted learning (CAL comprised the majority (45 articles. Other approaches included simulations and the use of multimedia software (20 articles, web-based learning (14 articles, and eTutor/eMentor programs (3 articles. Of the 69 articles that evaluated the effectiveness of e-learning tools, 35 studies compared outcomes between e-learning and other approaches, while 34 studies qualitatively analyzed student and faculty attitudes toward e-learning modalities

  4. If diversification is good, why don't countries diversify more? The political economy of diversification in resource-rich countries

    International Nuclear Information System (INIS)

    Wiig, Arne; Kolstad, Ivar

    2012-01-01

    For resource-rich countries, diversification is claimed to represent a strategy for reducing resource curse problems. This, however, depends on whether diversification has a positive effect on the country's institutions. While there is a lot of evidence that exports of oil have a negative impact on institutions, we know much less about the extent to which diversification leads to better institutions. This article applies recent political economy theory to the phenomenon of diversification. Theoretical arguments suggest that it is the pattern of industrial activity rather than diversification per se, which affects institutions like democracy. In other words, not all forms of diversification lead to better institutions. Furthermore, where diversification has a positive impact on institutions, diversification may be difficult to attain when it threatens the power base of the ruling elite. A possible implication of these arguments is that policies for diversification should focus on international regulation affecting elite incentives, rather than domestic industrial policy. - Highlights: ► Diversification can be a strategy for reducing resource curse problems in oil-rich countries. ► But this requires that diversification has a positive effect on the institutions of a country. ► It is the pattern of industrial activity rather than diversification per se, which affects institutions like democracy. ► Diversification may be difficult to attain when it threatens the power basis of the ruling elite. ► Policies for diversification should focus on international ruling affect elite incentives, rather than home industrial policy.

  5. Symposium on development and utilization of biomass energy resources in developing countries. Proceedings. V. 2: Country case studies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    The present publication presents the results of three UNIDO-sponsored case studies, each with a separate abstract, concerned with perspectives of development and utilisation of biomass energy resources in Brazil, Philippines and Romania. Emphasis is put on identifying regional biomass energy resources. Policies and strategies governing as well as barriers limiting the development and utilization of biomass energy are discussed. Innovative technologies as well as technology transfer related to biomass energy utilisation are dealt with, together with economic and environmental issues Refs, figs, tabs

  6. Global Pediatric Oncology: Lessons From Partnerships Between High-Income Countries and Low- to Mid-Income Countries

    Science.gov (United States)

    Antillon, Federico; Pedrosa, Francisco; Pui, Ching-Hon

    2016-01-01

    Partnerships between medical institutions in high-income countries (HICs) and low- to mid-income countries (LMICs) have succeeded in initiating and expanding pediatric cancer control efforts. The long-term goal is consistently a sustainable national pediatric cancer program. Here, we review the elements required for successful implementation, development, and long-term sustainability of pediatric cancer programs in LMICs that first arise as partnerships with institutions in HICs. Although plans must be adapted to each country's resources, certain components are unfailingly necessary. First, an essential step is provision of treatment regardless of ability to pay. Second, financial support for program development and long-term sustainability must be sought from sources both international and local, public and private. A local leader, typically a well-trained pediatric oncologist who devotes full-time effort to the project, should direct medical care and collaborate with hospital, governmental, and community leadership and international agencies. Third, nurses must be trained in pediatric cancer care and allowed to practice this specialty full-time. It is also essential to develop a grassroots organization, such as a foundation, dedicated solely to pediatric oncology. Its members must be trained and educated to provide pediatric cancer advocacy, fundraising, and (in concert with government) program sustainability. Finally, a project mentor in the HIC is crucial and should explore the possibility of collaborative research in the LMIC, which may offer significant opportunities. Relationships between the partnership's leaders and influential individuals in the community, hospital, grassroots foundation, and government will lay the foundation for productive collaboration and a sustainable pediatric oncology program. PMID:26578620

  7. The impact of health care resources, socioeconomic status, and demographics on life expectancy: a cross-country study in three Southeast Asian countries.

    Science.gov (United States)

    Chan, Moon Fai

    2015-03-01

    This study aimed to examine the impact of health care resources, socioeconomic status, and demographic changes on life expectancy in Indonesia, Philippines, and Vietnam. This was a cross-country study to collect annual data (1980-2008) from each target country. Life expectancy was the dependent variable and health care resources, socioeconomic status, and demographics were the 3 main determinants. Structural equation modeling was employed, and the results indicate that the availability of more health care resources (Indonesia: coefficient = .47, P = .008; Philippines: coefficient = .48, P = .017; Vietnam: coefficient = .48, P = .004) and higher levels of socioeconomic advantages (Indonesia: coefficient = .41, P = .014; Vietnam: coefficient = .34, P = .026) are more likely to increase life expectancy. In contrast, demographic changes are more likely to increase life expectancy because of the wide range of health care resources. These findings suggest that more effort, particularly during economic downturns, should be put into removing the barriers that impede access to health care services and increasing preventive care for the population that currently has less access to health care in communities where there is a shortage of medical resources. © 2013 APJPH.

  8. Is nonoperative management of adhesive intestinal obstruction applicable to children in a resource-poor country?

    Directory of Open Access Journals (Sweden)

    Osifo Osarumwense

    2010-01-01

    Full Text Available Background: Nonoperative management of adhesive intestinal obstruction gives good results in adults but there are scant studies on its outcome in children. This study reports outcomes and experiences with nonoperative and operative management of adhesive intestinal obstruction in children in a resource-poor country. Patients and Methods: This is a retrospective analysis of records of children who were managed with adhesive intestinal obstruction at the University of Benin Teaching Hospital between January 2002 and December 2008. Results: Adhesive intestinal obstruction accounted for 21 (8.8% of 238 children managed with intestinal obstruction. They were aged between 7 weeks and 16 years (mean 3 ± 6.4 years, comprising 13 males and eight females (ratio 1.6:1. Prior laparotomy for gangrenous/perforated intussusception (seven, 33.3%, perforated appendix (five, 23.8%, perforated volvulus (three, 14.3%, penetrating abdominal trauma (two, 9.5% and perforated typhoid (two, 9.5% were major aetiologies. Adhesive obstruction occurred between 6 weeks and 7 years after the index laparotomies. All the 21 children had initial nonoperative management without success, owing to lack of total parenteral nutrition and monitoring facilities. Outcomes of open adhesiolysis performed between 26 and 48 h in six (28.6% children due to poor response to nonoperative management, 11-13 days in 12 (57.1% who responded minimally and 2-5 weeks in three (14.3% who had relapse of symptoms were encouraging. Exploration of the 21 adhesive obstructions confirmed small bowel obstruction due to solitary bands (two, 9.5%, multiple bands/adhesions (13, 61.9% and encasement, including one bowel gangrene (six, 28.6%. Postoperatively, the only child who had recurrence during 1-6 years of follow-up did well after a repeat adhesiolysis. Conclusion: Nonoperative management was unsuccessful in this setting. Open adhesiolysis may be adopted in children to prevent avoidable morbidities and

  9. Examining Container Port Resources and Environments to Enhance Competitiveness: A Cross-Country Study from Resource-Based and Institutional Perspectives1

    Directory of Open Access Journals (Sweden)

    Hyuksoo CHO

    2015-09-01

    Full Text Available This study aims to analyze the competitiveness of container ports using a cross-country analysis with theoretical foundations. Tangible and intangible resources are discussed as determinants of container port competitiveness using the resource-based view and the institutional theory. This study analyzes the relationships among six variables: container port competitiveness, traffic volume, quality of infrastructure, linear shipping connectivity, operating efficiency, and institutional influence. This study retrieved country-level data on different indicators and countries from several trade and maritime databases. Structural Equation Modeling (SEM is used to test various hypotheses and to evaluate the casual relationships among six variables. Additionally, Ordinary Least Squares (OLS regression is used to test the moderating effects of institutional influence.

  10. The role of food-security solutions in the protection of natural resources and environment of developing countries.

    Science.gov (United States)

    Lashgarara, Farhad; Mirdamadi, Seyyed Mehdi; Hosseini, Seyyed Jamal Farajollah; Chizari, Mohammad

    2008-10-01

    The majority of the countries of the world, especially developing countries, face environmental problems. Limitations of basic resources (water and soil) and population growth have been the cause of these environmental problems that countries are confronted with. Developing countries have numerous problems, including destruction of forests, vegetable and animal species, and pollution of the environment. Damage to natural resources and the environment can influence the food-security situation. One of the main millennium development goals (MDGs) is protection of the environment and people's health. This cannot obtained unless there is ensured food security. Food security has been defined as a situation when all people, at all times, have physical and economic access to sufficient, safe, and nutritious food needed to maintain a healthy and active life. At the same time, with ensured food security, we can hope to protect the natural resources and environment. The methodology used is descriptive-analytical, and its main purpose is determining the importance and role of food-security solutions in the reduction of environmental hazards and improvement of natural resources and the environmental situation in developing countries. Therefore, some of the most important food-security solutions that can play an important role in this relation were discussed, including conventional research-based technology, biotechnology, information and communication technologies (ICTs), alternative energy sources, and food irradiation.

  11. Global Surgery 2030: a roadmap for high income country actors

    Science.gov (United States)

    Greenberg, Sarah L M; Abdullah, Fizan; Amado, Vanda; Anderson, Geoffrey A; Cossa, Matchecane; Costas-Chavarri, Ainhoa; Davies, Justine; Debas, Haile T; Dyer, George S M; Erdene, Sarnai; Farmer, Paul E; Gaumnitz, Amber; Hagander, Lars; Haider, Adil; Leather, Andrew J M; Lin, Yihan; Marten, Robert; Marvin, Jeffrey T; McClain, Craig D; Meara, John G; Meheš, Mira; Mock, Charles; Mukhopadhyay, Swagoto; Orgoi, Sergelen; Prestero, Timothy; Price, Raymond R; Raykar, Nakul P; Riesel, Johanna N; Riviello, Robert; Rudy, Stephen M; Saluja, Saurabh; Sullivan, Richard; Tarpley, John L; Taylor, Robert H; Telemaque, Louis-Franck; Toma, Gabriel; Varghese, Asha; Walker, Melanie; Yamey, Gavin; Shrime, Mark G

    2016-01-01

    The Millennium Development Goals have ended and the Sustainable Development Goals have begun, marking a shift in the global health landscape. The frame of reference has changed from a focus on 8 development priorities to an expansive set of 17 interrelated goals intended to improve the well-being of all people. In this time of change, several groups, including the Lancet Commission on Global Surgery, have brought a critical problem to the fore: 5 billion people lack access to safe, affordable surgical and anaesthesia care when needed. The magnitude of this problem and the world's new focus on strengthening health systems mandate reimagined roles for and renewed commitments from high income country actors in global surgery. To discuss the way forward, on 6 May 2015, the Commission held its North American launch event in Boston, Massachusetts. Panels of experts outlined the current state of knowledge and agreed on the roles of surgical colleges and academic medical centres; trainees and training programmes; academia; global health funders; the biomedical devices industry, and news media and advocacy organisations in building sustainable, resilient surgical systems. This paper summarises these discussions and serves as a consensus statement providing practical advice to these groups. It traces a common policy agenda between major actors and provides a roadmap for maximising benefit to surgical patients worldwide. To close the access gap by 2030, individuals and organisations must work collectively, interprofessionally and globally. High income country actors must abandon colonial narratives and work alongside low and middle income country partners to build the surgical systems of the future. PMID:28588908

  12. Symposium on development and utilization of biomass energy resources in developing countries. Proceedings. V. 1: Thematic papers

    International Nuclear Information System (INIS)

    1995-12-01

    The present publication consists of papers, each with a separate abstract, from fourteen countries giving broad perspectives on the development and utilisation of biomass energy resources. Emphasis is put on identifying regional biomass energy resources. Policies and strategies governing as well as barriers limiting the development and utilization of biomass energy are discussed. Innovative technologies as well as technology transfer related to biomass energy utilisation are dealt with, together with economic and environmental issues

  13. Symposium on development and utilization of biomass energy resources in developing countries. Proceedings. V. 1: Thematic papers

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    The present publication consists of papers, each with a separate abstract, from fourteen countries giving broad perspectives on the development and utilisation of biomass energy resources. Emphasis is put on identifying regional biomass energy resources. Policies and strategies governing as well as barriers limiting the development and utilization of biomass energy are discussed. Innovative technologies as well as technology transfer related to biomass energy utilisation are dealt with, together with economic and environmental issues Refs, figs, tabs

  14. Equity in the allocation of public sector financial resources in low- and middle-income countries: a systematic literature review.

    Science.gov (United States)

    Anselmi, Laura; Lagarde, Mylene; Hanson, Kara

    2015-05-01

    This review aims to identify, assess and analyse the evidence on equity in the distribution of public health sector expenditure in low- and middle-income countries. Four bibliographic databases and five websites were searched to identify quantitative studies examining equity in the distribution of public health funding in individual countries or groups of countries. Two different types of studies were identified: benefit incidence analysis (BIA) and resource allocation comparison (RAC) studies. Quality appraisal and data synthesis were tailored to each study type to reflect differences in the methods used and in the information provided. We identified 39 studies focusing on African, Asian and Latin American countries. Of these, 31 were BIA studies that described the distribution, typically across socio-economic status, of individual monetary benefit derived from service utilization. The remaining eight were RAC studies that compared the actual expenditure across geographic areas to an ideal need-based distribution. Overall, the quality of the evidence from both types of study was relatively weak. Looking across studies, the evidence confirms that resource allocation formulae can enhance equity in resource allocation across geographic areas and that the poor benefits proportionally more from primary health care than from hospital expenditure. The lack of information on the distribution of benefit from utilization in RAC studies and on the countries' approaches to resource allocation in BIA studies prevents further policy analysis. Additional research that relates the type of resource allocation mechanism to service provision and to the benefit distribution is required for a better understanding of equity-enhancing resource allocation policies. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  15. The carbon curse: Are fuel rich countries doomed to high CO2 intensities?

    International Nuclear Information System (INIS)

    Friedrichs, Jörg; Inderwildi, Oliver R.

    2013-01-01

    The carbon curse is a new theory, related to but distinct from the resource curse. It states that fossil-fuel rich countries tend to follow more carbon-intensive developmental pathways than [if they were] fossil-fuel poor countries, due to a hitherto unappreciated syndrome of causal mechanisms. First, fuel rich countries emit significant amounts of CO 2 in the extraction of fuel and through associated wasteful practices such as gas flaring. Second, easy access to domestic fuel in such countries leads to crowding-out effects for their energy mix and economic structure (for example, abundant oil may displace other fuels from the energy mix and lead to the “Dutch Disease”). Third, fuel abundance weakens the economic incentive to invest in energy efficiency. Fourth, governments in fuel rich countries are under considerable pressure to grant uneconomic fuel consumption subsidies, which further augments the carbon intensity of their economic output. Due to the combined effect of these causal mechanisms, it is genuinely difficult for fuel rich countries to evade carbon-intensive developmental pathways. And yet there are remarkable exceptions like Norway. Such positive outliers indicate that the carbon curse is not destiny when appropriate policies are adopted. - Highlights: • Fuel rich countries appear doomed to high carbon intensity, for four reasons. • First, extractive emissions; and, second, fuel-related crowding-out effects. • Third, weaker incentives to invest in improvements of energy efficiency. • Fourth, significant pressure to grant uneconomic fuel consumption subsidies. • But the carbon curse is not destiny, as indicated by positive outliers like Norway

  16. Human resource management interventions to improve health workers' performance in low and middle income countries : a realist review

    NARCIS (Netherlands)

    Dieleman, Marjolein; Gerretsen, Barend; van der Wilt, Gert Jan

    2009-01-01

    BACKGROUND: Improving health workers' performance is vital for achieving the Millennium Development Goals. In the literature on human resource management (HRM) interventions to improve health workers' performance in Low and Middle Income Countries (LMIC), hardly any attention has been paid to the

  17. Human resource management interventions to improve health workers' performance in low and middle income countries: a realist review.

    NARCIS (Netherlands)

    Dieleman, M.; Gerretsen, B.; Wilt, G.J. van der

    2009-01-01

    BACKGROUND: Improving health workers' performance is vital for achieving the Millennium Development Goals. In the literature on human resource management (HRM) interventions to improve health workers' performance in Low and Middle Income Countries (LMIC), hardly any attention has been paid to the

  18. GROWTH PERFORMANCE OF MENA AND AFRICAN COUNTRIES: IMPACTS OF THE VARIATIONS IN LAND AND NATURAL RESOURCE OWNERSHIP

    Directory of Open Access Journals (Sweden)

    Ece H. Guleryuz

    2017-12-01

    Full Text Available This paper examines the primary determinants of the contemporary economic growth performance in MENA and African countries using a panel data estimation and random effects model during the period 1996-2014 for 24 countries. It is hypothesized that the variation in natural resources rents, initial human capital stock, and initial inequality in land ownership have significant impacts on contemporary economic growth rates in different countries. Furthermore, various political economy factors are controlled for in order to measure the effect of institutional quality. The estimation results show that the natural resources rents, initial inequality in land ownership, initial income, and government effectiveness influence GDP per capita growth rates with a statistical significance.

  19. The global burden of visual difficulty in low, middle, and high income countries.

    Directory of Open Access Journals (Sweden)

    Ellen E Freeman

    Full Text Available Using a world-wide, population-based dataset of adults, we sought to determine the frequency of far visual difficulty and its associated risk factors.The World Health Survey (WHS was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design of adults ages 18 years and older. Far vision was assessed by asking "In the last 30 days, how much difficulty did you have in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters?". Responses included none, mild, moderate, severe, or extreme/unable. The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank. Prevalence and regression estimates were adjusted to account for the complex sample design.21% of adults reported any visual difficulty. The rate varied by the income status of the country with the percentage who had any visual difficulty being 24%, 23%, and 13% in low, middle, and high income countries, respectively. Five percent of people reported severe or extreme visual difficulty with rates in low, middle, and high income countries of 6%, 5%, and 2% respectively. Risk factors for visual difficulty included older age, female sex, poorer socioeconomic status, little to no formal education, and diabetes (P<0.05.One out of five adults in the WHS reported some degree of far visual difficulty. Given the importance of vision to living an independent life, better access to quality eye care services and life course factors affecting vision health (e.g. repeated eye infections, diet lacking vitamin A must receive adequate attention and resources, especially in low and middle income countries.

  20. Country report present status and need of human resource development in nuclear field in Vietnam

    International Nuclear Information System (INIS)

    Ngo Qui Viet; Vu Dang Ninh

    2000-01-01

    Vietnam Atomic Energy Commission (VAEC) was officially established in 1976, and is a national research and development organization in the field of nuclear science and technology for peaceful purposes in Vietnam. Under the VAEC, there are three institutes and one center. Status of main facilities, such as TRIGA MARK II, neutron generator, electron accelerator MT-17, and irradiation facilities are outlined in the paper. At present, the VAEC has a total staff of about 540 persons. The number of staff appears adequate to fulfill the present task on application of isotopes and nuclear techniques. When Vietnam decides to develop nuclear power program, the demand for human resources will be significantly high. During the last five years, Vietnam has been developing and implementing a national regulatory program on Radiation Protection and Nuclear Safety. The Ministry of Science, Technology and Environment (MOSTE) have established independent Vietnam Radiation Protection and Nuclear Safety Authority (VRPA) in 1994. If the Vietnamese Government approves the proposed nuclear power program, human resources training should be a key point for all research and development directions at all revel of personnel. When looking back in the history of formation and development of nuclear science and technology in Vietnam, the international cooperation has played an extremely important role in promoting the program. The exchange of information and direct participation in concrete cooperation activities under the framework of the Forum are expected. (Tanaka, Y.)

  1. Country report present status and need of human resource development in nuclear field in Vietnam

    Energy Technology Data Exchange (ETDEWEB)

    Ngo Qui Viet [Department of Organization and Scientific Human Resource Development, The Ministry of Science, Technology and Environment, Hanoi (Viet Nam); Vu Dang Ninh [Department of Administration and Personnel, The Vietnam Atomic Energy Commission, Hanoi (Viet Nam)

    2000-12-01

    Vietnam Atomic Energy Commission (VAEC) was officially established in 1976, and is a national research and development organization in the field of nuclear science and technology for peaceful purposes in Vietnam. Under the VAEC, there are three institutes and one center. Status of main facilities, such as TRIGA MARK II, neutron generator, electron accelerator MT-17, and irradiation facilities are outlined in the paper. At present, the VAEC has a total staff of about 540 persons. The number of staff appears adequate to fulfill the present task on application of isotopes and nuclear techniques. When Vietnam decides to develop nuclear power program, the demand for human resources will be significantly high. During the last five years, Vietnam has been developing and implementing a national regulatory program on Radiation Protection and Nuclear Safety. The Ministry of Science, Technology and Environment (MOSTE) have established independent Vietnam Radiation Protection and Nuclear Safety Authority (VRPA) in 1994. If the Vietnamese Government approves the proposed nuclear power program, human resources training should be a key point for all research and development directions at all revel of personnel. When looking back in the history of formation and development of nuclear science and technology in Vietnam, the international cooperation has played an extremely important role in promoting the program. The exchange of information and direct participation in concrete cooperation activities under the framework of the Forum are expected. (Tanaka, Y.)

  2. Delivering affordable cancer care in high-income countries.

    Science.gov (United States)

    Sullivan, Richard; Peppercorn, Jeffrey; Sikora, Karol; Zalcberg, John; Meropol, Neal J; Amir, Eitan; Khayat, David; Boyle, Peter; Autier, Philippe; Tannock, Ian F; Fojo, Tito; Siderov, Jim; Williamson, Steve; Camporesi, Silvia; McVie, J Gordon; Purushotham, Arnie D; Naredi, Peter; Eggermont, Alexander; Brennan, Murray F; Steinberg, Michael L; De Ridder, Mark; McCloskey, Susan A; Verellen, Dirk; Roberts, Terence; Storme, Guy; Hicks, Rodney J; Ell, Peter J; Hirsch, Bradford R; Carbone, David P; Schulman, Kevin A; Catchpole, Paul; Taylor, David; Geissler, Jan; Brinker, Nancy G; Meltzer, David; Kerr, David; Aapro, Matti

    2011-09-01

    The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies

  3. Using the CMS high level trigger as a cloud resource

    International Nuclear Information System (INIS)

    Colling, David; Huffman, Adam; Bauer, Daniela; McCrae, Alison; Cinquilli, Mattia; Gowdy, Stephen; Coarasa, Jose Antonio; Ozga, Wojciech; Chaze, Olivier; Lahiff, Andrew; Grandi, Claudio; Tiradani, Anthony; Sgaravatto, Massimo

    2014-01-01

    The CMS High Level Trigger is a compute farm of more than 10,000 cores. During data taking this resource is heavily used and is an integral part of the experiment's triggering system. However, outside of data taking periods this resource is largely unused. We describe why CMS wants to use the HLT as a cloud resource (outside of data taking periods) and how this has been achieved. In doing this we have turned a single-use cluster into an agile resource for CMS production computing. While we are able to use the HLT as a production cloud resource, there is still considerable further work that CMS needs to carry out before this resource can be used with the desired agility. This report, therefore, represents a snapshot of this activity at the time of CHEP 2013.

  4. Neo-Industrial and Sustainable Development of Russia as Mineral Resources Exploiting Country

    Science.gov (United States)

    Prokudina, Marina; Zhironkina, Olga; Kalinina, Oksana; Gasanov, Magerram; Agafonov, Felix

    2017-11-01

    In the Russian economy, the world leadership in the extraction of different mineral resources is combined with the potential for their processing and a significant scientific sector. Innovative development of raw materials extraction is impossible without the parallel technological modernization of the high-tech sector. In general, the complex of these processes is a neo-industrialization of the economy. Neo-industrially oriented transformation of the economy reflects complex changes in its structure, the transformation of established stable relationships between various elements of the system of social production that determine macroeconomic proportions. Neo-industrial transformations come along with the modification of economic relations associated with investments, innovations, labor and income distribution, with the process of locating productive forces and regulating the economy by the government. Neo-industrialization of economy is not only significant changes in its technological and reproductive structure (the development of high-tech industries, the integration of science and industry), but, above all, the implementation of a system structural policy of innovative development of raw material industry and the recovery of manufacturing industries on a new technological basis.

  5. Development challenges of resource-rich countries: the case of oil ...

    African Journals Online (AJOL)

    This paper discusses some of the challenges that confront oil-rich developing countries in their development quest. It stresses that one of the surest ways governments in oil-rich developing countries have at their disposal to avoid the so-called curse of oil is through the insulation of fiscal policy from the volatility associated ...

  6. Overseas oil-development policy of resource-poor countries: A case study from Japan

    International Nuclear Information System (INIS)

    Koike, Masanari; Mogi, Gento; Albedaiwi, Waleed H.

    2008-01-01

    Japan, currently the world's third largest oil consumer, depends on imports for almost all of its oil needs. Owing to this high level of dependence, Japanese citizens as well as the economy have historically been vulnerable. In the past, certain incidents caused by the interruption of oil imports have resulted in fatal damages to the country. In order to reduce these risks, the Japanese government has supported overseas exploration and development activities of the domestic upstream oil industry, which has not proven as successful as expected. This paper presents the experiences, policies, and the structure of Japan's attempts to increase the share of domestic oil needs met by development activities. While conducting this study, both internal and external constraints were encountered. In addition to the lack of domestic oil reserves, factors including the institutional design of cooperation between government and private industries, the early history of the upstream industry, the target area of overseas development, and the changing environment have created impediments toward achieving the targets. In 2006, Japan again set a new target for doubling the ratio of self-developed oil in its total imports by 2030, and will face challenges in clearing the above-mentioned hurdles

  7. GLOBAL PROSPECTS OF SYNTHETIC DIESEL FUEL PRODUCED FROM HYDROCARBON RESOURCES IN OIL&GAS EXPORTING COUNTRIES

    Directory of Open Access Journals (Sweden)

    Tomislav Kurevija

    2007-12-01

    Full Text Available Production of synthetic diesel fuel through Fischer-Tropsch process is a well known technology which dates from II World War, when Germany was producing transport fuel from coal. This process has been further improved in the South Africa due to period of international isolation. Today, with high crude oil market cost and increased demand of energy from China and India, as well as global ecological awareness and need to improve air quality in urban surroundings, many projects are being planned regarding production of synthetic diesel fuel, known as GTL (Gas To Liquid. Most of the future GTL plants are planned in oil exporting countries, such are Qatar and Nigeria, where natural gas as by-product of oil production is being flared, losing in that way precious energy and profit. In that way, otherwise flared natural gas, will be transformed into synthetic diesel fuel which can be directly used in all modern diesel engines. Furthermore, fossil fuel transportation and distribution technology grid can be used without any significant changes. According to lower emissions of harmful gasses during combustion than fossil diesel, this fuel could in the future play a significant part of EU efforts to reach 23% of alternative fuel share till 2020., which are now mostly relied on biodiesel, LPG (liquefied petroleum gas and CNG (compressed natural gas.

  8. Country-scale phosphorus balancing as a base for resources conservation

    NARCIS (Netherlands)

    Seyhan, D.

    2009-01-01

    In order to effectively conserve the non-renewable resource phosphorus (P), flows and stocks of P must be known at national, regional and global scales. P is a key non-renewable resource because its use as fertilizer cannot be substituted posing a constraint on the global food production in the

  9. Integration study of high quality teaching resources in universities

    Directory of Open Access Journals (Sweden)

    Honglu Liu

    2012-12-01

    Full Text Available Purpose: The development level and quality of education depend on the merits and efficiency in the use of teaching resources, especially in the case of obvious contradiction between the demand and supply of teaching resources. So to integrate teaching resources, improve the efficiency in the use of high quality teaching resources, and take the road of content development to enhance the competitiveness of education has become very important and urgent.Design/methodology/approach: On the basis of analysis on the teaching resources of universities and the problems they faced, this paper introduced the basic concepts of cloud storage, and built the integration architecture of high quality teaching resources in universities based on the cloud storage.Findings and Originality/value: The HDFS-based cloud storage proposed in this paper is a dynamically adjustable and Internet-based storage solution, and the users can access storage targets using the network through a common and easy-to-use protocol and application programming interfaces. This new technology is useful for end users benefits. With the continuous development and improvement of cloud storage, it will necessarily result in more and more applications in the institutions of higher learning and education network.Originality/value: This paper introduced the cloud storage into the integration of high quality teaching resources in universities first and as a new form of service, it can be a good solution.

  10. Leadership Development of Rehabilitation Professionals in a Low-Resource Country: A Transformational Leadership, Project-Based Model

    OpenAIRE

    Pascal, Maureen Romanow; Mann, Monika; Dunleavy, Kim; Chevan, Julia; Kirenga, Liliane; Nuhu, Assuman

    2017-01-01

    Background and rationale This paper presents an overview of the activities and outcomes of the Leadership Institute (LI), a short-term leadership development professional development course offered to physiotherapists in a low-resource country. Previous studies have provided examples of the benefits of such programs in medicine and nursing, but this has yet to be documented in the rehabilitation literature. The prototype of leadership development presented may provide guidance for similar tra...

  11. A Life-cycle Approach to Improve the Sustainability of Rural Water Systems in Resource-Limited Countries

    Directory of Open Access Journals (Sweden)

    Nicholas Stacey

    2012-11-01

    Full Text Available A WHO and UNICEF joint report states that in 2008, 884 million people lacked access to potable drinking water. A life-cycle approach to develop potable water systems may improve the sustainability for such systems, however, a review of the literature shows that such an approach has primarily been used for urban systems located in resourced countries. Although urbanization is increasing globally, over 40 percent of the world’s population is currently rural with many considered poor. In this paper, we present a first step towards using life-cycle assessment to develop sustainable rural water systems in resource-limited countries while pointing out the needs. For example, while there are few differences in costs and environmental impacts for many improved rural water system options, a system that uses groundwater with community standpipes is substantially lower in cost that other alternatives with a somewhat lower environmental inventory. However, a LCA approach shows that from institutional as well as community and managerial perspectives, sustainability includes many other factors besides cost and environment that are a function of the interdependent decision process used across the life cycle of a water system by aid organizations, water user committees, and household users. These factors often present the biggest challenge to designing sustainable rural water systems for resource-limited countries.

  12. High School Leadership: The Challenge of Managing Resources and Competencies

    Science.gov (United States)

    Alsaaty, Falih M.; Morris, Archie, III

    2015-01-01

    High schools play a vital role in achieving and reflecting American ideals and culture. They provide the foundation for the country's economic, social, and political systems as well as the impetus for its scientific progress and technological superiority. The purpose of this study was to explore the challenges facing high schools' leadership in…

  13. Characteristics and critical success factors for implementing problem-based learning in a human resource-constrained country.

    Science.gov (United States)

    Giva, Karen R N; Duma, Sinegugu E

    2015-08-31

    Problem-based learning (PBL) was introduced in Malawi in 2002 in order to improve the nursing education system and respond to the acute nursing human resources shortage. However, its implementation has been very slow throughout the country. The objectives of the study were to explore and describe the goals that were identified by the college to facilitate the implementation of PBL, the resources of the organisation that facilitated the implementation of PBL, the factors related to sources of students that facilitated the implementation of PBL, and the influence of the external system of the organisation on facilitating the implementation of PBL, and to identify critical success factors that could guide the implementation of PBL in nursing education in Malawi. This is an ethnographic, exploratory and descriptive qualitative case study. Purposive sampling was employed to select the nursing college, participants and documents for review.Three data collection methods, including semi-structured interviews, participant observation and document reviews, were used to collect data. The four steps of thematic analysis were used to analyse data from all three sources. Four themes and related subthemes emerged from the triangulated data sources. The first three themes and their subthemes are related to the characteristics related to successful implementation of PBL in a human resource-constrained nursing college, whilst the last theme is related to critical success factors that contribute to successful implementation of PBL in a human resource-constrained country like Malawi. This article shows that implementation of PBL is possible in a human resource-constrained country if there is political commitment and support.

  14. Types and Outcome of Fetal Urinary Anomalies in Low Resource Setting Countries: A Retrospective Study.

    Science.gov (United States)

    Shalaby, Hend; Hemida, Reda; Nabil, Hanan; Ibrahim, Mohammad

    2016-10-01

    Congenital anomalies of the kidney and urinary tract in the developing countries have a poor prognosis due to limited experience in antenatal and postnatal management. A 3-year retrospective study was carried out from January 2011 to December 2013. The following data were collected and analyzed: maternal age, gravidity, parity, gestational age at diagnosis, and ultrasonography findings. Final diagnosis after birth, the performed surgeries, follow-up data, as well as survival at one year were also analyzed. The mean age of the included patients was 28 years (range 20-35 years). The mean parity was 1.7 (range 0-4). The mean gestational age at diagnosis was 26 weeks (range 15-36 weeks). Consanguinity was reported in 10 cases (24.4 %). There were 25 males and 16 females. Bilateral renal agenesis was the commonest type (19.5 %). The anomalies of kidneys and urinary tract in our cases were associated with other anomalies in 8 cases (19.5 %). Oligohydramnios was detected in bilateral renal agenesis and posterior urethral valve. Surgical interference during the first 6 months was performed in 6 cases; pyeloplasty for unilateral or bilateral hydronephrosis was performed in 5 cases; and excision of solitary renal cyst performed in one case. By the end of the first year, two of the three cases with chronic renal disease, who were under peritoneal dialysis, died, and three cases who had undergone pyeloplasty were lost to follow-up. Among the 41 cases with antenatally diagnosed renal and urinary malformations; bilateral renal agenesis was the commonest anomaly (19.5 %). There were high rates of induction of abortion, IUFD, and neonatal deaths. The poor outcome may be due to lack of experience in performing invasive therapeutic fetal procedures.

  15. A RESOURCE-BASED VIEW OF SMALL EXPORT FIRMS' SOCIAL CAPITAL IN A SOUTHEAST ASIAN COUNTRY

    Directory of Open Access Journals (Sweden)

    Doren Chadee

    2011-07-01

    Full Text Available This study empirically examines the social capital that facilitates the flow of export knowledge, thereby supporting the entrepreneurial stance of small export firms. By applying the VRIO (value, rarity, inimitability and organisation of firm resources framework to the resource-based view (RBV of the firm, this study suggests that superior performance is a function of resources that are valuable, rare, inimitable and sufficiently organised to develop and sustain the firm's competitive advantage. This study argues that small, resource-constrained export firms in a developing economy are able to adopt entrepreneurial tactics and reap positive rates of return by exploiting their relational capital to acquire export knowledge. A survey of 175 small export firms in the Philippines was conducted, and the data were analysed using structural equation modelling. The results suggest positive relationships between the firm's social capital and export knowledge. Export knowledge is associated with entrepreneurial orientation, which then correlates with export performance.

  16. The Role of Historical Resource Constraints in Modern Gender Inequality: A Cross-Country Analysis

    OpenAIRE

    Hazarika, Gautam; Jha, Chandan Kumar; Sarangi, Sudipta

    2014-01-01

    We posit that historical resource scarcities played a role in the emergence of gender norms inimical to women that persist to this day. This thesis is supported by our finding that nations’ historical resource endowments, as measured by the historical availability of arable land, are statistically significantly negatively related to their present levels of gender inequality, as gauged by the United Nations Development Programme’s Gender Inequality Index.

  17. An investigation on e-resource utilisation among university students in a developing country: A case of Great Zimbabwe University

    Directory of Open Access Journals (Sweden)

    Talent Mawere

    2018-06-01

    Full Text Available Background: Electronic libraries are the recent development in the ever-changing technological world today. Students nowadays have the ability to carry the library wherever they are, their Internet-enabled devices being the only requirement. Most universities worldwide have subscribed to various online databases and other e-resources as a way of availing resources to their students. To their credit, most institutions of higher learning in developing countries have not been left out in this stampede.   Objectives: The study aimed at investigating the adoption and utilisation of e-resources by students at a university in a developing country.   Method: The Technology Acceptance Model (TAM model was used to conceptualise the study. A survey questionnaire was designed and distributed through social media platforms such as Facebook and WhatsApp. Quantitative data were analysed using the Statistical Package for the Social Sciences (SPSS. The Chi-squared test was used to test for casual relationships within the developed model. A thematic approach was used to analyse qualitative data. Results: Despite the fact that many Zimbabwean academic institutions have made the facility of e-libraries top agenda in their strategic plans, the adoption rate among students is still very limited. This can be attributed to a myriad of facts, inter alia, poor marketing strategies, lack of resources among the students and exorbitant data charges by Internet Service Providers (ISPs.   Conclusion: This study has provided some basic insights in utilisation of e-resources in universities of developing countries. Despite the younger generation being described as digital natives, it is, quite evident that their uptake of technological innovations especially in education is quite poor. This research will assist both researchers and management of institutions of higher learning to provide and design amicable solutions to the problem of poor utilisation of e-resources as

  18. Parental Resources and the Transition to Junior High.

    Science.gov (United States)

    Grolnick, Wendy S.; Kurowski, Carolyn O.; Dunlap, Kelly G.; Hevey, Cheryl

    2000-01-01

    This study examined whether maternal resources of involvement and autonomy support might buffer children against the negative effects of the transition to junior high. School, cognitive, and personal involvement were examined. Findings highlight the importance of the home environment in children's coping with the transition to junior high.…

  19. Migration from low- to high-risk countries:

    DEFF Research Database (Denmark)

    Kristiansen, M; Lue-Kessing, Linnea; Mygind, A

    2013-01-01

    to be caused by multiple factors, including genetics, health behaviour, stress, fertility and breastfeeding. Some women perceived breast cancer to be more prevalent in Denmark as compared with their country of birth, and perceived their risk of developing breast cancer to increase with length of stay......Migrants are less likely to participate in mammography screening programmes compared with local-born populations in Europe. We explored perceptions of breast cancer risk and the influence on participation in mammography screening programmes among migrant women born in countries with low incidence...... rates of breast cancer. We conducted eight individual interviews and six group interviews including a total of 29 women aged 50-69 years living in Copenhagen, Denmark. Women were migrants born in Somalia, Turkey, Pakistan or Arab countries. Phenomenological analysis was used. Breast cancer was perceived...

  20. The HIV Treatment Gap: Estimates of the Financial Resources Needed versus Available for Scale-Up of Antiretroviral Therapy in 97 Countries from 2015 to 2020.

    Directory of Open Access Journals (Sweden)

    Arin Dutta

    2015-11-01

    % CI 47.8, 49.6 billion under the WHO 2013 scenario, and US$52.5 (95% CI 51.4, 53.6 billion under the 90-90-90 scenario. After projecting recent external and domestic funding trends, the estimated 6-y financing gap ranges from US$19.8 billion to US$25.0 billion, depending on the costing scenario and the U.S. President's Emergency Plan for AIDS Relief contribution level, with the gap for ART commodities alone ranging from US$14.0 to US$16.8 billion. The study is limited by excluding above-facility and other costs essential to ART service delivery and by the availability and quality of country- and region-specific data.The projected number of people receiving ART across three scenarios suggests that countries are unlikely to meet the 90-90-90 treatment target (81% of people living with HIV on ART by 2020 unless they adopt a test-and-offer approach and increase ART coverage. Our results suggest that future resource needs for ART scale-up are smaller than stated elsewhere but still significantly threaten the sustainability of the global HIV response without additional resource mobilization from domestic or innovative financing sources or efficiency gains. As the world moves towards adopting the WHO 2015 guidelines, advances in technology, including the introduction of lower-cost, highly effective antiretroviral regimens, whose value are assessed here, may prove to be "game changers" that allow more people to be on ART with the resources available.

  1. High-altitude wind resources in the Middle East

    KAUST Repository

    Yip, Chak Man Andrew; Gunturu, Udaya; Stenchikov, Georgiy L.

    2017-01-01

    In the Middle East, near-surface wind resources are intermittent. However, high-altitude wind resources are abundant, persistent, and readily available and may provide alternative energy resources in this fossil-fuel-dependent region. Using wind field data from the Modern-Era Retrospective Analysis for Research and Applications Version 2 (MERRA-2), this study identifies areas favorable to the deployment of airborne wind energy (AWE) systems in the Middle East and computes the optimal heights at which such systems would best operate. AWE potential is estimated using realistic AWE system specifications and assumptions about deployment scenarios and is compared with the near-surface wind generation potential with respect to diurnal and seasonal variability. The results show the potential utility of AWE in areas in the Middle East where the energy demand is high. In particular, Oman and Saudi Arabia have a high level of the potential power generation with low annual variability.

  2. High-altitude wind resources in the Middle East

    KAUST Repository

    Yip, Chak Man Andrew

    2017-08-23

    In the Middle East, near-surface wind resources are intermittent. However, high-altitude wind resources are abundant, persistent, and readily available and may provide alternative energy resources in this fossil-fuel-dependent region. Using wind field data from the Modern-Era Retrospective Analysis for Research and Applications Version 2 (MERRA-2), this study identifies areas favorable to the deployment of airborne wind energy (AWE) systems in the Middle East and computes the optimal heights at which such systems would best operate. AWE potential is estimated using realistic AWE system specifications and assumptions about deployment scenarios and is compared with the near-surface wind generation potential with respect to diurnal and seasonal variability. The results show the potential utility of AWE in areas in the Middle East where the energy demand is high. In particular, Oman and Saudi Arabia have a high level of the potential power generation with low annual variability.

  3. Patient Reported Burden of Asthma on Resource Use and Productivity Across 11 Countries in Europe

    NARCIS (Netherlands)

    Fletcher, Monica; Jha, Ashok; Dunlop, William; Heron, Louise; Wolfram, Verena; Van der Molen, Thys; Price, David

    Asthma affects 30 million people in Western Europe, leading to substantial burden on healthcare systems and economies. REcognise Asthma and LInk to Symptoms and Experience (REALISE (TM)) was a large European survey across 11 countries assessing patient attitudes and behaviors towards their asthma.

  4. Tourism in Indian Country: Opportunities for Developing and Protecting Our Resources.

    Science.gov (United States)

    Sherman, Ben

    2001-01-01

    Tourism in Indian Country is a valuable economic development strategy, but must be sustainable. Issues of community impact, cultural appropriateness, and environmental impact are best blended with economic feasibility by educated tribal employees and Indian entrepreneurs. Better institutional tribal support of Indian entrepreneurs is needed. Four…

  5. Policies and practices of countries experiencing a crisis in Human Resources for Health : A tracking survey

    NARCIS (Netherlands)

    van den Broek, Ankie; Gedik, Gulin; dal Poz, Mario; Dieleman, M.A.

    2010-01-01

    In order to understand and monitor the progress in developing and implementing HRH policies in the 57 countries experiencing a critical deficit in the health workforce, this tracking survey provides an overview of the current situation in terms of HRH policies, plans, capacities and processes. The

  6. Estimation of forest resources from a country wide laser scanning survey and national forest inventory data

    DEFF Research Database (Denmark)

    Nord-Larsen, Thomas; Schumacher, Johannes

    2012-01-01

    Airborne laser scanning may provide a means for assessing local forest biomass resources. In this study, national forest inventory (NFI) data was used as reference data for modeling forest basal area, volume, aboveground biomass, and total biomass from laser scanning data obtained in a countrywid...

  7. Human resource management and performance in a developing country : the case of Eritrea

    NARCIS (Netherlands)

    Karsten, Luchien; Ghebregiorgis, F.

    This study investigates the relationship between human resource management (HRM) practices and organizational performance. Results based on a sample of 82 organizations from private and public sectors in Eritrea indicate that some of the practices have a significant impact on employee turnover,

  8. Competition and Constraint : Economic Globalization and Human Resource Practices in 23 European Countries

    NARCIS (Netherlands)

    Koster, Ferry; Wittek, Rafael

    2016-01-01

    Economic globalization is often considered to be one of the main causes of recent changes in the workplace and the way in which organizations manage their human resources. Nevertheless, an empirical study putting this claim to the test by relating the internationalization of the economy to the use

  9. Employee reactions to human resource management and performance in a developing country

    NARCIS (Netherlands)

    Karsten, Luchien; Ghebregiorgis, F.

    2007-01-01

    Purpose - This paper seeks to examine employee reactions to human resource management (HRM) and performance. It placed employees on a centre stage in analysing HRM to provide theoretical insights. Design/methodology/approach - To explore the theme, a survey of 252 employees drawn from eight

  10. Human resource training and development importance in post communist countries in cross-cultural context

    OpenAIRE

    Kumpikaitė, Vilmantė

    2009-01-01

    The manufacturing-dominated economies of Lithuania, Latvia and Estonia, formed during the Soviet occupation, collapsed with the USSR. However, they are now well into the process of evolving to market economies. Among other aspects, this evolutionary process includes adapting to new social institutions and economic relationships, reacting to the impact of new technologies, and meeting the increasing social needs and developing employees in these countries. This review addresses the importance ...

  11. Assessment of human resources for health using cross-national comparison of facility surveys in six countries

    Directory of Open Access Journals (Sweden)

    Dal Poz Mario R

    2009-03-01

    Full Text Available Abstract Background Health facility assessments are being increasingly used to measure and monitor indicators of health workforce performance, but the global evidence base remains weak. Partly this is due to the wide variability in assessment methods and tools, hampering comparability across and within countries and over time. The World Health Organization coordinated a series of facility-based surveys using a common approach in six countries: Chad, Côte d'Ivoire, Jamaica, Mozambique, Sri Lanka and Zimbabwe. The objectives were twofold: to inform the development and monitoring of human resources for health (HRH policy within the countries; and to test and validate the use of standardized facility-based human resources assessment tools across different contexts. Methods The survey methodology drew on harmonized questionnaires and guidelines for data collection and processing. In accordance with the survey's dual objectives, this paper presents both descriptive statistics on a number of policy-relevant indicators for monitoring and evaluation of HRH as well as a qualitative assessment of the usefulness of the data collection tool for comparative analyses. Results The findings revealed a large diversity in both the organization of health services delivery and, in particular, the distribution and activities of facility-based health workers across the sampled countries. At the same time, some commonalities were observed, including the importance of nursing and midwifery personnel in the skill mix and the greater tendency of physicians to engage in dual practice. While the use of standardized questionnaires offered the advantage of enhancing cross-national comparability of the results, some limitations were noted, especially in relation to the categories used for occupations and qualifications that did not necessarily conform to the country situation. Conclusion With increasing experience in health facility assessments for HRH monitoring comes

  12. Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

    Science.gov (United States)

    2018-04-05

    Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. NCT02179112.

  13. Increasing human resource capacity in African countries: A nursing and midwifery Research Summit

    Directory of Open Access Journals (Sweden)

    Carolyn Sun

    2017-01-01

    Conclusions: Evaluations provided favorable feedback regarding the process leading up to as well as the content of the Research Summit. While further long-term evaluations will be needed to determine the sustainability of this initiative, the Summit format afforded the opportunity for regional experts to meet, examine research priorities, and develop strategic action and mentorship plans. This paper describes a replicable method that could be utilized in other regions using available resources to minimize costs and modest grant funding.

  14. Determinants of Renewable Energy Resources and Their Relationship Between Economic Growth: The Case of Developing Countries

    OpenAIRE

    Serkan Çınar; Mine Yılmazer

    2015-01-01

    Literature on the relationship between energy consumption and economic growth is based on two different approaches that are supply-side and demand-side. The impact of renewable and non-renewable energy consumption on economic growth is investigated with traditional production function on supply-side approach. The relationship between renewable energy consumption, economic growth, CO2 and energy prices is analyzed on demand-side approach. In this study, the impact of renewable resources on eco...

  15. Intrahousehold Bargaining and Resource Allocation in Developing Countries-super-1

    OpenAIRE

    Cheryl Doss

    2013-01-01

    Many key development outcomes depend on women s ability to negotiate favorable intrahousehold allocations of resources. Yet it has been difficult to clearly identify which policies can increase women's bargaining power and result in better outcomes. This paper reviews both the analytical frameworks and the empirical evidence on the importance of women's bargaining power. It argues that there is sufficient evidence from rigorous studies to conclude that women's bargaining power does affect out...

  16. The impact of the financial crisis on human resources for health policies in three southern-Europe countries.

    Science.gov (United States)

    Correia, Tiago; Dussault, Gilles; Pontes, Carla

    2015-12-01

    The public health sector has been the target of austerity measures since the global financial crisis started in 2008, while health workforce costs have been a source of rapid savings in most European Union countries. This article aims to explore how health workforce policies have evolved in three southern European countries under external constraints imposed by emergency financial programmes agreed with the International Monetary Fund, Central European Bank and European Commission. The selected countries, Greece, Portugal and Cyprus, show similarities with regard to corporatist systems of social protection and comprehensive welfare mechanisms only recently institutionalized. Based on document analysis of the Memoranda of Understanding agreed with the Troika, our results reveal broadly similar policy responses to the crisis but also important differences. In Cyprus, General Practitioners have a key position in reducing public expenditure through gatekeeping and control of users' access, while Portugal and Greece seeks to achieve cost containment by constraining the decision-making powers of professionals. All three countries lack innovation as well as monitoring and assessment of the effects of the financial crisis in relation to the health workforce. Consequently, there is a need for health policy development to use human resources more efficiently in healthcare. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Sudan Country Profile - Human Resource Development (HRD) for the first Nuclear Power Program

    International Nuclear Information System (INIS)

    Yousif, Eltayeb H. Elneel

    2014-01-01

    Sudan has been decided to prepare a strategy plan for the first nuclear power plant for various reasons like production electricity and increase the national industries besides the capabilities to do the scientific and research activities. Sudan has been started to establish and develop a master plan for the human resource development and makes a comprehensive realistic assessment about the organizational, educational and industrial capabilities and determines the requirements for developing the quality and quantity of human resources needed. The national nuclear regulatory authority has been started to update all legislation and regulations and also reviews and evaluates the international agreements and conventions related to the nuclear energy. In this profile we used the methodology of the international atomic energy agency to assess and evaluate the capacity building in Sudan. The expected outcomes from this profile are identified the gaps regarding the strengthening the national infrastructure and nuclear regulatory framework and issuing regulations to met the requirements for safety and security of the nuclear power plant. The availability of the human resources skills are important for effectively monitors the activities of the companies and facilities involved in nuclear power plant. The new nuclear law and the new national policy of the nuclear program are now under the process of approval.(author)

  18. Survey of basic data on human resources development (HRD) in the nuclear field in FNCA countries (Contract research)

    International Nuclear Information System (INIS)

    2005-03-01

    In the 3rd FNCA* (Forum for Nuclear Cooperation in Asia) Coordinator Meeting held on March 2002, it was proposed to carry out 'Survey of the Basic Data on Human Resources Development in the Nuclear Field'. It was considered to be the first step for developing the HRD strategy by producing the quantitative data on HRD in nuclear field. The survey results were introduced by Project Leaders during the 2002 FNCA Workshop on HRD held on October 2002. The follow-up survey was conducted with the cooperation of other Project Leaders in the respective field of FNCA such as medical and agriculture applications in each member countries. The collected survey data was analyzed in 2003, and summarized as 'Summary of the Survey Data'. This report consists of the summary of 'Survey of the Basic Data on Human Resources Development in Nuclear Field'. It was reported during the 2003 FNCA Workshop on HRD held on October 2003 and updated until early 2004. (author)

  19. Exploring Variation in Glycemic Control Across and Within Eight High-Income Countries

    DEFF Research Database (Denmark)

    Charalampopoulos, Dimitrios; Hermann, Julia M; Svensson, Jannet

    2018-01-01

    OBJECTIVE: International studies on childhood type 1 diabetes (T1D) have focused on whole-country mean HbA1c levels, thereby concealing potential variations within countries. We aimed to explore the variations in HbA1c across and within eight high-income countries to best inform international ben...

  20. Potential for Zika virus introduction and transmission in resource limited countries in Africa and Asia-Pacific: A modeling study

    Science.gov (United States)

    German, Matthew; Creatore, Maria I.; Brent, Shannon; Watts, Alexander G.; Hay, Simon I.; Kulkarni, Manisha A.; Brownstein, John S.; Khan, Kamran

    2016-01-01

    Summary Background As the epidemic of Zika virus expands in the Americas, countries across Africa and the Asia-Pacific region are becoming increasingly susceptible to the importation and possible local spread of the virus. To support public health readiness, we aim to identify regions and times where the potential health, economic, and social effects from Zika virus are greatest, focusing on resource-limited countries in Africa and the Asia-Pacific region. Methods Our model combined transportation network analysis, ecological modelling of mosquito occurrences, and vector competence for flavivirus transmission, using data from the International Air Transport Association, entomological observations from Zika’s primary vector species, and climate conditions using WorldClim. We overlaid monthly flows of airline travellers arriving to Africa and the Asia-Pacific region from areas of the Americas suitable for year-round transmission of Zika virus with monthly maps of climatic suitability for mosquito-borne transmission of Zika virus within Africa and the Asia-Pacific region. Findings An estimated 2·6 billion people live in areas of Africa and the Asia-Pacific region where the presence of competent mosquito vectors and suitable climatic conditions could support local transmission of Zika virus. Countries with large volumes of travellers arriving from Zika affected areas of the Americas and large populations at risk of mosquito-borne Zika virus infection include, India (67 422 travellers arriving per year; 1·2 billion residents in potential Zika transmission areas), China (238 415 travellers; 242 million residents), Indonesia (13 865 travellers; 197 million residents), Philippines (35 635 travellers; 70 million residents), and Thailand (29 241 travellers; 59 million residents). Interpretation Many countries across Africa and the Asia-Pacific region are vulnerable to Zika virus. Strategic use of available health and human resources is essential to prevent or mitigate

  1. Status on high enthalpy geothermal resources in Greece

    International Nuclear Information System (INIS)

    Koutinas, G.A.

    1990-01-01

    Greece is privileged to have many high and medium enthalpy geothermal resources. Related activities during the last 5 years were conducted mainly on the previously discovered geothermal fields of Milos, Nisyros and Lesvos islands, without any deep geothermal drilling. Most efforts were focused on the demonstration of a high enthalpy geothermal reservoir on Milos, by generating electricity from high salinity fluid, with a 2 MW pilot plant. Significant experience has been gained there, by solving technical problems, but still site specific constraints have to be overcome in order to arrive at a comprehensive feasibility study, leading to the development phase. A pre-feasibility study has been carried out in the Nisyros geothermal field. Moreover, a detailed geoscientific exploration program has been completed on Lesvos island, where very promising geothermal areas have been identified. In this paper, reference is made to the most important data concerning high enthalpy geothermal resources by emphasizing the Milos geothermal field

  2. High-Amplitude Atlantic Hurricanes Produce Disparate Mortality in Small, Low-Income Countries.

    Science.gov (United States)

    Dresser, Caleb; Allison, Jeroan; Broach, John; Smith, Mary-Elise; Milsten, Andrew

    2016-12-01

    Hurricanes cause substantial mortality, especially in developing nations, and climate science predicts that powerful hurricanes will increase in frequency during the coming decades. This study examined the association of wind speed and national economic conditions with mortality in a large sample of hurricane events in small countries. Economic, meteorological, and fatality data for 149 hurricane events in 16 nations between 1958 and 2011 were analyzed. Mortality rate was modeled with negative binomial regression implemented by generalized estimating equations to account for variable population exposure, sequence of storm events, exposure of multiple islands to the same storm, and nonlinear associations. Low-amplitude storms caused little mortality regardless of economic status. Among high-amplitude storms (Saffir-Simpson category 4 or 5), expected mortality rate was 0.72 deaths per 100,000 people (95% confidence interval [CI]: 0.16-1.28) for nations in the highest tertile of per capita gross domestic product (GDP) compared with 25.93 deaths per 100,000 people (95% CI: 13.30-38.55) for nations with low per capita GDP. Lower per capita GDP and higher wind speeds were associated with greater mortality rates in small countries. Excessive fatalities occurred when powerful storms struck resource-poor nations. Predictions of increasing storm amplitude over time suggest increasing disparity between death rates unless steps are taken to modify the risk profiles of poor nations. (Disaster Med Public Health Preparedness. 2016;10:832-837).

  3. Cancer in adolescents and young adults in countries with limited resources.

    Science.gov (United States)

    Magrath, Ian; Epelman, Sidnei

    2013-08-01

    Cancer in adolescents and young adults (AYA) represents a higher fraction of all cancer in countries that are still undergoing a demographic transition. Such countries tend to have much younger populations, and therefore unless they have a particularly low incidence of cancer in this age group, will have a higher burden of cancer (absolute number of cases with cancer) in AYA. Cancers in AYA are comprised of the tail end of the incidence curve of cancers that have their peak incidence, or occur almost exclusively in childhood, the beginning of the incidence curve of cancers that primarily affect the elderly, and a third set of cancers that have their peak incidence (or are at least common) in the AYA age group (e.g., testicular cancer, sarcomas, melanoma, thyroid cancer). Many, but not all, of these cancers require radiation or cancer surgery, but the poorest countries do not have a sufficient number of radiation therapy units and surgical oncologists, or indeed medical and pediatric oncologists, to deal with the burden of cancer they face. The AYA age group is particularly important, both with regard to their contribution to the economy now and in the future (the majority are in the "working" age-group defined as 15-64 years), as well as their important role in caring for their families. Moreover, some of these cancers are eminently curable with chemotherapy alone, and more could be cured by simply improving the efficiency of existing health services and providing education and training to both the public as well as oncologists and other specialists required for the care of AYA (although such individuals will not necessarily be exclusively concerned with this age group). Of particular importance is the detection and diagnosis of cancer patients at the earliest possible time in the course of their disease. Avoiding delays in initiating therapy, which are partly due to the poverty and lack of education of the public as well as to a failure on the part of primary

  4. Childhood acute non-traumatic coma: aetiology and challenges in management in resource-poor countries of Africa and Asia.

    Science.gov (United States)

    Gwer, Samson; Chacha, Clifford; Newton, Charles R; Idro, Richard

    2013-08-01

    This review examines the best available evidence on the aetiology of childhood acute non-traumatic coma in resource-poor countries (RPCs), discusses the challenges associated with management, and explores strategies to address them. Publications in English and French which reported on studies on the aetiology of childhood non-traumatic coma in RPCs are reviewed. Primarily, the MEDLINE database was searched using the keywords coma, unconsciousness, causality, aetiology, child, malaria cerebral, meningitis, encephalitis, Africa, Asia, and developing countries. 14 records were identified for inclusion in the review. Cerebral malaria (CM) was the commonest cause of childhood coma in most of the studies conducted in Africa. Acute bacterial meningitis (ABM) was the second most common known cause of coma in seven of the African studies. Of the studies in Asia, encephalitides were the commonest cause of coma in two studies in India, and ABM was the commonest cause of coma in Pakistan. Streptococcus pneumoniae was the most commonly isolated organism in ABM. Japanese encephalitis, dengue fever and enteroviruses were the viral agents most commonly isolated. Accurate diagnosis of the aetiology of childhood coma in RPCs is complicated by overlap in clinical presentation, limited diagnostic resources, disease endemicity and co-morbidity. For improved outcomes, studies are needed to further elucidate the aetiology of childhood coma in RPCs, explore simple and practical diagnostic tools, and investigate the most appropriate specific and supportive interventions to manage and prevent infectious encephalopathies.

  5. High burden of impetigo and scabies in a tropical country.

    Directory of Open Access Journals (Sweden)

    Andrew C Steer

    2009-06-01

    Full Text Available Impetigo and scabies are endemic diseases in many tropical countries; however the epidemiology of these diseases is poorly understood in many areas, particularly in the Pacific.We conducted three epidemiological studies in 2006 and 2007 to determine the burden of disease due to impetigo and scabies in children in Fiji using simple and easily reproducible methodology. Two studies were performed in primary school children (one study was a cross-sectional study and the other a prospective cohort study over ten months and one study was performed in infants (cross-sectional. The prevalence of active impetigo was 25.6% (95% CI 24.1-27.1 in primary school children and 12.2% (95% CI 9.3-15.6 in infants. The prevalence of scabies was 18.5% (95% CI 17.2-19.8 in primary school children and 14.0% (95% CI 10.8-17.2 in infants. The incidence density of active impetigo, group A streptococcal (GAS impetigo, Staphylococcus aureus impetigo and scabies was 122, 80, 64 and 51 cases per 100 child-years respectively. Impetigo was strongly associated with scabies infestation (odds ratio, OR, 2.4, 95% CI 1.6-3.7 and was more common in Indigenous Fijian children when compared with children of other ethnicities (OR 3.6, 95% CI 2.7-4.7. The majority of cases of active impetigo in the children in our study were caused by GAS. S. aureus was also a common cause (57.4% in school aged children and 69% in infants.These data suggest that the impetigo and scabies disease burden in children in Fiji has been underestimated, and possibly other tropical developing countries in the Pacific. These diseases are more than benign nuisance diseases and consideration needs to be given to expanded public health initiatives to improve their control.

  6. Authorship ethics in global health research partnerships between researchers from low or middle income countries and high income countries.

    Science.gov (United States)

    Smith, Elise; Hunt, Matthew; Master, Zubin

    2014-05-28

    Over the past two decades, the promotion of collaborative partnerships involving researchers from low and middle income countries with those from high income countries has been a major development in global health research. Ideally, these partnerships would lead to more equitable collaboration including the sharing of research responsibilities and rewards. While collaborative partnership initiatives have shown promise and attracted growing interest, there has been little scholarly debate regarding the fair distribution of authorship credit within these partnerships. In this paper, we identify four key authorship issues relevant to global health research and discuss their ethical and practical implications. First, we argue that authorship guidance may not adequately apply to global health research because it requires authors to write or substantially revise the manuscript. Since most journals of international reputation in global health are written in English, this would systematically and unjustly exclude non-English speaking researchers even if they have substantially contributed to the research project. Second, current guidance on authorship order does not address or mitigate unfair practices which can occur in global health research due to power differences between researchers from high and low-middle income countries. It also provides insufficient recognition of "technical tasks" such as local participant recruitment. Third, we consider the potential for real or perceived editorial bias in medical science journals in favour of prominent western researchers, and the risk of promoting misplaced credit and/or prestige authorship. Finally, we explore how diverse cultural practices and expectations regarding authorship may create conflict between researchers from low-middle and high income countries and contribute to unethical authorship practices. To effectively deal with these issues, we suggest: 1) undertaking further empirical and conceptual research regarding

  7. Resilience of Vietnamese refugees: resources to cope with natural disasters in their resettled country.

    Science.gov (United States)

    Xin, Huaibo; Aronson, Robert E; Lovelace, Kay A; Strack, Robert W; Villalba, José A

    2013-08-01

    Study findings suggest that refugees are more vulnerable than the general population to mental disorders from disasters. This pilot study explored the nature of Vietnamese refugees' resilience to a potential natural disaster as a first step toward improving their disaster mental health. Interviews were conducted with 20 ethnic Vietnamese and Montagnard adult refugees using a semistructured interview guide. Factors in resilience at both individual and family levels were examined. Our results indicated that these refugees had positive personalities and strong family cohesion. However, although a majority of the participants had experienced natural disasters, they lacked knowledge and specific strategies to cope with these events. The individual participants and their families lacked sufficient information, financial resources, emergency supplies, or social support for a natural disaster. Enhancing refugees' current strengths in responding to disasters, delivering them tailored emergency training, strengthening relationships between refugee service providers and refugee communities, and advocating for refugees' socioeconomic capacity building should be considered.

  8. Urban waste landfill planning and karstic groundwater resources in developing countries: the example of Lusaka (Zambia)

    Science.gov (United States)

    De Waele, J.; Nyambe, I. A.; Di Gregorio, A.; Di Gregorio, F.; Simasiku, S.; Follesa, R.; Nkemba, S.

    2004-06-01

    Lusaka, the capital city of Zambia with more than two million inhabitants, derives approximately 70% of its water requirements from groundwater sourced in the underlying karstic Lusaka aquifer. This water resource is, therefore, extremely important for the future of the population. The characteristics of the aquifer and the shallow water table make the resource vulnerable and in need of protection and monitoring. A joint project between the Geology Departments of the University of Cagliari and the School of Mines of the University of Zambia, to investigate the "Anthropogenic and natural processes in the Lusaka area leading to environmental degradation and their possible mitigation" was carried out in July 2001. The main objective of the study was to evaluate the extent of the present environmental degradation, assessing the vulnerability of the carbonatic aquifer and the degree of pollution of the groundwater and to make proposals to mitigate adverse environmental effects. Analyses of water samples collected during project indicate some areas of concern, particularly with respect to the levels of ammonia, nitrates and some heavy metals. As groundwater quality and quantity are prerogatives for a healthy and sustainable society, the study offers guidelines for consideration by the local and national authorities. Uptake of these guidelines should result in a number of initiatives being taken, including: (a) closure or reclamation of existing waste dumps; (b) upgrading of existing waste dumps to controlled landfills; (c) establishing new urban waste landfills and plants in geo-environmentally suitable sites; (d) local waste management projects in all compounds (residential areas) to prevent and reduce haphazard waste dumping; (e) enlarging sewerage drainage systems to all compounds; (f) enforcing control on groundwater abstraction and pollution, and demarcation of zones of control at existing drill holes; (g) providing the city with new water supplies from outside the

  9. Postgraduate and research programmes in Medicine and Public Health in Rwanda: an exciting experience about training of human resources for health in a limited resources country.

    Science.gov (United States)

    Kakoma, Jean Baptiste

    2016-01-01

    The area of Human Resources for Health (HRH) is the most critical challenge for the achievement of health related development goals in countries with limited resources. This is even exacerbated in a post conflict environment like Rwanda. The aim of this commentary is to report and share the genesis and outcomes of an exciting experience about training of qualified health workers in medicine and public health as well as setting - up of a research culture for the last nine years (2006 - 2014) in Rwanda. Many initiatives have been taken and concerned among others training of qualified health workers in medicine and public health. From 2006 to 2014, achievements were as follows: launching and organization of 8 Master of Medicine programmes (anesthesiology, family and community medicine, internal medicine, obstetrics & gynecology, otorhinolaryngology, pediatrics, psychiatry and surgery) and 4 Master programmes in public health (MPH, MSc Epidemiology, MSc Field Epidemiology & Laboratory Management, and Master in Hospital and Healthcare Administration); training to completion of more than 120 specialists in medicine, and 200 MPH, MSc Epidemiology, and MSc Field Epidemiology holders; revival of the Rwanda Medical Journal; organization of graduate research training (MPhil and PhD); 3 Master programmes in the pipeline (Global Health, Health Financing, and Supply Chain Management); partnerships with research institutions of great renown, which contributed to the reinforcement of the institutional research capacity and visibility towards excellence in leadership, accountability, and self sustainability. Even though there is still more to be achieved, the Rwanda experience about postgraduate and research programmes is inspiring through close interactions between main stakeholders. This is a must and could allow Rwanda to become one of the rare examples to other more well-to-do Sub - Saharan countries, should Rwanda carry on doing that.

  10. Trends and implications for achieving VISION 2020 human resources for eye health targets in 16 countries of sub-Saharan Africa by the year 2020.

    Science.gov (United States)

    Palmer, Jennifer J; Chinanayi, Farai; Gilbert, Alice; Pillay, Devan; Fox, Samantha; Jaggernath, Jyoti; Naidoo, Kovin; Graham, Ronnie; Patel, Daksha; Blanchet, Karl

    2014-08-15

    Development of human resources for eye health (HReH) is a major global eye health strategy to reduce the prevalence of avoidable visual impairment by the year 2020. Building on our previous analysis of current progress towards key HReH indicators and cataract surgery rates (CSRs), we predicted future indicator achievement among 16 countries of sub-Saharan Africa by 2020. Surgical and HReH data were collected from national eye care programme coordinators on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and 'mid-level refractionists' and combined them with publicly available population data to calculate practitioner-to-population ratios and CSRs. Data on workforce entry and exit (2008 to 2010) was used to project practitioner population and CSR growth between 2011 and 2020 in relation to projected growth in the general population. Associations between indicator progress and the presence of a non-physician cataract surgeon cadre were also explored using Wilcoxon rank sum tests and Spearman rank correlations. In our 16-country sample, practitioner per million population ratios are predicted to increase slightly for surgeons (ophthalmologists/cataract surgeons, from 3.1 in 2011 to 3.4 in 2020) and ophthalmic nurses/clinical officers (5.8 to 6.8) but remain low for refractionists (including optometrists, at 3.6 in 2011 and 2020). Among countries that have not already achieved target indicators, however, practitioner growth will be insufficient for any additional countries to reach the surgeon and refractionist targets by year 2020. Without further strategy change and investment, even after 2020, surgeon growth is only expected to sufficiently outpace general population growth to reach the target in one country. For nurses, two additional countries will achieve the target while one will fall below it. In 2011, high surgeon practitioner ratios were associated with high CSR, regardless of the type

  11. Pre-natal genetic counselling in a resource limited country - a single center geneticist's perspectives

    International Nuclear Information System (INIS)

    Afroze, B.; Jehan, F.

    2014-01-01

    Objective: To assess the needs related to prenatal genetic counselling in a developing country. Methods: The prospective observational study was conducted at the Prenatal-Genetic Counselling Clinic of Aga Khan University Hospital, Karachi, from October 2007 to September 2010. In-depth interviews were conducted and the data was stored in the form of patient charts. Information was then extracted from the charts and entered into a structured questionnaire. Results: Of the 93 couples in the study, 49(53%) were in the self-referral group and 44(47%) were in the physician-referral group. Diagnosis was not given for previously affected children by the paediatrician or by obstetrician for recurrent miscarriages in 68(73%)cases. Besides, 20(22%) couples had voluntarily terminated a pregnancy without any tests because of the fear of having a diseased child. Eleven (12%) couples were looking for amniocentensis or chorionic villus sampling. Death in previous children was the main reason to seek genetic counselling and was seen in 57(61%) couples. Consanguinity was seen in 77(83%) couples. Conclusion: A clear deficiency of knowledge of genetics was seen among the non-genetic healthcare providers. Demand of antenatal genetic testing among the public was also seen, highlighting the need of diagnostic facility for genetic and metabolic disorders. However, this needs to be explored in the context of the existing healthcare infrastructure. (author)

  12. Estimating the tuberculosis burden in resource-limited countries: a capture-recapture study in Yemen.

    Science.gov (United States)

    Bassili, A; Al-Hammadi, A; Al-Absi, A; Glaziou, P; Seita, A; Abubakar, I; Bierrenbach, A L; van Hest, N A

    2013-04-01

    The lack of applicable population-based methods to measure tuberculosis (TB) incidence rates directly at country level emphasises the global need to generate robust TB surveillance data to ascertain trends in disease burden and to assess the performance of TB control programmes in the context of the United Nations Millenium Development Goals and World Health Organization targets for TB control. To estimate the incidence of TB cases (all forms) and sputum smear-positive disease, and the level of under-reporting of TB in Yemen in 2010. Record-linkage and three-source capture-recapture analysis of data collected through active prospective longitudinal surveillance within the public and private non-National Tuberculosis Programme sector in twelve Yemeni governorates, selected by stratified cluster random sampling. For all TB cases, the estimated ratio of notified to incident cases and completeness of case ascertainment after record linkage, i.e., the ratio of detected to incident cases, was respectively 71% (95%CI 64-80) and 75% (95%CI 68-85). For sputum smear-positive TB cases, these ratios were respectively 67% (95%CI 58-75) and 76% (95%CI 66-84). We estimate that there were 13 082 (95%CI 11 610-14 513) TB cases in Yemen in 2010. Under-reporting of TB in Yemen is estimated at 29% (95%CI 20-36).

  13. Cyclic Investigation of Geophysical Studies in the Exploration and Discovery of Natural Resources in Our Country

    International Nuclear Information System (INIS)

    Gonulalan, A. U.

    2007-01-01

    Although the methods of exploration geophysics were first utilized after the discovery of an oil field in 1921, they have also applied in the old centuries. Likewise, the half of the total production in the United States of America is covered by new oil fields discovered by utilizing geophysical methods. The industry's energy necessity increases the interest to oil. The investments in the field of geophysics by the companies which makes large amount of money in order to discover new oil fields, widespread use of computers, the developments of space technology and world-wide nuclear competition even though its great danger for human beings have great share in the development of geophysics. Our country has 18 different types mines which has more than 10 billion $ potential. Geophysical engineers have great Kowledge and labor in the discovery of 1,795 trillion wealth from borax to building stone, and 60 billion $ oil and gas. On the other hand, as 1,5 billion investment in the field of geophysics is only 0.08 % of total investments, the increase of investments will add more contribution

  14. Approaches for optimizing the utilization of nuclear medical resources in developing countries

    International Nuclear Information System (INIS)

    Adelstein, S.

    1978-10-01

    Contemplation of the use of nuclear medicine technologies in developing countries raises the issue, what purposes they would serve in relation to the major health needs of the region. This investigation was an attempt to assess and to test a methodology for conducting this assessment. Several potential nuclear medicine applications were selected on the basis of their intrinsic promise and in order to evaluate a variety of techniques. These applications were then subjected to a cost-effectiveness analysis, either on their own or in comparison with some competing procedure. To give reality to the study, it was performed in the context of the Indian health scene. The situations examined were the following: Screening blood units for hepatitis B surface antigen prior to transfusion. Costs and benefits of radiorespirometry and conventional culture methods as means to improve case-finding in tuberculosis surveys. Improved tests for diagnosing tuberculous meningitis. Population screening for thyroid diseases. Studies of this type are typically impeded by an insufficiency of key data, they nevertheless can shed some light on the value of potential radionuclide applications

  15. The U.S. natural gas and oil resource base is abundant; but can we produce what the country needs?

    International Nuclear Information System (INIS)

    Ewing, T.E.

    1994-01-01

    Recent studies agree that the United States has abundant resources of gas and oil left to find and produce over the next 50--75 years -- if its exploration and production companies are given the resources to do the job. The NPC's estimate of 1,295 TCF of natural gas (advanced technology case) represents a resource/present production ration of 68 years. A similar estimate for oil gives 62 years. Furthermore, these resource estimates have been increasing through the 1980s, as the effects of new geological, geophysical, and engineering technologies has become more apparent. However, only 30% of this tremendous resource will be available under today's business-as-usual economic regime. The rest of the resource will be accessed if: (1) tax policies (and financial and trade policies) are adopted to stabilize prices and stimulate exploration and production (estimated 27% of the resource base); (2) technology is developed, transferred, and used (17%); (3) environmental regulation is held to a balanced level, considers economic costs as well as environmental benefits, and is applied consistently (13%); (4) access to Federal lands is eased for environmentally responsible drilling and development (13%). To convert America's gas and oil resources into delivered products in a timely manner, assuring the nation's gas users of a reliable supply -- and contribute up to $8.7 trillion to the nation's economy -- a doubling of industry effort is required, even at today's high levels of finding and producing efficiency. Coordinated action by industry, government, and the investment community is required to secure the future development of energy supplies. Government in particular must develop policies that encourage the needed investment in America's natural gas and oil

  16. Improving pediatric cardiac surgical care in developing countries: matching resources to needs.

    Science.gov (United States)

    Dearani, Joseph A; Neirotti, Rodolfo; Kohnke, Emily J; Sinha, Kingshuk K; Cabalka, Allison K; Barnes, Roxann D; Jacobs, Jeffrey P; Stellin, Giovanni; Tchervenkov, Christo I; Cushing, John C

    2010-01-01

    This article reviews a systematic approach to the design and support of pediatric cardiac surgery programs in the developing world with the guidance and strategies of Children's HeartLink, an experienced non-government organization for more than 40 years. An algorithm with criteria for the selection of a partner site is outlined. A comprehensive education strategy from the physician to the allied health care provider is the mainstay for successful program development. In a partner program, the road to successful advancement and change depends on many factors, such as government support, hospital administration support, medical staff leadership, and a committed and motivated faculty with requisite skills, incentives, and resources. In addition to these factors, it is essential that the development effort includes considerations of environment (eg, governmental support, regulatory environment, and social structure) and health system (elements related to affordability, access, and awareness of care) that impact success. Partner programs should be willing to initiate a clinical database with the intent to analyze and critique their results to optimize quality assurance and improve outcomes. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  17. Stillbirths 5. Stillbirths : the way forward in high-income countries

    NARCIS (Netherlands)

    Flenady, Vicki; Middleton, Philippa; Smith, Gordon C.; Duke, Wes; Erwich, Jan Jaap; Khong, T. Yee; Neilson, Jim; Ezzati, Majid; Koopmans, Laura; Ellwood, David; Fretts, Ruth; Froen, J. Frederik

    2011-01-01

    Stillbirth rates in high-income countries declined dramatically from about 1940, but this decline has slowed or stalled over recent times. The present variation in stillbirth rates across and within high-income countries indicates that further reduction in stillbirth is possible. Large disparities

  18. Comparative meta-analysis of tuberculosis contact investigation interventions in eleven high burden countries.

    Directory of Open Access Journals (Sweden)

    Lucie Blok

    Full Text Available Screening of household contacts of tuberculosis (TB patients is a recommended strategy to improve early case detection. While it has been widely implemented in low prevalence countries, the most optimal protocols for contact investigation in high prevalence, low resource settings is yet to be determined. This study evaluated contact investigation interventions in eleven lower and middle income countries and reviewed the association between context or program-related factors and the yield of cases among contacts.We reviewed data from nineteen first wave TB REACH funded projects piloting innovations to improve case detection. These nineteen had fulfilled the eligibility criteria: contact investigation implementation and complete data reporting. We performed a cross-sectional analysis of the percentage yield and case notifications for each project. Implementation strategies were delineated and the association between independent variables and yield was analyzed by fitting a random effects logistic regression.Overall, the nineteen interventions screened 139,052 household contacts, showing great heterogeneity in the percentage yield of microscopy confirmed cases (SS+, ranging from 0.1% to 6.2%. Compared to the most restrictive testing criteria (at least two weeks of cough the aOR's for lesser (any TB related symptom and least (all contacts restrictive testing criteria were 1.71 (95%CI 0.94-3.13 and 6.90 (95% CI 3.42-13.93 respectively. The aOR for inclusion of SS- and extra-pulmonary TB was 0.31 (95% CI 0.15-0.62 compared to restricting index cases to SS+ TB. Contact investigation contributed between <1% and 14% to all SS+ cases diagnosed in the intervention areas.This study confirms that high numbers of active TB cases can be identified through contact investigation in a variety of contexts. However, design and program implementation factors appear to influence the yield of contact investigation and its concomitant contribution to TB case detection.

  19. GLOBAL PROSPECTS OF SYNTHETIC DIESEL FUEL PRODUCED FROM HYDROCARBON RESOURCES IN OIL&GAS EXPORTING COUNTRIES

    OpenAIRE

    Kurevija, Tomislav; Kukulj, Nenad; Rajković, Damir

    2007-01-01

    Production of synthetic diesel fuel through Fischer-Tropsch process is a well known technology which dates from II World War, when Germany was producing transport fuel from coal. This process has been further improved in the South Africa due to period of international isolation. Today, with high crude oil market cost and increased demand of energy from China and India, as well as global ecological awareness and need to improve air quality in urban surroundings, many projects are being planned...

  20. The future of textile production in high wage countries

    Science.gov (United States)

    Kemper, M.; Gloy, Y.-S.; Gries, T.

    2017-10-01

    It is undisputed that smart production in the context of industry 4.0 offers significant potential for industrial production in Germany. Exploiting this potential provides an opportunity to meet the growing competitive pressure for textile production in high-wage Germany. The complete cross-linking of textile mills towards Textile Production 4.0 means substantial savings. However, currently there are still some challenges that have to be overcome on the long way to Textile Production 4.0. This paper initially reflects the particular challenges of textile production in high-wage Germany. Later, the vision of the future of smart textile production will be outlined. In addition, first pilot solutions and current research approaches which pave the way for Textile Production 4.0 are described.

  1. Analysis of High Plains Resource Risk and Economic Impacts

    Energy Technology Data Exchange (ETDEWEB)

    Tidwell, Vincent C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Vargas, Vanessa N [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Jones, Shannon M [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Dealy, Bern Caudill [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Shaneyfelt, Calvin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Smith, Braeton James [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Moreland, Barbara Denise [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-04-01

    The importance of the High Plains Aquifer is broadly recognized as is its vulnerability to continued overuse. T his study e xplore s how continued depletions of the High Plains Aquifer might impact both critical infrastructure and the economy at the local, r egional , and national scale. This analysis is conducted at the county level over a broad geographic region within the states of Kansas and Nebraska. In total , 140 counties that overlie the High Plains Aquifer in these two states are analyzed. The analysis utilizes future climate projections to estimate crop production. Current water use and management practices are projected into the future to explore their related impact on the High Plains Aquifer , barring any changes in water management practices, regulat ion, or policy. Finally, the impact of declining water levels and even exhaustion of groundwater resources are projected for specific sectors of the economy as well as particular elements of the region's critical infrastructure.

  2. Mapping human resources for eye health in 21 countries of sub-Saharan Africa: current progress towards VISION 2020

    Science.gov (United States)

    2014-01-01

    Background Development of human resources for eye health (HReH) is a major focus of the Global Action Plan 2014 to 2019 to reduce the prevalence of avoidable visual impairment by 25% by the year 2019. The eye health workforce is thought to be much smaller in sub-Saharan Africa than in other regions of the world but data to support this for policy-making is scarce. We collected HReH and cataract surgeries data from 21 countries in sub-Sahara to estimate progress towards key suggested population-based VISION 2020 HReH indicators and cataract surgery rates (CSR) in 2011. Methods Routinely collected data on practitioner and surgery numbers in 2011 was requested from national eye care coordinators via electronic questionnaires. Telephone and e-mail discussions were used to determine data collection strategies that fit the national context and to verify reported data quality. Information was collected on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and ‘mid-level refractionists’ and combined with publicly available population data to calculate practitioner to population ratios and CSRs. Associations with development characteristics were conducted using Wilcoxon rank sum tests and Spearman rank correlations. Results HReH data was not easily available. A minority of countries had achieved the suggested VISION 2020 targets in 2011; five countries for ophthalmologists/cataract surgeons, four for ophthalmic nurses/clinical officers and two for CSR. All countries were below target for optometrists, even when other cadres who perform refractions as a primary duty were considered. The regional (sample) ratio for surgeons (ophthalmologists and cataract surgeons) was 2.9 per million population, 5.5 for ophthalmic clinical officers and nurses, 3.7 for optometrists and other refractionists, and 515 for CSR. A positive correlation between GDP and CSR as well as many practitioner ratios was observed

  3. Mapping human resources for eye health in 21 countries of sub-Saharan Africa: current progress towards VISION 2020.

    Science.gov (United States)

    Palmer, Jennifer J; Chinanayi, Farai; Gilbert, Alice; Pillay, Devan; Fox, Samantha; Jaggernath, Jyoti; Naidoo, Kovin; Graham, Ronnie; Patel, Daksha; Blanchet, Karl

    2014-08-15

    Development of human resources for eye health (HReH) is a major focus of the Global Action Plan 2014 to 2019 to reduce the prevalence of avoidable visual impairment by 25% by the year 2019. The eye health workforce is thought to be much smaller in sub-Saharan Africa than in other regions of the world but data to support this for policy-making is scarce. We collected HReH and cataract surgeries data from 21 countries in sub-Sahara to estimate progress towards key suggested population-based VISION 2020 HReH indicators and cataract surgery rates (CSR) in 2011. Routinely collected data on practitioner and surgery numbers in 2011 was requested from national eye care coordinators via electronic questionnaires. Telephone and e-mail discussions were used to determine data collection strategies that fit the national context and to verify reported data quality. Information was collected on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and 'mid-level refractionists' and combined with publicly available population data to calculate practitioner to population ratios and CSRs. Associations with development characteristics were conducted using Wilcoxon rank sum tests and Spearman rank correlations. HReH data was not easily available. A minority of countries had achieved the suggested VISION 2020 targets in 2011; five countries for ophthalmologists/cataract surgeons, four for ophthalmic nurses/clinical officers and two for CSR. All countries were below target for optometrists, even when other cadres who perform refractions as a primary duty were considered. The regional (sample) ratio for surgeons (ophthalmologists and cataract surgeons) was 2.9 per million population, 5.5 for ophthalmic clinical officers and nurses, 3.7 for optometrists and other refractionists, and 515 for CSR. A positive correlation between GDP and CSR as well as many practitioner ratios was observed (CSR P = 0

  4. Factors influencing trainee doctor emigration in a high income country: a mixed methods study.

    OpenAIRE

    Clarke, Nicholas; Crowe, Sophie; Humphries, Niamh; Conroy, Ronan; O'Hare, Simon; Kavanagh, Paul; Brugha, Ruairi F

    2017-01-01

    BACKGROUND: The Global Code of Practice on the International Recruitment of Health Personnel focuses particularly on migration of doctors from low- and middle-income countries. Less is understood about migration from high-income countries. Recession has impacted several European countries in recent years, and in some cases emigration has reached unprecedented levels. This study measures and explores the predictors of trainee doctor emigration from Ireland. METHODS: Using a partially mixed ...

  5. Factors influencing trainee doctor emigration in a high income country: a mixed methods study.

    LENUS (Irish Health Repository)

    Clarke, Nicholas

    2017-09-25

    The Global Code of Practice on the International Recruitment of Health Personnel focuses particularly on migration of doctors from low- and middle-income countries. Less is understood about migration from high-income countries. Recession has impacted several European countries in recent years, and in some cases emigration has reached unprecedented levels. This study measures and explores the predictors of trainee doctor emigration from Ireland.

  6. Current R and D Status on High-Level Radioactive Waste Disposal in Selected Countries

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Youn Myoung; Hwang, Yong Soo

    2008-11-15

    Current R and D status of such countries moving forward as the United States, Sweden, France, Japan and a few other countries for high-level radioactive waste (HLW) disposal in deep geological formation has been reviewed. Even though no HLW repositories have not practically constructed nor operated yet, lots of related R and D are being proceeded in many countries as well as in Korea. Through this brief review further progress is anticipated in this related R and D area in Korea.

  7. Law for Country: the Structure of Warlpiri Ecological Knowledge and Its Application to Natural Resource Management and Ecosystem Stewardship

    Directory of Open Access Journals (Sweden)

    Miles C. C. Holmes

    2013-09-01

    Full Text Available Indigenous Ecological Knowledge (IEK is deeply encoded in social processes. Our research shows that from an Indigenous perspective, IEK is a way of living whose core aim is to sustain the healthy functioning of people and country through relationships of reciprocity. However, IEK is often portrayed more prosaically as a body of knowledge about the environment. We introduce a framework, called ngurra-kurlu, that enables appreciation of indigenous perspectives on IEK. The framework was identified from the collaborative work of the authors with Warlpiri aboriginal elders in the Tanami Desert region of central Australia. Ngurra-kurlu facilitates cross-cultural understanding by distilling, from a complex cultural system, the five distinct conceptual categories that comprise IEK: law, skin, ceremony, language, and country. The framework enables engagement with nuanced environmental knowledge because it synthesizes, for cross-cultural audiences, all the key areas of knowledge and practice in which IEK is located. In particular, the framework highlights how social systems mediate the transmission, deployment, and regulation of environmental knowledge in on-ground situations, including collaborative natural resource management. Although the framework was generated in relation to one indigenous group, the epistemological structure of Warlpiri IEK is relevant throughout Australia, and the framework can be applied internationally to the emerging interest in fostering ecosystem stewardship in which the cultural connections between people and place are an integral part of ecosystems management.

  8. Investigations of Very High Enthalpy Geothermal Resources in Iceland.

    Science.gov (United States)

    Elders, W. A.; Fridleifsson, G. O.

    2012-12-01

    The Iceland Deep Drilling Project (IDDP) is investigating the economic feasibility of producing electricity from supercritical geothermal reservoirs. Earlier modeling indicates that the power output of a geothermal well producing from a supercritical reservoir could potentially be an order of magnitude greater than that from a conventional hot geothermal reservoir, at the same volumetric flow rate. However, even in areas with an unusually high geothermal gradient, for normal hydrostatic pressure gradients reaching supercritical temperatures and pressures will require drilling to depths >4 km. In 2009 the IDDP attempted to drill the first deep supercritical well, IDDP-01, in the caldera of the Krafla volcano, in NE Iceland. However drilling had to be terminated at only 2.1 km depth when ~900°C rhyolite magma flowed into the well. Our studies indicate that this magma formed by partial melting of hydrothermally altered basalts within the Krafla caldera. Although this well was too shallow to reach supercritical pressures, it is highly productive, and is estimated to be capable of generating up to 36 MWe from the high-pressure, superheated steam produced from the upper contact zone of the intrusion. With a well-head temperature of ~440°C, it is at present apparently the hottest producing geothermal well in the world. A pilot plant is investigating the optimal utilization of this magmatically heated resource. A special issue of the journal Geothermics with 16 papers reporting on the IDDP-01 is in preparation. However, in order to continue the search for supercritical geothermal resources, planning is underway to drill a 4.5 km deep well at Reykjanes in SW Iceland in 2013-14. Although drilling deeper towards the heat source of this already developed high-temperature geothermal field will be more expensive, if a supercritical resource is found, this cost increase should be offset by the considerable increase in the power output and lifetime of the Reykjanes geothermal

  9. Poverty, energy, and resource use in developing countries: focus on Africa.

    Science.gov (United States)

    Kammen, Daniel M; Kirubi, Charles

    2008-01-01

    Energy poverty affects poor communities and poor nations far more severely, and more directly, than in developed nations. Poor rural communities are particularly vulnerable, and the poor globally spend by far the largest percentage of income on energy. To make matters worse, record-high oil prices combined with sharp decline in foreign exchange earnings are key processes influencing the energy sector in Africa. These increases cause tremendous local hardships, but can be used to steer development decisions toward renewable energy technologies. At the same time, breaking up of public monopolies and liberalizing generation and distribution provides an opportunity for a new approach to rural electrification. Given the right incentives and institutional framework, a new set of players (e.g., private entrepreneurs, cooperatives, nongovernmental organizations, and communities) are likely to emerge and dominate reformed rural electricity markets in the future. Through technological and institutional "leap-frogging," Africa stands to gain significantly by augmenting current initiatives with experience and lessons recently gained in South Asia and Latin America. In these regions, a number of remarkable recent strides to seed and grow rural electricity markets while stimulating and encouraging private investments. Examples of innovative regulatory tools to address poverty include licensing, standards and guidelines, metering, tariffs, transmission charges, and performance-based contracting for energy services.

  10. Breast Camps for Awareness and Early Diagnosis of Breast Cancer in Countries With Limited Resources: A Multidisciplinary Model From Kenya.

    Science.gov (United States)

    Sayed, Shahin; Moloo, Zahir; Ngugi, Anthony; Allidina, Amyn; Ndumia, Rose; Mutuiri, Anderson; Wasike, Ronald; Wahome, Charles; Abdihakin, Mohamed; Kasmani, Riaz; Spears, Carol D; Oigara, Raymond; Mwachiro, Elizabeth B; Busarla, Satya V P; Kibor, Kibet; Ahmed, Abdulaziz; Wawire, Jonathan; Sherman, Omar; Saleh, Mansoor; Zujewski, Jo Anne; Dawsey, Sanford M

    2016-09-01

    Breast cancer is the most common cancer of women in Kenya. There are no national breast cancer early diagnosis programs in Kenya. The objective was to conduct a pilot breast cancer awareness and diagnosis program at three different types of facilities in Kenya. This program was conducted at a not-for-profit private hospital, a faith-based public hospital, and a government public referral hospital. Women aged 15 years and older were invited. Demographic, risk factor, knowledge, attitudes, and screening practice data were collected. Breast health information was delivered, and clinical breast examinations (CBEs) were performed. When appropriate, ultrasound imaging, fine-needle aspirate (FNA) diagnoses, core biopsies, and onward referrals were provided. A total of 1,094 women were enrolled in the three breast camps. Of those, 56% knew the symptoms and signs of breast cancer, 44% knew how breast cancer was diagnosed, 37% performed regular breast self-exams, and 7% had a mammogram or breast ultrasound in the past year. Of the 1,094 women enrolled, 246 (23%) had previously noticed a lump in their breast. A total of 157 participants (14%) had abnormal CBEs, of whom 111 had ultrasound exams, 65 had FNAs, and 18 had core biopsies. A total of 14 invasive breast cancers and 1 malignant phyllodes tumor were diagnosed Conducting a multidisciplinary breast camp awareness and early diagnosis program is feasible in different types of health facilities within a low- and middle-income country setting. This can be a model for breast cancer awareness and point-of-care diagnosis in countries with limited resources like Kenya. This work describes a novel breast cancer awareness and early diagnosis demonstration program in a low- and middle-income country within a limited resource setting. The program includes breast self-awareness and breast cancer education, clinical exams, and point-of-care diagnostics for women in three different types of health facilities in Kenya. This pilot

  11. Reciprocity in Labor Market Relationships: Evidence from an Experiment across High-Income OECD Countries

    Directory of Open Access Journals (Sweden)

    Israel Waichman

    2015-10-01

    Full Text Available We study differences in behavior across countries in a labor market context. To this end, we conducted a bilateral gift-exchange experiment comparing the behavior of subjects from five high-income OECD countries: Germany, Spain, Israel, Japan and the USA. We observe that in all countries, effort levels are increasing while rejection rates are decreasing in wage offers. However, we also find considerable differences in behavior across countries in both one-shot and repeated relationships, the most striking between Germany and Spain. We also discuss the influence of socio-economic indicators and the implications of our findings.

  12. Convergence in Food Demand and Delivery: Do Middle-Income Countries Follow High-Income Trends?

    OpenAIRE

    Regmi, Anita; Takeshima, Hiroyuki; Unnevehr, Laurian J.

    2008-01-01

    This study uses food expenditures and food-sales data from 1990 to 2004 to examine whether food-consumption patterns and food-delivery-mechanism trends are converging across 47 high- and middle-income countries. Results point to a high degree of convergence in global food systems. Middle-income countries appear to be following trends in high-income countries. Convergence is apparent in most important food-expenditure categories and in indicators of food-system modernization such as supermarke...

  13. Regional energy resource development and energy security under CO{sub 2} emission constraint in the greater Mekong sub-region countries (GMS)

    Energy Technology Data Exchange (ETDEWEB)

    Watcharejyothin, Mayurachat; Shrestha, Ram M. [School of Environment, Resources and Development, Asian Institute of Technology (Thailand)

    2009-11-15

    The paper evaluates effects of energy resource development within the Greater Mekong Sub-region (GMS) on energy supply mix, energy system cost, energy security and environment during 2000-2035. A MARKAL-based integrated energy system model of the five GMS countries was developed to examine benefits of regional energy resource development for meeting the energy demand of these countries. The study found that an unrestricted energy resource development and trade within the region would reduce the total-regional energy systems cost by 18% and would abate the total CO{sub 2} emission by 5% as compared to the base case. All the five countries except Myanmar would benefit from the expansion of regional energy resource integration in terms of lower energy systems costs and better environmental qualities. An imposition of CO{sub 2} emission reduction constraint by 5% on each of the study countries from that of the corresponding emissions under the unrestricted energy resource development in the GMS is found to improve energy security, reduce energy import and fossil fuels dependences and increase volume of power trade within the region. The total energy system cost under the joint CO{sub 2} emission reduction strategy would be less costly than that under the individual emission targets set for each country. (author)

  14. Regional energy resource development and energy security under CO2 emission constraint in the greater Mekong sub-region countries (GMS)

    International Nuclear Information System (INIS)

    Watcharejyothin, Mayurachat; Shrestha, Ram M.

    2009-01-01

    The paper evaluates effects of energy resource development within the Greater Mekong Sub-region (GMS) on energy supply mix, energy system cost, energy security and environment during 2000-2035. A MARKAL-based integrated energy system model of the five GMS countries was developed to examine benefits of regional energy resource development for meeting the energy demand of these countries. The study found that an unrestricted energy resource development and trade within the region would reduce the total-regional energy systems cost by 18% and would abate the total CO 2 emission by 5% as compared to the base case. All the five countries except Myanmar would benefit from the expansion of regional energy resource integration in terms of lower energy systems costs and better environmental qualities. An imposition of CO 2 emission reduction constraint by 5% on each of the study countries from that of the corresponding emissions under the unrestricted energy resource development in the GMS is found to improve energy security, reduce energy import and fossil fuels dependences and increase volume of power trade within the region. The total energy system cost under the joint CO 2 emission reduction strategy would be less costly than that under the individual emission targets set for each country.

  15. Technologies for the exploration of highly mineralized geothermal resources

    Science.gov (United States)

    Alkhasov, A. B.; Alkhasova, D. A.; Ramazanov, A. Sh.; Kasparova, M. A.

    2017-09-01

    The prospects of the integrated processing of the high-parameter geothermal resources of the East Ciscaucasia of artesian basin (ECAB) with the conversion of their heat energy into electric energy at a binary geoPP and the subsequent extraction of solved chemical compounds from thermal waters are evaluated. The most promising areas for the exploration such resources are overviewed. The integrated exploration of hightemperature hydrogeothermal brines is a new trend in geothermal power engineering, which can make it possible to significantly increase the production volume of hydrogeothermal resources and develop the geothermal field at a higher level with the realization of the energy-efficient advanced technologies. The large-scale exploration of brines can solve the regional problems of energy supply and import substitution and fulfill the need of Russia in food and technical salt and rare elements. The necessity of the primary integrated exploration of the oil-field highly mineralized brines of the South Sukhokumskii group of gas-oil wells of Northern Dagestan was shown in view of the exacerbated environmental problems. Currently, the oil-field brines with the radioactive background exceeding the allowable levels are discharged at disposal fields. The technological solutions for their deactivation and integrated exploration are proposed. The realization of the proposed technological solutions provides 300 t of lithium carbonate, 1650 t of caustic magnesite powder, 27300 t of chemically precipitated chalk, 116100 t of food salt, and up to 1.4 mln m3 of desalinated water from oil-field brines yearly. Desalinated water at the output of a geotechnological complex can be used for different economic needs, which is important for the arid North Caucasus region, where the fresh water deficiency is acute, especially in its plain part within the ECAB.

  16. From Smart-Eco Building to High-Performance Architecture: Optimization of Energy Consumption in Architecture of Developing Countries

    Science.gov (United States)

    Mahdavinejad, M.; Bitaab, N.

    2017-08-01

    Search for high-performance architecture and dreams of future architecture resulted in attempts towards meeting energy efficient architecture and planning in different aspects. Recent trends as a mean to meet future legacy in architecture are based on the idea of innovative technologies for resource efficient buildings, performative design, bio-inspired technologies etc. while there are meaningful differences between architecture of developed and developing countries. Significance of issue might be understood when the emerging cities are found interested in Dubaization and other related booming development doctrines. This paper is to analyze the level of developing countries’ success to achieve smart-eco buildings’ goals and objectives. Emerging cities of West of Asia are selected as case studies of the paper. The results of the paper show that the concept of high-performance architecture and smart-eco buildings are different in developing countries in comparison with developed countries. The paper is to mention five essential issues in order to improve future architecture of developing countries: 1- Integrated Strategies for Energy Efficiency, 2- Contextual Solutions, 3- Embedded and Initial Energy Assessment, 4- Staff and Occupancy Wellbeing, 5- Life-Cycle Monitoring.

  17. A proven and highly cost-effective method of early detection of breast cancer for developing countries

    International Nuclear Information System (INIS)

    Rebentisch, D.P.; Rebentisch, H.D.; Thomas, K.; Karat, S.; Jadhav, A.J.

    1995-01-01

    Carcinoma of the breast is the third most common cancer in Indian women. With rapid industrialization and effective control of communicable diseases, better diagnostic and treatment facilities, cancer is emerging as a major health problem. Since early detection is the only way to reduce morbidity and mortality from breast cancer, we undertook a pilot project to evaluate efficacy of using existing manpower and resources for screening women in the high risk group. Methodology pros and cons, results, and recommendations are presented. Our method can be adopted by any developing country interested in a screening programme for malignant disease

  18. A proven and highly cost-effective method of early detection of breast cancer for developing countries.

    Science.gov (United States)

    Rebentisch, D P; Rebentisch, H D; Thomas, K; Karat, S; Jadhav, A J

    1995-12-01

    Carcinoma of the breast is the third most common cancer in Indian women. With rapid industrialization and effective control of communicable diseases, better diagnostic and treatment facilities, cancer is emerging as a major health problem. Since early detection is the only way to reduce morbidity and mortality from breast cancer, we undertook a pilot project to evaluate efficacy of using existing manpower and resources for screening women in the high risk group. Methodology pros and cons, results, and recommendations are presented. Our method can be adopted by any developing country interested in a screening programme for malignant disease.

  19. Ecologically Safe Geothermal Energy Resources in Western Siberia near high-rise construction zones

    Science.gov (United States)

    Shevchenko, Alexandr; Shiganova, Olga

    2018-03-01

    The development of geothermal energy in combination with other renewable energy sources (the sun, the wind) will help to solve the problem of heat supply and electrification in near high-rise construction zones of the country, especially in sparsely populated parts, where centralized energy and heat supply is economically unacceptable, and will improve the ecological situation. The aim of the research is to analyze the geothermal resources of the main aquifers in Western Siberia and to develop recommendations for further study and use of heat and power resources of this territory. The article gives retrospective of state research programs and potential use of hydrothermal resources of administrative units geographically entering the territory under consideration. It is noted that by now such programs have been curtailed for various reasons, although there are examples of their successful and effective use in various fields of industry and agriculture. According to the decision of the Supreme Ecological Council of the State Duma Committee of the Russian Federation adopted in 2014 on the beginning of the development of federal targeted programs for the use of heat power water as a source of electricity and heat supply, the Ministry of Natural Resources and Ecology of the Russian Federation made proposals for further research and use of hydrothermal waters in Western Siberia. Implementation of the programs proposed by the authors, alongside with other positive aspects, will solve the problems of heat supply in remote territories and improve the environmental situation in the region.

  20. Financial resources for development. Capital markets in developing countries: a study on borrowing by developing countries in the emerging capital markets of the Middle East

    Energy Technology Data Exchange (ETDEWEB)

    Nashashibi, H S

    1980-10-01

    Private transfers of capital from the Organization of Petroleum Exporting Countries (OPEC) to developing countries are intended to complement private transfers from the Organization of Economic Cooperation and Development (OECD) by tapping the emerging capital markets in the Middle East. Developing countries will be able to diversify their borrowing and gain additional financing. The long-term investment of oil-producing countries will benefit and the pressures on the banking institutions to recycle funds will lessen. Middle East capital markets include international loans and international bonds. The history of the Kuwaiti dinar (KD) bond market, with its advantages for both investors and borrowers, illustrates the successful development of a capital market. Financial intermediation needs to be improved, however, if the Middle East is to become efficient enough to compete with the Euromarkets. Efficiency will require different measures and should reflect strengthening relationships among Middle East nations. (DCK)

  1. Pediatric tuberculosis immigration screening in high-immigration, low-incidence countries.

    Science.gov (United States)

    Alvarez, G G; Clark, M; Altpeter, E; Douglas, P; Jones, J; Paty, M-C; Posey, D L; Chemtob, D

    2010-12-01

    Tuberculosis (TB) screening in migrant children, including immigrants, refugees and asylum seekers, is an ongoing challenge in low TB incidence countries. Many children from high TB incidence countries harbor latent TB infection (LTBI), and some have active TB disease at the point of immigration into host nations. Young children who harbor LTBI have a high risk of progression to TB disease and are at a higher risk than adults of developing disseminated severe forms of TB with significant morbidity and mortality. Many countries have developed immigration TB screening programs to suit the needs of adults, but have not focused much attention on migrant children. To compare the TB immigration medical examination requirements in children in selected countries with high immigration and low TB incidence rates. Descriptive study of TB immigration screening programs for systematically selected countries. Of 18 eligible countries, 16 responded to the written survey and telephone interview. No two countries had the same approach to TB screening among migrant children. The optimal evidenced-based manner in which to screen migrant children requires further research.

  2. "Living high - training low" vs. "living high - training high": erythropoietic responses and performance of adolescent cross-country skiers.

    Science.gov (United States)

    Christoulas, K; Karamouzis, M; Mandroukas, K

    2011-03-01

    To determine and compare the erythropoietic response and exercise performance of adolescent cross-country skiers, as a result of "living high-training high" (HH) and "living high-training low" (HL). Nine female and six male adolescent cross-country skiers volunteered to participate in separate trials. In the first trial (HH), the skiers lived and trained for 21 days at 1550-2050 m, while in the second trial (HL) they trained near sea level (450-500 m) but resided at 1550 m. All participants underwent maximal cycle ergometer tests for the determination of VO2max and cardiorespiratory parameters via an open circuit system at sea level before ascent to altitude, and 1-2 days after descent from altitude. Blood samples were drawn prior to and immediately after maximal cycle exercise testing, at sea level prior to ascent, on days 1 (D1) and 21 (D21) at altitude (1740 m), and 1-2 days post-altitude, for the determination of serum erythropoietin (EPO) concentration, haemoglobin (Hb), hematocrit (Ht), and red blood cell (RBC) volume. The results showed that both boys and girls cross-country skiers, significantly improved their sea level VO2max after 21 days of living at moderate altitude and training near sea level. The present study demonstrates that living at moderate altitude, 1550-2050 m and training low, near sea level (450-500 m) significantly increases VO2max and RBC mass for both boys and girls. Results indicate that applying the training concept "living high - training low" in adolescent athletes may improve their endurance performance.

  3. Regulatory strategies for high-level radioactive waste management in nine countries: Final report

    International Nuclear Information System (INIS)

    1987-12-01

    This report provides information on the regulatory strategies being developed or implemented in nine countries for the management and disposal of spent nuclear fuel and high-level radioactive waste. The study was performed by International Energy Associates Limited on behalf of Pacific Northwest Laboratories and the US Department of Energy. IEAL obtained information for this report from the regulatory authorities in each country, who also later reviewed drafts of the respective country sections of the report. The nine countries surveyed were Belgium, Canada, the Federal Republic of Germany, France, Japan, Sweden, Switzerland, the United Kingdom and the United States. These countries were selected for study because they are among the largest producers of nuclear energy in the world today and have aggressive programs for spent fuel management and waste disposal

  4. Local level epidemiological analysis of TB in people from a high incidence country of birth

    Directory of Open Access Journals (Sweden)

    Massey Peter D

    2013-01-01

    Full Text Available Abstract Background The setting for this analysis is the low tuberculosis (TB incidence state of New South Wales (NSW, Australia. Local level analysis of TB epidemiology in people from high incidence countries-of-birth (HIC in a low incidence setting has not been conducted in Australia and has not been widely reported. Local level analysis could inform measures such as active case finding and targeted earlier diagnosis. The aim of this study was to use a novel approach to identify local areas in an Australian state that have higher TB rates given the local areas’ country of birth profiles. Methods TB notification data for the three year period 2006–2008 were analysed by grouping the population into those from a high-incidence country-of-birth and the remainder. Results During the study period there were 1401 notified TB cases in the state of NSW. Of these TB cases 76.5% were born in a high-incidence country. The annualised TB notification rate for the high-incidence country-of-birth group was 61.2/100,000 population and for the remainder of the population was 1.8/100,000. Of the 152 Local Government Areas (LGA in NSW, nine had higher and four had lower TB notification rates in their high-incidence country-of-birth populations when compared with the high-incidence country-of-birth population for the rest of NSW. The nine areas had a higher proportion of the population with a country of birth where TB notification rates are >100/100,000. Those notified with TB in the nine areas also had a shorter length of stay in Australia than the rest of the state. The areas with higher TB notification rates were all in the capital city, Sydney. Among LGAs with higher TB notification rates, four had higher rates in both people with a high-incidence country of birth and people not born in a high-incidence country. The age distribution of the HIC population was similar across all areas, and the highest differential in TB rates across areas was in the 5–19

  5. Local level epidemiological analysis of TB in people from a high incidence country of birth.

    Science.gov (United States)

    Massey, Peter D; Durrheim, David N; Stephens, Nicola; Christensen, Amanda

    2013-01-22

    The setting for this analysis is the low tuberculosis (TB) incidence state of New South Wales (NSW), Australia. Local level analysis of TB epidemiology in people from high incidence countries-of-birth (HIC) in a low incidence setting has not been conducted in Australia and has not been widely reported. Local level analysis could inform measures such as active case finding and targeted earlier diagnosis. The aim of this study was to use a novel approach to identify local areas in an Australian state that have higher TB rates given the local areas' country of birth profiles. TB notification data for the three year period 2006-2008 were analysed by grouping the population into those from a high-incidence country-of-birth and the remainder. During the study period there were 1401 notified TB cases in the state of NSW. Of these TB cases 76.5% were born in a high-incidence country. The annualised TB notification rate for the high-incidence country-of-birth group was 61.2/100,000 population and for the remainder of the population was 1.8/100,000. Of the 152 Local Government Areas (LGA) in NSW, nine had higher and four had lower TB notification rates in their high-incidence country-of-birth populations when compared with the high-incidence country-of-birth population for the rest of NSW. The nine areas had a higher proportion of the population with a country of birth where TB notification rates are >100/100,000. Those notified with TB in the nine areas also had a shorter length of stay in Australia than the rest of the state. The areas with higher TB notification rates were all in the capital city, Sydney. Among LGAs with higher TB notification rates, four had higher rates in both people with a high-incidence country of birth and people not born in a high-incidence country. The age distribution of the HIC population was similar across all areas, and the highest differential in TB rates across areas was in the 5-19 years age group. Analysing local area TB rates and possible

  6. Awareness and Misconceptions of High School Students about Renewable Energy Resources and Applications: Turkey Case

    Science.gov (United States)

    Tortop, Hasan Said

    2012-01-01

    Turkey is the one of the countries in the world which has potential of renewable energy resource because of its geographical position. However, being usage of renewable energy resources and applications (RERAs) is low, it shows that awareness and consciousness of RERAs is very low too. Education must play a key role in growing out of an energy…

  7. On the nature and scope of reported child maltreatment in high-income countries: opportunities for improving the evidence base.

    Science.gov (United States)

    Jud, Andreas; Fluke, John; Alink, Lenneke R A; Allan, Kate; Fallon, Barbara; Kindler, Heinz; Lee, Bong Joo; Mansell, James; van Puyenbroek, Hubert

    2013-11-01

    Although high-income countries share and value the goal of protecting children from harm, national data on child maltreatment and the involvement of social services, the judiciary and health services remain relatively scarce. To explore potential reasons for this, a number of high-income countries across the world (Belgium, Canada, Germany, the Netherlands, New Zealand, South Korea, Switzerland and the United States) were compared. Amongst other aspects, the impact of service orientation (child protection-vs-family-services-orientated), the complexity of systems, and the role of social work as a lead profession in child welfare are discussed. Special consideration is given to indigenous and minority populations. The call for high-income countries to collect national data on child maltreatment is to promote research to better understand the risks to children. Its remit ranges well beyond these issues and reflects a major gap in a critical resource to increase prevention and intervention in these complex social situations. Fortunately, initiatives to close this gap are increasing.

  8. Post-approval monitoring and oversight of U.S.-initiated human subjects research in resource-constrained countries.

    Science.gov (United States)

    Brown, Brandon; Kinsler, Janni; Folayan, Morenike O; Allen, Karen; Cáceres, Carlos F

    2014-06-01

    The history of human subjects research and controversial procedures in relation to it has helped form the field of bioethics. Ethically questionable elements may be identified during research design, research implementation, management at the study site, or actions by a study's investigator or other staff. Post-approval monitoring (PAM) may prevent violations from occurring or enable their identification at an early stage. In U.S.-initiated human subjects research taking place in resource-constrained countries with limited development of research regulatory structures, arranging a site visit from a U.S. research ethics committee (REC) becomes difficult, thus creating a potential barrier to regulatory oversight by the parent REC. However, this barrier may be overcome through the use of digital technologies, since much of the world has at least remote access to the Internet. Empirical research is needed to pilot test the use of these technologies for research oversight to ensure the protection of human subjects taking part in research worldwide.

  9. Setting up home-based palliative care in countries with limited resources: a model from Sarawak, Malaysia.

    Science.gov (United States)

    Devi, B C R; Tang, T S; Corbex, M

    2008-12-01

    The provision of palliative care (PC) and opioids is difficult to ensure in remote areas in low- and middle-income countries. We describe here the set up of a home-care program in Sarawak (the Malaysian part of the Borneo Island), where half the population lives in villages that are difficult to access. The establishment of this program, initiated in 1994 by the Department of Radiotherapy of Sarawak General Hospital, consisted of training, empowering nurses, simplifying referral, facilitating access to medication, and increasing awareness among public and health professionals about PC. The program has been sustainable and cost efficient, serving 936 patients in 2006. The total morphine usage in the program increased from 1400 g in 2006. The results show that pain medication can be provided even in remote areas with effective organization and empowerment of nurses, who were the most important determinants for the set up of this program. Education of family was also a key aspect. The authors believe that the experience gained in Sarawak may help other regions with low or middle resources in the set up of their PC program especially for their remote rural population.

  10. Problems of introducing first nuclear power plant in a developing country with some natural energy resources. The case of Indonesia

    International Nuclear Information System (INIS)

    Subki, I.R.

    1997-01-01

    Indonesia, an archipelagic country, has limited hydro, oil/gas, coal and geothermal resources distributed unevenly over many islands. The use of nuclear energy is very potential not only for optimal energy mix but also to reduce the depletion rates of the fossil fuels. This potential was seriously studied by launching a comprehensive Feasibility Study and Site Investigation from November 1991 to May 1996. The study gives positive results for Nuclear Power Plant's (NPP) introduction, especially from technoeconomic aspects which cover : technology, safety, economy, radioactive waste management and acceptable site at Ujung Lemahabang in Central Java. Financial aspects pose some problem due to the government's policy of accepting no risks both political and financial in big projects undertaking. But, this can be overcome through Build Operate Own (BOO) and barter financing projects. The most difficult problems are non-technical, they are : people's perception on nuclear safety and psycho-political aspects of nuclear energy. We propose a combined solution of continuing more effective public information and developing a wisdom in decision making process. (author)

  11. Cardiovascular Risk and Events in 17 Low-, Middle-, and High-Income Countries.

    OpenAIRE

    Yusuf, S; Rangarajan, S; Teo, K; Islam, S; Li, W; Liu, L; Bo, J; Lou, Q; Lu, F; Liu, T; Yu, L; Zhang, S; Mony, P; Swaminathan, S; Mohan, V

    2014-01-01

    : More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. : We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk using the INTERHEART Risk Score, a validated score for quantifying risk-factor burden without the use of laboratory testing (with higher scores indicating greater r...

  12. Explicit Bias Toward High-Income-Country Research: A Randomized, Blinded, Crossover Experiment Of English Clinicians.

    Science.gov (United States)

    Harris, Matthew; Marti, Joachim; Watt, Hillary; Bhatti, Yasser; Macinko, James; Darzi, Ara W

    2017-11-01

    Unconscious bias may interfere with the interpretation of research from some settings, particularly from lower-income countries. Most studies of this phenomenon have relied on indirect outcomes such as article citation counts and publication rates; few have addressed or proven the effect of unconscious bias in evidence interpretation. In this randomized, blinded crossover experiment in a sample of 347 English clinicians, we demonstrate that changing the source of a research abstract from a low- to a high-income country significantly improves how it is viewed, all else being equal. Using fixed-effects models, we measured differences in ratings for strength of evidence, relevance, and likelihood of referral to a peer. Having a high-income-country source had a significant overall impact on respondents' ratings of relevance and recommendation to a peer. Unconscious bias can have far-reaching implications for the diffusion of knowledge and innovations from low-income countries.

  13. The Dutch disease effect in a high versus low oil dependent countries

    OpenAIRE

    Allegret , Jean-Pierre; Benkhodja , Mohamed Tahar

    2014-01-01

    To investigate the main impacts of the recent increase of oil price on oil exporting economies, we estimate a DSGE model for a sample of 16 oil exporting countries (Algeria, Argentina, Ecuador, Gabon, Indonesia, Kuwait, Libya, Malaysia, Mexico, Nigeria, Oman, Russia, Saudi Arabia, United Arab Emirates, and Venezuela) over the period from 1980 to 2010, except for Russia where our sample begins in 1992. In order to distinguish between high-dependent and low-dependent countries, we use two indic...

  14. Price comparison of high-cost originator medicines in European countries.

    Science.gov (United States)

    Vogler, Sabine; Zimmermann, Nina; Babar, Zaheer-Ud-Din

    2017-04-01

    In recent years, high-cost medicines have increasingly been challenging the public health budget in all countries including high-income economies. In this context, this study aims to survey, analyze and compare prices of medicines that likely contribute to high expenditure for the public payers in high-income countries. We chose the following 16 European countries: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, the Netherlands, Portugal, Sweden, Slovakia, Spain and United Kingdom. The ex-factory price data of 30 medicines in these countries were collected in national databases accessible through the Pharmaceutical Price Information (PPI) service of Gesundheit Österreich GmbH (Austrian Public Health Institute). The ex-factory prices (median) per unit (e.g. per tablet, vial) ranged from 10.67 cent (levodopa + decarboxylase inhibitor) to 17,000 euro (ipilimumab). A total of 53% of the medicines surveyed had a unit ex-factory price (median) above 200 Euro. For two thirds of the medicines, price differences between the highest-priced country and lowest-priced country ranged between 25 and 100%; the remaining medicines, mainly low-priced medicines, had higher price differential, up to 251%. Medicines with unit prices of a few euros or less were medicines for the treatment of diseases in the nervous system (anti-depressants, medicines to treat Parkinson and for the management of neuropathic pain), of obstructive airway diseases and cardio-vascular medicines (lipid modifying agents). High-priced medicines were particularly cancer medicines. Medicine prices of Greece, Hungary, Slovakia and UK were frequently at the lower end, German and Swedish, as well as Danish and Irish prices at the upper end. For high-priced medicines, actual paid prices are likely to be lower due to confidential discounts and similar funding arrangements between industry and public payers. Pricing authorities refer to the higher undiscounted prices when they use

  15. Cigarette Design Features in Low-, Middle-, and High-Income Countries

    Directory of Open Access Journals (Sweden)

    Rosalie V. Caruso

    2012-01-01

    Full Text Available Previous studies have shown that country income grouping is correlated with cigarette engineering. Cigarettes (=111 brands were purchased during 2008–2010 from 11 low-, middle-, and high-income countries to assess physical dimensions and an array of cigarette design features. Mean ventilation varied significantly across low- (7.5%, middle- (15.3%, and high-income (26.2% countries (≤0.001. Differences across income groups were also seen in cigarette length (=0.001, length of the tipping paper (=0.01, filter weight (=0.017, number of vent rows (=0.003, per-cigarette tobacco weight (=0.04, and paper porosity (=0.008. Stepwise linear regression showed ventilation and tobacco length as major predictors of ISO tar yields in low-income countries (=0.909, 0.047, while tipping paper (<0.001, filter length (<0.001, number of vent rows (=0.014, and per-cigarette weight (=0.015 were predictors of tar yields in middle-income countries. Ventilation (<0.001, number of vent rows (=0.009, per-cigarette weight (<0.001, and filter diameter (=0.004 predicted tar yields in high-income countries. Health officials must be cognizant of cigarette design issues to provide effective regulation of tobacco products.

  16. The deforestation problem in oil-importing developing countries: A capital theory approach to a renewable resource

    International Nuclear Information System (INIS)

    Rodriguez, A.E.

    1991-01-01

    This study attempts an analysis of the effects of a crude-oil price shock on the tropical rain-forest biomass of oil-importing developing countries. It establishes the logical plausibility of this relationship between price shocks and deforestation by developing a stylized capital-theoretic intertemporal model with a trade constraint. This formulation allows one to determine the correct price path at each moment in time, an efficiency consideration. A second theoretical model purports to show that justification for the building of high dams as a response to energy shocks was based on myopic expectations of crude oil supplier behavior. Once rational supplier response to natural capital stocks is taken into consideration, a different result emerges suggesting a much larger optical biomass stock. Noting that deforestation is an externality with global repercussions and appealing to the logic of the Folk Theorem of game theory, the last chapter proposes an international collaborative effort whereby concerned nations would supply crude oil to oil-importing developing countries that have witnessed the deterioration of their forest biomass as a direct or indirect consequence of oil price shocks

  17. Human resource governance: what does governance mean for the health workforce in low- and middle-income countries?

    Directory of Open Access Journals (Sweden)

    Kaplan Avril D

    2013-02-01

    Full Text Available Abstract Background Research on practical and effective governance of the health workforce is limited. This paper examines health system strengthening as it occurs in the intersection between the health workforce and governance by presenting a framework to examine health workforce issues related to eight governance principles: strategic vision, accountability, transparency, information, efficiency, equity/fairness, responsiveness and citizen voice and participation. Methods This study builds off of a literature review that informed the development of a framework that describes linkages and assigns indicators between governance and the health workforce. A qualitative analysis of Health System Assessment (HSA data, a rapid indicator-based methodology that determines the key strengths and weaknesses of a health system using a set of internationally recognized indicators, was completed to determine how 20 low- and middle-income countries are operationalizing health governance to improve health workforce performance. Results/discussion The 20 countries assessed showed mixed progress in implementing the eight governance principles. Strengths highlighted include increasing the transparency of financial flows from sources to providers by implementing and institutionalizing the National Health Accounts methodology; increasing responsiveness to population health needs by training new cadres of health workers to address shortages and deliver care to remote and rural populations; having structures in place to register and provide licensure to medical professionals upon entry into the public sector; and implementing pilot programs that apply financial and non-financial incentives as a means to increase efficiency. Common weaknesses emerging in the HSAs include difficulties with developing, implementing and evaluating health workforce policies that outline a strategic vision for the health workforce; implementing continuous licensure and regulation systems to

  18. Human resource governance: what does governance mean for the health workforce in low- and middle-income countries?

    Science.gov (United States)

    Kaplan, Avril D; Dominis, Sarah; Palen, John Gh; Quain, Estelle E

    2013-02-15

    Research on practical and effective governance of the health workforce is limited. This paper examines health system strengthening as it occurs in the intersection between the health workforce and governance by presenting a framework to examine health workforce issues related to eight governance principles: strategic vision, accountability, transparency, information, efficiency, equity/fairness, responsiveness and citizen voice and participation. This study builds off of a literature review that informed the development of a framework that describes linkages and assigns indicators between governance and the health workforce. A qualitative analysis of Health System Assessment (HSA) data, a rapid indicator-based methodology that determines the key strengths and weaknesses of a health system using a set of internationally recognized indicators, was completed to determine how 20 low- and middle-income countries are operationalizing health governance to improve health workforce performance. The 20 countries assessed showed mixed progress in implementing the eight governance principles. Strengths highlighted include increasing the transparency of financial flows from sources to providers by implementing and institutionalizing the National Health Accounts methodology; increasing responsiveness to population health needs by training new cadres of health workers to address shortages and deliver care to remote and rural populations; having structures in place to register and provide licensure to medical professionals upon entry into the public sector; and implementing pilot programs that apply financial and non-financial incentives as a means to increase efficiency. Common weaknesses emerging in the HSAs include difficulties with developing, implementing and evaluating health workforce policies that outline a strategic vision for the health workforce; implementing continuous licensure and regulation systems to hold health workers accountable after they enter the workforce

  19. A tale of two countries : blessed with huge heavy oil resources, Canada and Venezuela pursue different paths

    International Nuclear Information System (INIS)

    Ball, C.

    2005-01-01

    Both Canada and Venezuela are rich in heavy oil resources. This article presented an overview of current development activities in both countries. International interest in the oil sands region has been highlighted by the French oil company Total's acquisition of Deer Creek Energy Ltd in Alberta for $1.35 billion. The acquisition supports the company's strategy of expanding heavy oil operations in the Athabasca region. With 47 per cent participation in the Sincor project, Total is already a major player in Venezuela. Although the Sincor project is one of the world's largest developments, future investment is in jeopardy due to an unpredictable government and shifts in policy by the state-run oil company Petroleos de Venezuela S.A. (PDVSA). The country's energy minister has recently announced that all existing agreements will be terminated as of December 31, 2005. The government has allowed 6 months for companies to enter into new agreements with new terms. Under revised rules, foreign companies will be required to pay income tax at a rate of 50 per cent. The rate will be applied retroactively to profits made over the last 5 years. Under the new law, agreements could be established under the terms of mixed companies, where Venezuela will have majority equity in the company that exploits the oil. In addition, the government has accused companies of not paying the required income tax levels on contracts, and some companies have been fined as much as $100 million. It was suggested that current difficulties are the result of an incoherent energy policy and an unstable regime. The international oil and gas community is watching developments, and it was anticipated that parties previously considering Venezuela as an investment opportunity will now reconsider. By contrast, Alberta has been praised by oil companies for its stable regulatory regime and its reasonable royalty structure. Thanks to a purge of 18,000 employees from PDVSA by Venezuelan president, Alberta is now

  20. WE-FG-201-00: High Impact Technologies for Low Resource Environments

    International Nuclear Information System (INIS)

    2016-01-01

    Many low- and middle-income countries lack the resources and services to manage cancer, from screening and diagnosis to radiation therapy planning, treatment and quality assurance. The challenges in upgrading or introducing the needed services are enormous, and include severe shortages in equipment and trained staff. In this symposium, we will describe examples of technology and scientific research that have the potential to impact all these areas. These include: (1) the development of high-quality/low-cost colposcopes for cervical cancer screening, (2) the application of automated radiotherapy treatment planning to reduce staffing shortages, (3) the development of a novel radiotherapy treatment unit, and (4) utilizing a cloud-based infrastructure to facilitate collaboration and QA. Learning Objectives: Understand some of the issues in cancer care in low- resource environments, including shortages in staff and equipment, and inadequate physical infrastructure for advanced radiotherapy. Understand the challenges in developing and deploying diagnostic and treatment devices and services for low-resource environments. Understand some of the emerging technological solutions for cancer management in LMICs. NCI; L. Court, NIH, Varian, Elekta; I. Feain, Ilana Feain is founder and CTO of Nano-X Pty Ltd

  1. WE-FG-201-00: High Impact Technologies for Low Resource Environments

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    Many low- and middle-income countries lack the resources and services to manage cancer, from screening and diagnosis to radiation therapy planning, treatment and quality assurance. The challenges in upgrading or introducing the needed services are enormous, and include severe shortages in equipment and trained staff. In this symposium, we will describe examples of technology and scientific research that have the potential to impact all these areas. These include: (1) the development of high-quality/low-cost colposcopes for cervical cancer screening, (2) the application of automated radiotherapy treatment planning to reduce staffing shortages, (3) the development of a novel radiotherapy treatment unit, and (4) utilizing a cloud-based infrastructure to facilitate collaboration and QA. Learning Objectives: Understand some of the issues in cancer care in low- resource environments, including shortages in staff and equipment, and inadequate physical infrastructure for advanced radiotherapy. Understand the challenges in developing and deploying diagnostic and treatment devices and services for low-resource environments. Understand some of the emerging technological solutions for cancer management in LMICs. NCI; L. Court, NIH, Varian, Elekta; I. Feain, Ilana Feain is founder and CTO of Nano-X Pty Ltd.

  2. Adapting clinical guidelines in low-resources countries : a study on the guideline on the management and prevention of type 2 diabetes mellitus in Indonesia

    NARCIS (Netherlands)

    Widyahening, Indah S.; Wangge, Grace; van der Graaf, Yolanda; van der Heijden, Geert J M G

    2017-01-01

    Rationale, aims and objectives: Most of the clinical guidelines in low-resource countries are adaptations from preexisting international guidelines. This adaptation can be problematic when those international guidelines are not based on current evidence or original evidence-based international

  3. Summary of questionnaires completed by participating countries: for the project on the management of water resources in the Sahel region, using isotopic techniques

    International Nuclear Information System (INIS)

    Ito, Mari

    2012-07-01

    This presentation was carried out as part of the project on water resources management in the Sahel region, using isotope techniques. It summarizes the two sets of questionnaires made, highlights the basins (aquifers) selected for the Sahel project which are the Lullemen Basin, Taoudeni Basin, Lake Chad Basin and Liptako Gourma. Also, as well as the number of questionnaires completed by the participating countries.

  4. Annotated Bibliography of Children's Literature Resources on War, Terrorism, and Disaster since 1945: By Continents/Countries for Grades K-8

    Science.gov (United States)

    Gangi, Jane M.

    2009-01-01

    This article presents an annotated bibliography of children's literature resources on war, terrorism, and disaster since 1945. This annotated bibliography focuses on grades K-8 from different continents/countries, including (1) Africa; (2) Asia; (3) The Caribbean; (4) Central and South America; (5) Europe; and (6) The Middle East.

  5. The water footprint of cotton consumption: An assessment of the impact of worldwide consumption of cotton products on the water resources in the cotton producing countries

    NARCIS (Netherlands)

    Chapagain, Ashok; Hoekstra, Arjen Ysbert; Savenije, H.H.G.; Gautam, R.

    2006-01-01

    The consumption of a cotton product is connected to a chain of impacts on the water resources in the countries where cotton is grown and processed. The aim of this paper is to assess the ‘water footprint’ of worldwide cotton consumption, identifying both the location and the character of the

  6. Problem solving for breast health care delivery in low and middle resource countries (LMCs): consensus statement from the Breast Health Global Initiative.

    NARCIS (Netherlands)

    Harford, J.B.; Otero, I.V.; Anderson, B.O.; Cazap, E.; Gradishar, W.J.; Gralow, J.R.; Kane, G.M.; Niens, L.M.; Porter, P.L.; Reeler, A.V.; Rieger, P.T.; Shockney, L.D.; Shulman, L.N.; Soldak, T.; Thomas, D.B.; Thompson, B.; Winchester, D.P.; Zelle, S.G.; Badwe, R.A.

    2011-01-01

    International collaborations like the Breast Health Global Initiative (BHGI) can help low and middle income countries (LMCs) to establish or improve breast cancer control programs by providing evidence-based, resource-stratified guidelines for the management and control of breast cancer. The Problem

  7. The European Research Elite: A Cross-National Study of Highly Productive Academics in 11 Countries

    Science.gov (United States)

    Kwiek, Marek

    2016-01-01

    In this paper, we focus on a rare scholarly theme of highly productive academics, statistically confirming their pivotal role in knowledge production across 11 systems studied. The upper 10% of highly productive academics in 11 European countries studied (N = 17,211) provide on average almost half of all academic knowledge production. In contrast…

  8. Early neurologic complications and long-term sequelae of childhood bacterial meningitis in a limited-resource country (Kosovo).

    Science.gov (United States)

    Namani, Sadie A; Koci, Bulëza M; Milenković, Zvonko; Koci, Remzie; Qehaja-Buçaj, Emine; Ajazaj, Lindita; Mehmeti, Murat; Ismaili-Jaha, Vlora

    2013-02-01

    Since neurologic complications of childhood bacterial meningitis are encountered frequently despite antibiotic treatments, the purpose of this study was to analyze early neurologic complications and long-term sequelae of bacterial meningitis in children in a limited-resource country (Kosovo) This study uses a retrospective chart review of children treated for bacterial meningitis in two study periods: 277 treated during years 1997-2002 and 77 children treated during years 2009-2010. Of the 277 vs 77 children treated for bacterial meningitis, 60 (22%) vs 33 (43%) patients developed early neurologic complications, while there were 15 (5.4%) vs 2 (2.6%) deaths. The most frequent early neurologic complications were the following: subdural effusions (13 vs 29%), recurrent seizures (11 vs 8%), and hydrocephalus (3 vs 3%). The relative risk (95% confidence interval) for neurologic complications was the highest in infants (3.56 (2.17-5.92) vs 2.69 (1.62-4.59)) and in cases caused by Haemophilus influenzae 1.94 (1.09-3.18) vs Streptococcus pneumoniae 2.57(1.26-4.47). Long-term sequelae were observed in 10 vs 12% of children, predominantly in infants. The most frequent long-term sequelae were late seizures 9 vs 1%, neuropsychological impairment 1 vs 5%, and deafness 1 vs 3%. In both study periods, the most frequent early neurologic complications of childhood bacterial meningitis were subdural effusions. Long-term sequelae were observed in 10% of children, with late seizures, neuropsychological impairment, and deafness being the most common one. Age prior to 12 months was risk factor for both early neurologic complications and long-term sequelae of bacterial meningitis in children.

  9. High Out-of-Pocket Health Spending in Countries With a Mediterranean Connection

    Directory of Open Access Journals (Sweden)

    Simon Grima

    2018-05-01

    Full Text Available In this study, we analyzed healthcare provision and health expenditure across six Mediterranean countries that adopt the National Health System (Beveridge model and that form part of the European Union (EU with the main aim being that of analyzing and comparing out-of-pocket health spending in countries with a European Mediterranean connection. To this end, we considered various economic indicators and statistics to derive commonalities and differences across these countries and also compared trends in these indicators to those observed across the rest of the EU. We then analyzed these findings in light of other data related to the quality of healthcare delivery and the infrastructure of the health system and discussed recent developments in healthcare within each country and the main challenges faced by the respective health systems. The results show that on average, Mediterranean countries spend less on total healthcare expenditure (THE than the EU average, both as a proportion of GDP, as well as in per capita terms. This is primarily driven by lower-than-EU-average public funding of healthcare. The 2008/2009 macro-economic and financial crisis had a significant impact on the countries under review, and explains the persistent reductions in public health spending as part of the austerity measures put in force across sectors. On the flipside, Mediterranean countries have a higher presence of private health providers in total funding, thereby explaining the higher Out-of-Pocket (OOPs health expenditures in these countries relative to the EU-average. With regard to the overall health infrastructure in these countries, we observed that although the supply of physicians is largely in line with the rest of the EU, there is under-supply when it comes to hospital beds. This may be symptomatic of lower government funding. Nonetheless, all countries score highly in the evaluation of the quality of health services, as recorded by international rankings

  10. Access to Specialized Care Through Telemedicine in Limited-Resource Country: Initial 1,065 Teleconsultations in Albania.

    Science.gov (United States)

    Latifi, Rifat; Gunn, Jayleen K L; Bakiu, Evis; Boci, Arian; Dasho, Erion; Olldashi, Fatos; Pipero, Pellumb; Stroster, John A; Qesteri, Orland; Kucani, Julian; Sulo, Ardi; Oshafi, Manjola; Osmani, Kalterina L; Dogjani, Agron; Doarn, Charles R; Shatri, Zhaneta; Kociraj, Agim; Merrell, Ronald C

    2016-12-01

    To analyze the initial experience of the nationwide clinical telemedicine program of Albania, as a model of implementation of telemedicine using "Initiate-Build-Operate-Transfer" strategy. This was a retrospective study of prospectively collected data from teleconsultations in Albania between January 1, 2014 and August 26, 2015, delivered synchronously, asynchronously, or a combination of both methods. Patient's demographics, mode of consultation, clinical specialty, hospitals providing referral and consultation, time from initial call to completion of consultation, and patient disposition following teleconsultation were analyzed. Challenges of the newly created program have been identified and analyzed as well. There were 1,065 teleconsultations performed altogether during the study period. Ninety-one patients with autism managed via telemedicine were not included in this analysis and will be reported separately. Of 974 teleconsults, the majority were for radiology, neurotrauma, and stroke (55%, 16%, and 10% respectively). Asynchronous technology accounted for nearly two-thirds of all teleconsultations (63.7%), followed by combined (24.3%), and then synchronous (12.0%). Of 974 cases, only 20.0% of patients in 2014 and 22.72% of patients in 2015 were transferred to a tertiary hospital. A majority (98.5%) of all teleconsultations were conducted within the country itself. The Integrated Telemedicine and e-Health program of Albania has become a useful tool to improve access to high-quality healthcare, particularly in high demanding specialty disciplines. A number of challenges were identified and these should serve as lessons for other countries in their quest to establish nationwide telemedicine programs.

  11. The Desire for (Danish) Quality in High and Low Income Countries

    DEFF Research Database (Denmark)

    Nguyen, Daniel Xuyen

    with sales. These correlations are significantly different across destination countries within product categories, but across years for a given product-destination pair. While some existing theories perform better than others at predicting these patterns, none can reconcile the variation across countries......We estimate the correlation between firm prices and sales within a CN8 product-country-year market. We do this for every market to which at least 16 different Danish firms exported between 1999 and 2006. Approximately 60% of Danish exports are to markets in which the price is negatively correlated....... To fully explain the patterns, We introduce a model in which the price-sales correlation can be interpreted as the market's desire for high quality goods over low cost substitutes. We discover an inverted U shaped relation between a country's desire for quality and its per capita GDP, which we term...

  12. Locating operations in high labor cost countries – Evidence from Spain

    Directory of Open Access Journals (Sweden)

    Angel Diaz

    2017-06-01

    Full Text Available The location of operations in high labor cost countries is increasingly discussed in the media, in part for recent declarations and actions from the president of USA, Donald Trump. While this particular instance can be labeled as populist or protectionist, the factors underlying the debate are extremely important: advances in systematic increases in productivity, low population growth, and the transfer of jobs to countries with lower labor costs are creating unemployment and underemployment in developed countries that could eventually result in protectionism and restrictions to free trade. This phenomenon has enormous social and economic implications, and has attracted considerable interest from researchers. In particular, this study provides empirical evidence of the location of manufacturing and services in the context of a European country (Spain, exploring the drivers, social implications and organizational theories that can explain it.

  13. Multivitamin use and adverse birth outcomes in high-income countries

    DEFF Research Database (Denmark)

    Wolf, Hanne T.; Hegaard, Hanne K.; Huusom, Lene D.

    2017-01-01

    of the studies compared the use of folic acid and iron vs the use of multivitamins. The use of multivitamin did not change the risk of the primary outcome, preterm birth (relative risk, 0.84 [95% confidence interval, 0.69–1.03]). However, the risk of small for gestational age (relative risk, 0.77 [95% confidence......Background In high-income countries, a healthy diet is widely accessible. However, a change toward a poor-quality diet with a low nutritional value in high-income countries has led to an inadequate vitamin intake during pregnancy. Objective We conducted a systematic review and meta......). Study Design We searched electronic databases (MEDLINE, Embase, Cochrane, Scopus, and CINAHL) from inception to June 17, 2016, using synonyms of pregnancy, study/trial type, and multivitamins. Eligible studies were all studies in high-income countries investigating the association between multivitamin...

  14. Free Open Access Medical Education resource knowledge and utilisation amongst Emergency Medicine trainees: A survey in four countries

    Directory of Open Access Journals (Sweden)

    Natalie Thurtle

    2016-03-01

    The Emergency Medicine trainees in both developed and low resource settings studied were aware that Free Open Access Medical Education resources exist, but trainees in lower income settings were generally less aware of specific resources. Lack of internet and device access was not a barrier to use in this group.

  15. Mo' Money, Mo' Problems? High-Achieving Black High School Students' Experiences with Resources, Racial Climate, and Resilience

    Science.gov (United States)

    Allen, Walter; Griffin, Kimberly

    2006-01-01

    A multi-site case study analyzed the college preparatory processes of nine African American high achievers attending a well-resourced, suburban high school and eight academically successful African Americans attending a low-resourced urban school. Students at both schools experienced barriers, that is, racial climate and a lack of resources, that…

  16. Water in Africa: the paradoxes of a highly- coveted resource

    International Development Research Centre (IDRC) Digital Library (Canada)

    available good quality, ... natural resource management and food security in Africa .... quality. Access to water is essential since it allows for the achievement of several goals: (i) to improve ... human health, (ii) to promote agricultural production.

  17. Current status of high level radioactive waste disposal in Japan and foreign countries

    International Nuclear Information System (INIS)

    Tanaka, Satoru; Tanabe, Hiromi; Inagaki, Yusuke; Ishida, Hisahiro; Kato, Osamu; Kurata, Mitsuyuki; Yamachika, Hidehiko

    2002-01-01

    At a time point of 2002, there is no country actually disposing high level radioactive wastes into grounds, but in most of countries legislative preparation and practicing agents are carried out and site selection is promoted together with energetic advancement of its R and Ds. As disposal methods of the high level radioactive wastes, various methods such as space disposal, oceanic bottom disposal, ice bed disposal, ground disposal, and so on have been examined. And, a processing technology called partitioning and transmutation technology separating long-lived radionuclides from liquid high level radioactive waste and transmutation into short-lived or harmless radionuclides has also been studied. Here was introduced their wrestling conditions in Japan and main foreign countries, as a special issue of the Current status of high level radioactive waste disposal in Japan and foreign countries'. The high level radioactive wastes (glassification solids or spent nuclear fuels) are wastes always formed by nuclear power generation and establishment of technologies is an important subject for nuclear fuel cycle. (G.K.)

  18. Integration of childhood TB into guidelines for the management of acute malnutrition in high burden countries.

    Science.gov (United States)

    Patel, L N; Detjen, A K

    2017-06-21

    Introduction: Childhood tuberculosis (TB) and undernutrition are major global public health challenges. In 2015, although an estimated 1 million children aged malnutrition from 17 high TB burden countries were reviewed to gather information on TB symptom screening, exposure history, and treatment. Results: Seven (41%) countries recommend routine TB screening among children with acute malnutrition, and six (35%) recommend obtaining a TB exposure history. Conclusion: TB screening is not consistently included in guidelines for acute malnutrition in high TB burden countries. Routine TB risk assessment, especially history of TB exposure, among acutely malnourished children, combined with improved linkages with TB services, would help increase TB case finding and could impact outcomes. Operational research on how best to integrate services at different levels of the health care system is needed.

  19. Health Care Spending in the United States and Other High-Income Countries.

    Science.gov (United States)

    Papanicolas, Irene; Woskie, Liana R; Jha, Ashish K

    2018-03-13

    Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations. Analysis of data primarily from 2013-2016 from key international organizations including the Organisation for Economic Co-operation and Development (OECD), comparing underlying differences in structural features, types of health care and social spending, and performance between the United States and 10 high-income countries. When data were not available for a given country or more accurate country-level estimates were available from sources other than the OECD, country-specific data sources were used. In 2016, the US spent 17.8% of its gross domestic product on health care, and spending in the other countries ranged from 9.6% (Australia) to 12.4% (Switzerland). The proportion of the population with health insurance was 90% in the US, lower than the other countries (range, 99%-100%), and the US had the highest proportion of private health insurance (55.3%). For some determinants of health such as smoking, the US ranked second lowest of the countries (11.4% of the US population ≥15 years smokes daily; mean of all 11 countries, 16.6%), but the US had the highest percentage of adults who were overweight or obese at 70.1% (range for other countries, 23.8%-63.4%; mean of all 11 countries, 55.6%). Life expectancy in the US was the lowest of the 11 countries at 78.8 years (range for other countries, 80.7-83.9 years; mean of all 11 countries, 81.7 years), and infant

  20. Emergency medicine clerkship curriculum in a high-income developing country: methods for development and application.

    Science.gov (United States)

    Cevik, Arif Alper; Cakal, Elif Dilek; Abu-Zidan, Fikri M

    2018-06-07

    The published recommendations for international emergency medicine curricula cover the content, but exclude teaching and learning methods, assessment, and evaluation. We aim to provide an overview on available emergency medicine clerkship curricula and report the development and application experience of our own curriculum. Our curriculum is an outcome-based education, enriched by e-learning and various up-to-date pedagogic principles. Teaching and learning methods, assessment, and evaluation are described. The theory behind our practice in the light of recent literature is discussed aiming to help other colleagues from developing countries to have a clear map for developing and tailoring their own curricula depending on their needs. The details of our emergency medicine clerkship will serve as an example for developing and developed countries having immature undergraduate emergency medicine clerkship curricula. However, these recommendations will differ in various settings depending on available resources. The main concept of curriculum development is to create a curriculum having learning outcomes and content relevant to the local context, and then align the teaching and learning activities, assessments, and evaluations to be in harmony. This may assure favorable educational outcome even in resource limited settings.

  1. Identifying barriers to the availability and use of Magnesium Sulphate Injection in resource poor countries: a case study in Zambia.

    Science.gov (United States)

    Ridge, Anna L; Bero, Lisa A; Hill, Suzanne R

    2010-12-16

    Pre-eclampsia and eclampsia are serious complications of pregnancy and major causes of maternal mortality and morbidity worldwide. According to systematic reviews and WHO guidelines magnesium sulphate injection (MgSO4) should be the first -line treatment for severe pre-eclampsia and eclampsia. Studies have shown that this safe and effective medicine is unavailable and underutilized in many resource poor countries. The objective of this study was to identify barriers to the availability and use of MgSO4 in the Zambian Public Health System. A 'fishbone' (Ishikawa) diagram listing probable facilitators to the availability and use of MgSO4 identified from the literature was used to develop an assessment tool. Barriers to availability and use of MgSO4 were assessed at the regulatory/government, supply, procurement, distribution, health facility and health professional levels. The assessment was completed during August 2008 using archival data, and observations at a pragmatic sample of health facilities providing obstetric services in Lusaka District, Zambia. The major barrier to the availability of MgSO4 within the public health system in Zambia was lack of procurement by the Ministry of Health. Other barriers identified included a lack of demand by health professionals at the health centre level and a lack of in-service training in the use of MgSO4. Where there was demand by obstetricians, magnesium sulphate injection was being procured from the private sector by the hospital pharmacy despite not being registered and licensed for use for the treatment of severe pre-eclampsia and eclampsia by the national Pharmaceutical Regulatory Authority. The case study in Zambia highlights the complexities that underlie making essential medicines available and used appropriately. The fishbone diagram is a useful theoretical framework for illustrating the complexity of translating research findings into clinical practice. A better understanding of the supply system and of the pattern

  2. Human resource management interventions to improve health workers' performance in low and middle income countries: a realist review

    Directory of Open Access Journals (Sweden)

    van der Wilt Gert Jan

    2009-04-01

    Full Text Available Abstract Background Improving health workers' performance is vital for achieving the Millennium Development Goals. In the literature on human resource management (HRM interventions to improve health workers' performance in Low and Middle Income Countries (LMIC, hardly any attention has been paid to the question how HRM interventions might bring about outcomes and in which contexts. Such information is, however, critical to assess the transferability of results. Our aim was to explore if realist review of published primary research provides better insight into the functioning of HRM interventions in LMIC. Methodology A realist review not only asks whether an intervention has shown to be effective, but also through which mechanisms an intervention produces outcomes and which contextual factors appear to be of critical influence. Forty-eight published studies were reviewed. Results The results show that HRM interventions can improve health workers' performance, but that different contexts produce different outcomes. Critical implementation aspects were involvement of local authorities, communities and management; adaptation to the local situation; and active involvement of local staff to identify and implement solutions to problems. Mechanisms that triggered change were increased knowledge and skills, feeling obliged to change and health workers' motivation. Mechanisms to contribute to motivation were health workers' awareness of local problems and staff empowerment, gaining acceptance of new information and creating a sense of belonging and respect. In addition, staff was motivated by visible improvements in quality of care and salary supplements. Only a limited variety of HRM interventions have been evaluated in the health sector in LMIC. Assumptions underlying HRM interventions are usually not made explicit, hampering our understanding of how HRM interventions work. Conclusion Application of a realist perspective allows identifying which HRM

  3. Identifying barriers to the availability and use of Magnesium Sulphate Injection in resource poor countries: A case study in Zambia

    Directory of Open Access Journals (Sweden)

    Hill Suzanne R

    2010-12-01

    Full Text Available Abstract Background Pre-eclampsia and eclampsia are serious complications of pregnancy and major causes of maternal mortality and morbidity worldwide. According to systematic reviews and WHO guidelines magnesium sulphate injection (MgSO4 should be the first -line treatment for severe pre-eclampsia and eclampsia. Studies have shown that this safe and effective medicine is unavailable and underutilized in many resource poor countries. The objective of this study was to identify barriers to the availability and use of MgSO4 in the Zambian Public Health System. Methods A 'fishbone' (Ishikawa diagram listing probable facilitators to the availability and use of MgSO4 identified from the literature was used to develop an assessment tool. Barriers to availability and use of MgSO4 were assessed at the regulatory/government, supply, procurement, distribution, health facility and health professional levels. The assessment was completed during August 2008 using archival data, and observations at a pragmatic sample of health facilities providing obstetric services in Lusaka District, Zambia. Results The major barrier to the availability of MgSO4 within the public health system in Zambia was lack of procurement by the Ministry of Health. Other barriers identified included a lack of demand by health professionals at the health centre level and a lack of in-service training in the use of MgSO4. Where there was demand by obstetricians, magnesium sulphate injection was being procured from the private sector by the hospital pharmacy despite not being registered and licensed for use for the treatment of severe pre-eclampsia and eclampsia by the national Pharmaceutical Regulatory Authority. Conclusions The case study in Zambia highlights the complexities that underlie making essential medicines available and used appropriately. The fishbone diagram is a useful theoretical framework for illustrating the complexity of translating research findings into clinical

  4. Approaches to achieve high grain yield and high resource use efficiency in rice

    Directory of Open Access Journals (Sweden)

    Jianchang YANG

    2015-06-01

    Full Text Available This article discusses approaches to simultaneously increase grain yield and resource use efficiency in rice. Breeding nitrogen efficient cultivars without sacrificing rice yield potential, improving grain fill in later-flowering inferior spikelets and enhancing harvest index are three important approaches to achieving the dual goal of high grain yield and high resource use efficiency. Deeper root distribution and higher leaf photosynthetic N use efficiency at lower N rates could be used as selection criteria to develop N-efficient cultivars. Enhancing sink activity through increasing sugar-spikelet ratio at the heading time and enhancing the conversion efficiency from sucrose to starch though increasing the ratio of abscisic acid to ethylene in grains during grain fill could effectively improve grain fill in inferior spikelets. Several practices, such as post-anthesis controlled soil drying, an alternate wetting and moderate soil drying regime during the whole growing season, and non-flooded straw mulching cultivation, could substantially increase grain yield and water use efficiency, mainly via enhanced remobilization of stored carbon from vegetative tissues to grains and improved harvest index. Further research is needed to understand synergistic interaction between water and N on crop and soil and the mechanism underlying high resource use efficiency in high-yielding rice.

  5. Techniques for assessing water resource potentials in the developing countries: with emphasis on streamflow, erosion and sediment transport, water movement in unsaturated soils, ground water, and remote sensing in hydrologic applications

    Science.gov (United States)

    Taylor, George C.

    1971-01-01

    Hydrologic instrumentation and methodology for assessing water-resource potentials have originated largely in the developed countries of the temperature zone. The developing countries lie largely in the tropic zone, which contains the full gamut of the earth's climatic environments, including most of those of the temperate zone. For this reason, most hydrologic techniques have world-wide applicability. Techniques for assessing water-resource potentials for the high priority goals of economic growth are well established in the developing countries--but much more are well established in the developing countries--but much more so in some than in other. Conventional techniques for measurement and evaluation of basic hydrologic parameters are now well-understood in the developing countries and are generally adequate for their current needs and those of the immediate future. Institutional and economic constraints, however, inhibit growth of sustained programs of hydrologic data collection and application of the data to problems in engineering technology. Computer-based technology, including processing of hydrologic data and mathematical modelling of hydrologic parameters i also well-begun in many developing countries and has much wider potential application. In some developing counties, however, there is a tendency to look on the computer as a panacea for deficiencies in basic hydrologic data collection programs. This fallacy must be discouraged, as the computer is a tool and not a "magic box." There is no real substitute for sound programs of basic data collection. Nuclear and isotopic techniques are being used increasingly in the developed countries in the measurement and evaluation of virtually all hydrologic parameter in which conventional techniques have been used traditionally. Even in the developed countries, however, many hydrologists are not using nuclear techniques, simply because they lack knowledge of the principles involved and of the potential benefits

  6. Influenza vaccination coverage and reasons to refrain among high-risk persons in four European countries.

    NARCIS (Netherlands)

    Kroneman, M.; Essen, G.A. van; Paget, J.

    2006-01-01

    This paper examines influenza vaccine coverage using a population base of an average of 2300 persons in each of four European countries (Germany, Spain, Poland and Sweden). The reasons for non-vaccination of those in the high-risk groups were explored by questionnaire. The vaccine coverage rate

  7. Childhood immunization, vaccine hesitancy, and provaccination policy in high-income countries

    DEFF Research Database (Denmark)

    Thomsen, Frej Klem

    2017-01-01

    Increasing vaccine hesitancy among parents in high-income countries and the resulting drop in early childhood immunization constitute an important public health problem, and raise the issue of what policies might be taken to promote higher rates of vaccination. This article first outlines the bac...

  8. Leveling the Playing Field: Giving Girls An Equal Chance for Basic Education--Three Countries' Efforts. EDI Learning Resources Series.

    Science.gov (United States)

    Stromquist, Nelly; Murphy, Paud

    This booklet examines the efforts of Pakistan, Bangladesh and Malawi to increase the enrollment of girls in their schools. Each country has severe problems of access to education for girls; the gender gap in the gross enrollment rate at the primary school level is at least 10 percentage points in each country. What is noteworthy about these three…

  9. Methodology for Clustering High-Resolution Spatiotemporal Solar Resource Data

    Energy Technology Data Exchange (ETDEWEB)

    Getman, Dan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lopez, Anthony [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mai, Trieu [National Renewable Energy Lab. (NREL), Golden, CO (United States); Dyson, Mark [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-09-01

    In this report, we introduce a methodology to achieve multiple levels of spatial resolution reduction of solar resource data, with minimal impact on data variability, for use in energy systems modeling. The selection of an appropriate clustering algorithm, parameter selection including cluster size, methods of temporal data segmentation, and methods of cluster evaluation are explored in the context of a repeatable process. In describing this process, we illustrate the steps in creating a reduced resolution, but still viable, dataset to support energy systems modeling, e.g. capacity expansion or production cost modeling. This process is demonstrated through the use of a solar resource dataset; however, the methods are applicable to other resource data represented through spatiotemporal grids, including wind data. In addition to energy modeling, the techniques demonstrated in this paper can be used in a novel top-down approach to assess renewable resources within many other contexts that leverage variability in resource data but require reduction in spatial resolution to accommodate modeling or computing constraints.

  10. The Development of the Guide to Economic Analysis and Research (GEAR) Online Resource for Low- and Middle-Income Countries' Health Economics Practitioners: A Commentary.

    Science.gov (United States)

    Adeagbo, Chiaki Urai; Rattanavipapong, Waranya; Guinness, Lorna; Teerawattananon, Yot

    2018-05-01

    Public health authorities around the world are increasingly using economic evaluation to set priorities and inform decision making in health policy, especially in the development of health benefit packages. Nevertheless, researchers in low- and middle-income countries (LMICs) encounter many barriers when conducting economic evaluations. In 2015, the Health Intervention and Technology Assessment Program identified key technical and context-specific challenges faced in conducting and using health economic evaluations in LMICs. On the basis of these research findings, the Guide to Economic Analysis and Research (GEAR) online resource (www.gear4health.com) was developed as a reliable aid to researchers in LMICs that would help overcome those challenges. Funded by the Thailand Research Fund and the Bill and Melinda Gates Foundation, GEAR is a free online resource that provides a visual aid tool for planning economic evaluation studies (GEAR mind maps), a repository of national and international economic evaluation guidelines (GEAR guideline comparison), and an active link to a network of volunteer international experts (GEAR: Ask an expert). GEAR will evolve over time to provide relevant, reliable, and up-to-date information through inputs from its users (e.g., periodic survey on methodological challenges) and experts (e.g., in responding to users' questions). The objective of this commentary was to give a brief description of the development and key features of this unique collective information hub aimed at facilitating high-quality research and empowering health care decision makers and stakeholders to use economic evaluation evidence. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Analysis of human resources for health strategies and policies in 5 countries in Sub-Saharan Africa, in response to GFATM and PEPFAR-funded HIV-activities.

    Science.gov (United States)

    Cailhol, Johann; Craveiro, Isabel; Madede, Tavares; Makoa, Elsie; Mathole, Thubelihle; Parsons, Ann Neo; Van Leemput, Luc; Biesma, Regien; Brugha, Ruairi; Chilundo, Baltazar; Lehmann, Uta; Dussault, Gilles; Van Damme, Wim; Sanders, David

    2013-10-25

    Global Health Initiatives (GHIs), aiming at reducing the impact of specific diseases such as Human Immunodeficiency Virus (HIV), have flourished since 2000. Amongst these, PEPFAR and GFATM have provided a substantial amount of funding to countries affected by HIV, predominantly for delivery of antiretroviral therapy (ARV) and prevention strategies. Since the need for additional human resources for health (HRH) was not initially considered by GHIs, countries, to allow ARV scale-up, implemented short-term HRH strategies, adapted to GHI-funding conditionality. Such strategies differed from one country to another and slowly evolved to long-term HRH policies. The processes and content of HRH policy shifts in 5 countries in Sub-Saharan Africa were examined. A multi-country study was conducted from 2007 to 2011 in 5 countries (Angola, Burundi, Lesotho, Mozambique and South Africa), to assess the impact of GHIs on the health system, using a mixed methods design. This paper focuses on the impact of GFATM and PEPFAR on HRH policies. Qualitative data consisted of semi-structured interviews undertaken at national and sub-national levels and analysis of secondary data from national reports. Data were analysed in order to extract countries' responses to HRH challenges posed by implementation of HIV-related activities. Common themes across the 5 countries were selected and compared in light of each country context. In all countries successful ARV roll-out was observed, despite HRH shortages. This was a result of mostly short-term emergency response by GHI-funded Non-Governmental Organizations (NGOs) and to a lesser extent by governments, consisting of using and increasing available HRH for HIV tasks. As challenges and limits of short-term HRH strategies were revealed and HIV became a chronic disease, the 5 countries slowly implemented mid to long-term HRH strategies, such as formalisation of pilot initiatives, increase in HRH production and mitigation of internal migration of HRH

  12. Synthetic Scenarios from CMIP5 Model Simulations for Climate Change Impact Assessments in Managed Ecosystems and Water Resources: Case Study in South Asian Countries

    Science.gov (United States)

    Anandhi, A.; Omani, N.; Chaubey, I.; Horton, R.; Bader, D.; Nanjundiah, R. S.

    2017-01-01

    Increasing population, urbanization, and associated demand for food production compounded by climate change and variability have important implications for the managed ecosystems and water resources of a region. This is particularly true for south Asia, which supports one quarter of the global population, half of whom live below the poverty line. This region is largely dependent on monsoon precipitation for water. Given the limited resources of the developing countries in this region, the objective of our study was to empirically explore climate change in south Asia up to the year 2099 using monthly simulations from 35 global climate models (GCMs) participating in the fifth phase of the Climate Model Inter-comparison Project (CMIP5) for two future emission scenarios (representative concentration pathways RCP4.5 and RCP8.5) and provide a wide range of potential climate change outcomes. This was carried out using a three-step procedure: calculating the mean annual, monsoon, and non-monsoon precipitation and temperatures; estimating the percent change from historical conditions; and developing scenario funnels and synthetic scenarios. This methodology was applied for the entire south Asia region; however, the percent change information generated at 1.5deg grid scale can be used to generate scenarios at finer spatial scales. Our results showed a high variability in the future change in precipitation (-23% to 52%, maximum in the non-monsoon season) and temperature (0.8% to 2.1%) in the region. Temperatures in the region consistently increased, especially in the Himalayan region, which could have impacts including a faster retreat of glaciers and increased floods. It could also change rivers from perennial to seasonal, leading to significant challenges in water management. Increasing temperatures could further stress groundwater reservoirs, leading to withdrawal rates that become even more unsustainable. The high precipitation variability (with higher propensity for

  13. Increasing access to kidney transplantation in countries with limited resources: the Indian experience with kidney paired donation.

    Science.gov (United States)

    Kute, Vivek B; Vanikar, Aruna V; Shah, Pankaj R; Gumber, Manoj R; Patel, Himanshu V; Engineer, Divyesh P; Modi, Pranjal R; Shah, Veena R; Trivedi, Hargovind L

    2014-10-01

    According to the Indian chronic kidney disease registry, in 2010 only 2% of end stage kidney disease patients were managed with kidney transplantation, 37% were managed with dialysis and 61% were treated conservatively without renal replacement therapy. In countries like India, where a well-organized deceased donor kidney transplantation program is not available, living donor kidney transplantation is the major source of organs for kidney transplantation. The most common reason to decline a donor for directed living donation is ABO incompatibility, which eliminates up to one third of the potential living donor pool. Because access to transplantation with human leukocyte antigen (HLA)-desensitization protocols and ABO incompatible transplantation is very limited due to high costs and increased risk of infections from more intense immunosuppression, kidney paired donation (KPD) promises hope to a growing number of end stage kidney disease patients. KPD is a rapidly growing and cost-effective living donor kidney transplantation strategy for patients who are incompatible with their healthy, willing living donor. In principle, KPD is feasible for any centre that performs living donor kidney transplantation. In transplant centres with a large living donor kidney transplantation program KPD does not require extra infrastructure, decreases waiting time, avoids transplant tourism and prevents commercial trafficking. Although KPD is still underutilized in India, it has been performed more frequently in recent times. To substantially increase donor pool and transplant rates, transplant centres should work together towards a national KPD program and frame a uniform acceptable allocation policy. © 2014 Asian Pacific Society of Nephrology.

  14. Online Resources for High School Teachers--A CLIC Away

    Science.gov (United States)

    Holmes, Jon L.

    2000-04-01

    "I'm a high school teacher. I don't have time to sift through all of JCE to find what I need. I don't have enough time as it is!" If you need to find things in a hurry, go to JCE HS CLIC, the JCE High School Chemed Learning Information Center, http://JChemEd.chem.wisc.edu/HS/. You will find good solid, reliable information, and you will find it fast. CLIC is open 24 hours every day, all over the world. What You Will Find at JCE CLIC We know teachers are pressed for time. During the few minutes between classes or at the end of the day, information needs to be found very quickly. Perhaps you are looking for a demo that illustrates electrochemistry using Cu, Mg, orange juice, and a clock; or a student activity on chromatography that is ready to copy and hand out; or a video to illustrate the action of aqua regia on gold, because you can't use aqua regia and can't afford gold. You can find each of these quickly at CLIC. The Journal has always provided lots of articles designed with high school teachers in mind. What the new JCE HS CLIC does is collect the recent materials at one address on JCE Online, making it quicker and easier for you to find them. Information has been gathered from both print and online versions of the Journal, from JCE Software, and from JCE Internet. It is organized as shown at the bottom of the page. Getting Access to Information You have located something that interests you, perhaps a list of tested demonstrations that pertain to consumer chemistry. Now it is time to get it. JCE subscribers (individuals and libraries) can read, download, and print the full versions of the articles as well as all supplemental materials, including student handouts and instructor's notes. You will need the username and password that are on the mailing label that comes with your Journaleach month. JCE HS CLIC home page: http://JChemEd.chem.wisc.edu/HS/ Your Suggestions, Please Our plans for JCE HS CLIC do not end with what you find now. Other resources and features

  15. Isolation facilities for highly infectious diseases in Europe--a cross-sectional analysis in 16 countries.

    Directory of Open Access Journals (Sweden)

    Stefan Schilling

    Full Text Available BACKGROUND: Highly Infectious Diseases (HIDs are (i easily transmissible form person to person; (ii cause a life-threatening illness with no or few treatment options; and (iii pose a threat for both personnel and the public. Hence, even suspected HID cases should be managed in specialised facilities minimizing infection risks but allowing state-of-the-art critical care. Consensus statements on the operational management of isolation facilities have been published recently. The study presented was set up to compare the operational management, resources, and technical equipment among European isolation facilities. Due to differences in geography, population density, and national response plans it was hypothesized that adherence to recommendations will vary. METHODS AND FINDINGS: Until mid of 2010 the European Network for Highly Infectious Diseases conducted a cross-sectional analysis of isolation facilities in Europe, recruiting 48 isolation facilities in 16 countries. Three checklists were disseminated, assessing 44 items and 148 specific questions. The median feedback rate for specific questions was 97.9% (n = 47/48 (range: n = 7/48 (14.6% to n = 48/48 (100%. Although all facilities enrolled were nominated specialised facilities' serving countries or regions, their design, equipment and personnel management varied. Eighteen facilities fulfilled the definition of a High Level Isolation Unit'. In contrast, 24 facilities could not operate independently from their co-located hospital, and five could not ensure access to equipment essential for infection control. Data presented are not representative for the EU in general, as only 16/27 (59.3% of all Member States agreed to participate. Another limitation of this study is the time elapsed between data collection and publication; e.g. in Germany one additional facility opened in the meantime. CONCLUSION: There are disparities both within and between European countries regarding the design

  16. Dietary health behaviour and beliefs among university students from 26 low, middle and high income countries.

    Science.gov (United States)

    Pengpid, Supa; Peltzer, Karl

    2015-01-01

    The aim of this study was to assess the prevalence of six healthy dietary behaviours and associated factors in university students from 26 low, middle and high income countries. In a cross-sectional survey, we used a self-administered questionnaire (largely based on the European Health and Behaviour Survey) among 19503 undergraduate university students (mean age 20.8, Standard deviation=2.8, age range of 16-30 years) from 27 universities in 26 countries. Results indicated that for a total of six healthy dietary behaviours, overall, students scored a mean of 2.8 healthy dietary behaviours. More female than male students indicated healthy dietary behaviours. In multivariate linear regression among men and women, living in an upper middle income or high income country, dieting to lose weight, the high importance of dietary health benefits, high non-organized religious activity, high physical activity and currently a non-tobacco user were associated with the healthy dietary behaviour index. The study found a high prevalence of relatively poor dietary healthy behaviours.

  17. Does the Budget Expenditure Composition Matter for Long-Run Economic Growth in a Resource Rich Country? Evidence from Azerbaijan

    Directory of Open Access Journals (Sweden)

    Khatai Aliyev

    2016-06-01

    Full Text Available This study investigates the role of budget expenditure composition over Azerbaijan’s non-oil economic growth in the long-run by classifying public spending as capital, social and other expenditures. Authors’ employ ARDLBT approach to co-integration for the period of 2000Q1-2014Q4 to estimate long-run contribution of each spending category before-and-after the oil boom while controlling for oilrelated factors. Empirical results endorse the validity of long-run association among variables. Results concluded insignificant negative impact of capital expenditures, and significant negative impact of other expenditures. However, social spending has statistically and economically strong positive impact over the non-oil output growth. Therefore, research findings confirm that public expenditure composition significantly matters for long-run non-oil economic growth, and social expenditures have the greater positive impact in a resource-rich economy, Azerbaijan. Research results are highly useful for the government officials to consider while planning the expenditures in order to minimize negative response of non-oil sector to the fiscal contraction.

  18. Resource Provisions of a High School Library Collection

    Science.gov (United States)

    Collins, Karla B.; Doll, Carol A.

    2012-01-01

    The mission of the school library "is to ensure students and staff are effective users of ideas and information" (AASL 2009, 8). The school library collection should, therefore, support instruction throughout the school. However, teachers do not always understand the potential value of the resources available. This research explored…

  19. Citizenship Education: Instructional Materials/Resources for High School Citizenship.

    Science.gov (United States)

    Kinoshita, Jane

    This resource guide contains six units of study on citizenship education for use at the secondary level. The purpose of the units is to help students examine the political and legal processes of American society and the rights, responsibilities, and roles of its citizens. The units can be used as the basis for a one-semester elective course in…

  20. Projections of costs, financing, and additional resource requirements for low- and lower middle-income country immunization programs over the decade, 2011-2020.

    Science.gov (United States)

    Gandhi, Gian; Lydon, Patrick; Cornejo, Santiago; Brenzel, Logan; Wrobel, Sandra; Chang, Hugh

    2013-04-18

    The Decade of Vaccines Global Vaccine Action Plan has outlined a set of ambitious goals to broaden the impact and reach of immunization across the globe. A projections exercise has been undertaken to assess the costs, financing availability, and additional resource requirements to achieve these goals through the delivery of vaccines against 19 diseases across 94 low- and middle-income countries for the period 2011-2020. The exercise draws upon data from existing published and unpublished global forecasts, country immunization plans, and costing studies. A combination of an ingredients-based approach and use of approximations based on past spending has been used to generate vaccine and non-vaccine delivery costs for routine programs, as well as supplementary immunization activities (SIAs). Financing projections focused primarily on support from governments and the GAVI Alliance. Cost and financing projections are presented in constant 2010 US dollars (US$). Cumulative total costs for the decade are projected to be US$57.5 billion, with 85% for routine programs and the remaining 15% for SIAs. Delivery costs account for 54% of total cumulative costs, and vaccine costs make up the remainder. A conservative estimate of total financing for immunization programs is projected to be $34.3 billion over the decade, with country governments financing 65%. These projections imply a cumulative funding gap of $23.2 billion. About 57% of the total resources required to close the funding gap are needed just to maintain existing programs and scale up other currently available vaccines (i.e., before adding in the additional costs of vaccines still in development). Efforts to mobilize additional resources, manage program costs, and establish mutual accountability between countries and development partners will all be necessary to ensure the goals of the Decade of Vaccines are achieved. Establishing or building on existing mechanisms to more comprehensively track resources and

  1. Pollution protection and resource conservation in the economic aid of developing countries: a contribution to survival. Umwelt- und Ressourcenschutz in der Entwicklungshilfe: Beihilfe zum Ueberleben

    Energy Technology Data Exchange (ETDEWEB)

    Hartje, V J

    1982-01-01

    The contribution of the bilateral economic aid of the F.R. of Germany for diminishing the pollution and resource problems of the Third World is investigated. Not only the imported air and water pollution are considered the reasons for these problems but the specific aspects of environmental deterioration in developing countries as deforestation, desertification and ground erosion caused primarily by the poverty of the Third World are also included.

  2. The classification, cost categories and the system of accounting for uranium resources in the Russian Federation and CIS countries

    International Nuclear Information System (INIS)

    Naumov, S.S.; Shumilin, M.V.

    1998-01-01

    In 1992 the uranium resource classification systems of Kazakhstan, Russian Federation, Ukraine and Uzbekistan are the same as the system used in the former Soviet Union. The Soviet Union adopted this system as a state law in 1981. Under this system resources are reported as ''in situ'' with no allowance for mining or milling losses and resource depletion. The resources are subdivided according to the degree of exploration and economic value. The classification system divides resources into 7 categories. This includes 3 categories of explored resources (A, B, and C); one of preliminary assessment (C2); and 3 as prognosticated or speculative (P1, P2 and P3). Further analyses and classification is used to determine the readiness for production. This system is used to define the inventory of ''State Balance''. Examples are given for classifying vein-type and rollfront-type sandstone hosted deposits. A discussion of how resources are classified by cost category is given. It is stated, however, that any coincidence between the cost categories used in the former Soviet Union and the cost categories of the IAEA system are ''purely accidental''. (author)

  3. The relationship between air pollution, fossil fuel energy consumption, and water resources in the panel of selected Asia-Pacific countries.

    Science.gov (United States)

    Rafindadi, Abdulkadir Abdulrashid; Yusof, Zarinah; Zaman, Khalid; Kyophilavong, Phouphet; Akhmat, Ghulam

    2014-10-01

    The objective of the study is to examine the relationship between air pollution, fossil fuel energy consumption, water resources, and natural resource rents in the panel of selected Asia-Pacific countries, over a period of 1975-2012. The study includes number of variables in the model for robust analysis. The results of cross-sectional analysis show that there is a significant relationship between air pollution, energy consumption, and water productivity in the individual countries of Asia-Pacific. However, the results of each country vary according to the time invariant shocks. For this purpose, the study employed the panel least square technique which includes the panel least square regression, panel fixed effect regression, and panel two-stage least square regression. In general, all the panel tests indicate that there is a significant and positive relationship between air pollution, energy consumption, and water resources in the region. The fossil fuel energy consumption has a major dominating impact on the changes in the air pollution in the region.

  4. Health care expenditure in the Islamic Republic of Iran versus other high spending countries.

    Science.gov (United States)

    Khosravi, Bahman; Soltani, Shahin; Javan-Noughabi, Javad; Faramarzi, Ahmad

    2017-01-01

    Background: In all countries, health expenditures are a main part of government expenditure, and governments try to find policies and strategies to reduce this expenditure. Overall expenditure index has been raised 30 times during the past 20 years in Iran, while in the health sector, the growth in health expenditures index has been 71 times. The present study aimed at examining health care expenditure in the Islamic Republic of Iran versus other high spending countries. Methods: A comparative panel study was conducted in selected countries with the high mean of health expenditure per capita. Data were collected from the WORLD BANK. Out- of- pocket (OOP), health expenditure per capita, public and private health expenditure, and total health expenditure were compared among the selected counties. Results: Iran has the lowest health expenditure per capita compared to other countries and the USA has the highest health expenditures per capita. In Iran, out- of- pocket expenditure, with more than 50%, was the most cost, while in Luxembourg it was the least cost during 2004 to 2014, with less than 12%. Conclusion: Our findings revealed that politicians and health care executives should find a stable source to finance the health system. Stable sources of financing lead to having a steady trend in health expenditure.

  5. Should all suspected tuberculosis cases in high income countries be tested with GeneXpert?

    Science.gov (United States)

    Vella, Venanzio; Broda, Agnieszka; Drobniewski, Francis

    2018-05-01

    In countries with a low incidence of multidrug-resistant tuberculosis (MDR-TB), universal testing with GeneXpert might not be always cost-effective. This study provides hospital managers in low MDR-TB incidence countries with criteria on when decentralised universal GeneXpert testing would make sense. The alternatives taken into consideration include: universal microbiological culture and drug susceptibility testing (DST) only (comparator); as above but with concurrent centralized GeneXpert in a referral laboratory vs a decentralized GeneXpert system in every hospital to test smear-positive cases only; as above but testing all samples with GeneXpert regardless of smear status. The parameters were from the national TB statistics for England and from a systematic review. Decentralised GeneXpert to test any suspected TB case was the most cost-effective option when 6% or more TB patients belonged to the high-risk group, defined as previous TB diagnosis and or being born in countries with a high MDR-TB incidence. Hospital managers in England and other low MDR-TB incidence countries could use these findings to decide when to invest in GeneXpert or other molecular diagnostics with similar performance criteria for TB diagnostics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Prevalence of high-risk human papillomavirus among women in two English-speaking Caribbean countries.

    Science.gov (United States)

    Andall-Brereton, Glennis; Brown, Eulynis; Slater, Sherian; Holder, Yvette; Luciani, Silvana; Lewis, Merle; Irons, Beryl

    2017-06-08

    To characterize high-risk human papillomavirus (HPV) infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1) a specimen for a Papanicolaou (Pap) test and (2) a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace). High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. High-risk HPV was detected in 102 of 404 (25.2%) in Saint Kitts and Nevis and in 109 of 368 (29.6%) in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies) and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study's results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.

  7. Prevalence of high-risk human papillomavirus among women in two English-speaking Caribbean countries

    Directory of Open Access Journals (Sweden)

    Glennis Andall-Brereton

    2017-06-01

    Full Text Available ABSTRACT Objective To characterize high-risk human papillomavirus (HPV infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. Methods Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1 a specimen for a Papanicolaou (Pap test and (2 a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace. High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. Results High-risk HPV was detected in 102 of 404 (25.2% in Saint Kitts and Nevis and in 109 of 368 (29.6% in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. Conclusions These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study’s results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.

  8. Supportive and palliative care for metastatic breast cancer: resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement.

    Science.gov (United States)

    Cleary, James; Ddungu, Henry; Distelhorst, Sandra R; Ripamonti, Carla; Rodin, Gary M; Bushnaq, Mohammad A; Clegg-Lamptey, Joe N; Connor, Stephen R; Diwani, Msemo B; Eniu, Alexandru; Harford, Joe B; Kumar, Suresh; Rajagopal, M R; Thompson, Beti; Gralow, Julie R; Anderson, Benjamin O

    2013-10-01

    Many women diagnosed with breast cancer in low- and middle-income countries (LMICs) present with advanced-stage disease. While cure is not a realistic outcome, site-specific interventions, supportive care, and palliative care can achieve meaningful outcomes and improve quality of life. As part of the 5th Breast Health Global Initiative (BHGI) Global Summit, an expert international panel identified thirteen key resource recommendations for supportive and palliative care for metastatic breast cancer. The recommendations are presented in three resource-stratified tables: health system resource allocations, resource allocations for organ-based metastatic breast cancer, and resource allocations for palliative care. These tables illustrate how health systems can provide supportive and palliative care services for patients at a basic level of available resources, and incrementally add services as more resources become available. The health systems table includes health professional education, patient and family education, palliative care models, and diagnostic testing. The metastatic disease management table provides recommendations for supportive care for bone, brain, liver, lung, and skin metastases as well as bowel obstruction. The third table includes the palliative care recommendations: pain management, and psychosocial and spiritual aspects of care. The panel considered pain management a priority at a basic level of resource allocation and emphasized the need for morphine to be easily available in LMICs. Regular pain assessments and the proper use of pharmacologic and non-pharmacologic interventions are recommended. Basic-level resources for psychosocial and spiritual aspects of care include health professional and patient and family education, as well as patient support, including community-based peer support. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Addressing Factors Associated with Arab Women's Socioeconomic Status May Reduce Breast Cancer Mortality: Report from a Well Resourced Middle Eastern Country.

    Science.gov (United States)

    Donnelly, Tam Truong; Al Khater, Al-Hareth; Al Kuwari, Mohamed Ghaith; Al-Bader, Salha Bujassoum; Abdulmalik, Mariam; Al-Meer, Nabila; Singh, Rajvir; Fung, Tak

    2015-01-01

    Differences in socioeconomic status (SES) such as income levels may partly explain why breast cancer screening (BCS) disparities exist in countries where health care services are free or heavily subsidized. However, factors that contribute to such differences in SES among women living in well resourced Middle East countries are not fully understood. This quantitative study investigated factors that influence SES and BCS of Arab women. Understanding of such factors can be useful for the development of effective intervention strategies that aim to increase BCS uptake among Arab women. Using data from a cross-sectional survey among 1,063 Arabic-speaking women in Qatar, age 35+, additional data analysis was performed to determine the relationship between socioeconomic indicators such as income and other factors in relation to BCS activities. This study found that income is determined and influenced by education level, occupation, nationality, years of residence in the country, level of social activity, self-perceived health status, and living area. Financial stress, unemployment, and unfavorable social conditions may impede women's participation in BCS activities in well resourced Middle East countries.

  10. An audit of the predictors of outcome in status epilepticus from a resource-poor country: a comparison with developed countries.

    Science.gov (United States)

    Hassan, Haseeb; Rajiv, Keni Ravish; Menon, Ramshekhar; Menon, Deepak; Nair, Muralidharan; Radhakrishnan, Ashalatha

    2016-06-01

    Status epilepticus is a neurological emergency with significant morbidity and mortality. This study describes the clinical profile, treatment, and predictors of outcome of status epilepticus in a tertiary referral centre in a developing country and aims to highlight the similarities and differences from data available from the western world. A retrospective analysis of data of patients treated for status epilepticus was conducted from prospectively maintained records, between January 2000 and September 2010. The demographic data, clinical profile and investigations (including neuroimaging and EEG), aetiology, treatment, and outcomes were studied and compared with data available from the western world. The analysis included 108 events in 84 patients. A single episode of status epilepticus was treated in 72 patients (86%) and multiple status epilepticus events, ranging from two to six per patient, were managed in 12 patients (14%). Mean age was 24.1±20.3 years and 63% were males. The types of status epilepticus included convulsive status in 98 (90.7%), non-convulsive status in seven (6.5%), and myoclonic status in three (2.8%). The majority of events (60%) were remote symptomatic, 16% were acute symptomatic, 16% were of unexplained aetiology, and 8% were progressive symptomatic. In 85 events (79%), status epilepticus could be aborted with first and second-line drugs. The remaining 23 events (21%) progressed to refractory status epilepticus, among which, 13 (56%) were controlled with continuous intravenous midazolam infusion. Case fatality rate was 11%, neurological sequelae were reported in 22%, and 67% returned to baseline. Acute symptomatic status, older age, altered sensorium at the time of admission, and delayed hospitalisation were predictors of poor outcome. Aetiology was the most important determinant of outcome of status epilepticus, as in reports from the western world, with remote symptomatic aetiology secondary to gliosis being the most common

  11. High-technology exports of EEC countries: Persistence and diversity of specialization patterns

    International Nuclear Information System (INIS)

    Papagni, E.

    1992-01-01

    This analysis of the persistence and diversity of specialization patterns in EEC high technology exports is based on a package of products selected from the Eurostat database, COMEXT. High technology goods are considered as an innovative output indicator. A test of hypotheses of hysteresis and diversity of trade patterns at a national level is performed to verify some claims made by the 'evolutionary' theory of innovation and trade. The three-mode principal component analysis carried out confirms the persistence of specialization patterns of each EEC country in high technology exports, and highlights their sharp differences

  12. Acculturation and obesity among migrant populations in high income countries – a systematic review

    Science.gov (United States)

    2013-01-01

    Background There is evidence to suggest that immigrant populations from low or medium-income countries to high income countries show a significant change in obesogenic behaviors in the host society, and that these changes are associated with acculturation. However, the results of studies vary depending on how acculturation is measured. The objective of this study is to systematically review the evidence on the relationship between acculturation - as measured with a standardized acculturation scale - and overweight/obesity among adult migrants from low/middle countries to high income countries. Methods A systematic review of relevant studies was undertaken using six EBSCOhost databases and following the Centre for Reviews and Dissemination’s Guidance for Undertaking Reviews in Health Care. Results The initial search identified 1135 potentially relevant publications, of which only nine studies met the selection criteria. All of the studies were from the US with migrant populations from eight different countries. Six studies employed bi-directional acculturation scales and three used uni-directional scales. Six studies indicated positive general associations between higher acculturation and body mass index (BMI), and three studies reported that higher acculturation was associated with lower BMI, as mainly among women. Conclusion Despite the small number of studies, a number of potential explanatory hypotheses were developed for these emerging patterns. The ‘Healthy Migrant Effect’ may diminish with greater acculturation as the host culture potentially promotes more unhealthy weight gain than heritage cultures. This appears particularly so for men and a rapid form of nutrition transition represents a likely contributor. The inconsistent results observed for women may be due to the interplay of cultural influences on body image, food choices and physical activity. That is, the Western ideal of a slim female body and higher values placed on physical activity and

  13. Public reporting on quality, waiting times and patient experience in 11 high-income countries

    OpenAIRE

    Rechel, Bernd; McKee, Martin; Haas, Marion; Marchildon, Gregory P; Bousquet, Frederic; Blümel, Miriam; Geissler, Alexander; van Ginneken, Ewout; Ashton, Toni; Saunes, Ingrid Sperre; Anell, Anders; Quentin, Wilm; Saltman, Richard; Culler, Steven; Barnes, Andrew

    2016-01-01

    : This article maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, we found that the data most commonly made available to the public are on waiting times for hospital treatment, being reported for major hospi...

  14. Local level epidemiological analysis of TB in people from a high incidence country of birth

    OpenAIRE

    Massey Peter D; Durrheim David N; Stephens Nicola; Christensen Amanda

    2013-01-01

    Abstract Background The setting for this analysis is the low tuberculosis (TB) incidence state of New South Wales (NSW), Australia. Local level analysis of TB epidemiology in people from high incidence countries-of-birth (HIC) in a low incidence setting has not been conducted in Australia and has not been widely reported. Local level analysis could inform measures such as active case finding and targeted earlier diagnosis. The aim of this study was to use a novel approach to identify local ar...

  15. Income inequality and schizophrenia: increased schizophrenia incidence in countries with high levels of income inequality.

    Science.gov (United States)

    Burns, Jonathan K; Tomita, Andrew; Kapadia, Amy S

    2014-03-01

    Income inequality is associated with numerous negative health outcomes. There is evidence that ecological-level socio-environmental factors may increase risk for schizophrenia. The aim was to investigate whether measures of income inequality are associated with incidence of schizophrenia at the country level. We conducted a systematic review of incidence rates for schizophrenia, reported between 1975 and 2011. For each country, national measures of income inequality (Gini coefficient) along with covariate risk factors for schizophrenia were obtained. Multi-level mixed-effects Poisson regression was performed to investigate the relationship between Gini coefficients and incidence rates of schizophrenia controlling for covariates. One hundred and seven incidence rates (from 26 countries) were included. Mean incidence of schizophrenia was 18.50 per 100,000 (SD = 11.9; range = 1.7-67). There was a significant positive relationship between incidence rate of schizophrenia and Gini coefficient (β = 1.02; Z = 2.28; p = .02; 95% CI = 1.00, 1.03). Countries characterized by a large rich-poor gap may be at increased risk of schizophrenia. We suggest that income inequality impacts negatively on social cohesion, eroding social capital, and that chronic stress associated with living in highly disparate societies places individuals at risk of schizophrenia.

  16. Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review.

    Science.gov (United States)

    Battersby, Cheryl; Santhalingam, Tharsika; Costeloe, Kate; Modi, Neena

    2018-03-01

    To conduct a systematic review of neonatal necrotising enterocolitis (NEC) rates in high-income countries published in peer-reviewed journals. We searched MEDLINE, Embase and PubMed databases for observational studies published in peer-reviewed journals. We selected studies reporting national, regional or multicentre rates of NEC in 34 Organisation for Economic Co-operation and Development countries. Two investigators independently screened studies against predetermined criteria. For included studies, we extracted country, year of publication in peer-reviewed journal, study time period, study population inclusion and exclusion criteria, case definition, gestation or birth weight-specific NEC and mortality rates. Of the 1888 references identified, 120 full manuscripts were reviewed, 33 studies met inclusion criteria, 14 studies with the most recent data from 12 countries were included in the final analysis. We identified an almost fourfold difference, from 2% to 7%, in the rate of NEC among babies born REVIEWS REGISTRATION NUMBER: CRD42015030046. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Public reporting on quality, waiting times and patient experience in 11 high-income countries.

    Science.gov (United States)

    Rechel, Bernd; McKee, Martin; Haas, Marion; Marchildon, Gregory P; Bousquet, Frederic; Blümel, Miriam; Geissler, Alexander; van Ginneken, Ewout; Ashton, Toni; Saunes, Ingrid Sperre; Anell, Anders; Quentin, Wilm; Saltman, Richard; Culler, Steven; Barnes, Andrew; Palm, Willy; Nolte, Ellen

    2016-04-01

    This article maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, we found that the data most commonly made available to the public are on waiting times for hospital treatment, being reported for major hospitals in seven countries. Information on patient experience at hospital level is also made available in many countries, but it is not generally available in respect of primary care services. Only one of the 11 countries (England) publishes composite measures of overall quality and safety of care that allow the ranking of providers of hospital care. Similarly, the publication of information on outcomes of individual physicians remains rare. We conclude that public reporting of aggregate measures of quality and safety, as well as of outcomes of individual physicians, remain relatively uncommon. This is likely to be due to both unresolved methodological and ethical problems and concerns that public reporting may lead to unintended consequences. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  18. Toward evaluating the effect of climate change on investments in the water resources sector: insights from the forecast and analysis of hydrological indicators in developing countries

    International Nuclear Information System (INIS)

    Strzepek, Kenneth; Jacobsen, Michael; Boehlert, Brent; Neumann, James

    2013-01-01

    The World Bank has recently developed a method to evaluate the effects of climate change on six hydrological indicators across 8951 basins of the world. The indicators are designed for decision-makers and stakeholders to consider climate risk when planning water resources and related infrastructure investments. Analysis of these hydrological indicators shows that, on average, mean annual runoff will decline in southern Europe; most of Africa; and in southern North America and most of Central and South America. Mean reference crop water deficit, on the other hand, combines temperature and precipitation and is anticipated to increase in nearly all locations globally due to rising global temperatures, with the most dramatic increases projected to occur in southern Europe, southeastern Asia, and parts of South America. These results suggest overall guidance on which regions to focus water infrastructure solutions that could address future runoff flow uncertainty. Most important, we find that uncertainty in projections of mean annual runoff and high runoff events is higher in poorer countries, and increases over time. Uncertainty increases over time for all income categories, but basins in the lower and lower-middle income categories are forecast to experience dramatically higher increases in uncertainty relative to those in the upper-middle and upper income categories. The enhanced understanding of the uncertainty of climate projections for the water sector that this work provides strongly support the adoption of rigorous approaches to infrastructure design under uncertainty, as well as design that incorporates a high degree of flexibility, in response to both risk of damage and opportunity to exploit water supply ‘windfalls’ that might result, but would require smart infrastructure investments to manage to the greatest benefit. (letter)

  19. Toward evaluating the effect of climate change on investments in the water resources sector: insights from the forecast and analysis of hydrological indicators in developing countries

    Science.gov (United States)

    Strzepek, Kenneth; Jacobsen, Michael; Boehlert, Brent; Neumann, James

    2013-12-01

    The World Bank has recently developed a method to evaluate the effects of climate change on six hydrological indicators across 8951 basins of the world. The indicators are designed for decision-makers and stakeholders to consider climate risk when planning water resources and related infrastructure investments. Analysis of these hydrological indicators shows that, on average, mean annual runoff will decline in southern Europe; most of Africa; and in southern North America and most of Central and South America. Mean reference crop water deficit, on the other hand, combines temperature and precipitation and is anticipated to increase in nearly all locations globally due to rising global temperatures, with the most dramatic increases projected to occur in southern Europe, southeastern Asia, and parts of South America. These results suggest overall guidance on which regions to focus water infrastructure solutions that could address future runoff flow uncertainty. Most important, we find that uncertainty in projections of mean annual runoff and high runoff events is higher in poorer countries, and increases over time. Uncertainty increases over time for all income categories, but basins in the lower and lower-middle income categories are forecast to experience dramatically higher increases in uncertainty relative to those in the upper-middle and upper income categories. The enhanced understanding of the uncertainty of climate projections for the water sector that this work provides strongly support the adoption of rigorous approaches to infrastructure design under uncertainty, as well as design that incorporates a high degree of flexibility, in response to both risk of damage and opportunity to exploit water supply ‘windfalls’ that might result, but would require smart infrastructure investments to manage to the greatest benefit.

  20. The Influence of Community Health Resources on Effectiveness and Sustainability of Community and Lay Health Worker Programs in Lower-Income Countries: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Daniel H de Vries

    Full Text Available Despite the availability of practical knowledge and effective interventions required to reduce priority health problems in low-income countries, poor and vulnerable populations are often not reached. One possible solution to this problem is the use of Community or Lay Health Workers (CLHWs. So far, however, the development of sustainability in CLHW programs has failed and high attrition rates continue to pose a challenge. We propose that the roles and interests which support community health work should emerge directly from the way in which health is organized at community level. This review explores the evidence available to assess if increased levels of integration of community health resources in CLHW programs indeed lead to higher program effectiveness and sustainability.This review includes peer-reviewed articles which meet three eligibility criteria: 1 specific focus on CLHWs or equivalent; 2 randomized, quasi-randomized, before/after methodology or substantial descriptive assessment; and 3 description of a community or peer intervention health program located in a low- or middle-income country. Literature searches using various article databases led to 2930 hits, of which 359 articles were classified. Of these, 32 articles were chosen for extensive review, complemented by analysis of the results of 15 other review studies. Analysis was conducted using an excel based data extraction form. Because results showed that no quantitative data was published, a descriptive synthesis was conducted. The review protocol was not proactively registered. Findings show minimal inclusion of even basic community level indicators, such as the degree to which the program is a community initiative, community input in the program or training, the background and history of CLHW recruits, and the role of the community in motivation and retention. Results show that of the 32 studies, only one includes one statistical measure of community integration. As a result

  1. Lessons Learned from Implementing E-Learning for the Education of Health Professionals in Resource-Constrained Countries

    Science.gov (United States)

    Gupta, Manu; Marsden, Sophie; Oluka, Tony; Sharma, Reetu; Lucas, Henry

    2017-01-01

    The growing global demand for tertiary education has led to the increased use of e-learning approaches around the world. Demand has increased most rapidly in low and middle income countries (LMICs), which account for half of the students currently enrolled in higher educational institutions (HEIs). But the implementation of e-learning programmes…

  2. Philippines -- country wide water development projects and funds needed. Water crisis in Manila coincide with parliamentarians seminar on water resources and population.

    Science.gov (United States)

    1997-01-01

    The Philippines' Clean Water Act was developed to protect the country's remaining water resources by institutionalizing mechanisms to monitor, regulate, and control human and industrial activities which contribute to the ongoing environmental degradation of marine and freshwater resources. Approximately 70 participants attended the Philippine Parliamentarians' Conference on Water Resources, Population and Development held December 3-4, 1997, at the Sulo Hotel in Quezon City. Participants included the legislative staff of the members of the House of Representatives and the Senate, Committee Secretaries of the House and Senate, and government and nongovernmental organization officials. Following the opening programs, panel discussions were held on the role of nongovernmental organizations as legitimate monitors of governments' activities; the need to evaluate water sector assessment methods, water policy and strategy, and water legislation standards; and waste water treatment and sewerage systems used in households and industries. The following issues were raised during the conference's open forum: the need to implement new methods in water resource management; the handling of water for both economic and social purposes; the need to implement guidelines, policies, and pricing mechanisms on bottled water; regulating the construction of recreational facilities such as golf courses; and transferring watershed rehabilitation from the Department of Environment and Natural Resources to local water districts. A declaration was prepared and signed by the participants at the close of the conference.

  3. IAEA Helps Remove Highly Radioactive Material from Five South American Countries

    International Nuclear Information System (INIS)

    2018-01-01

    The International Atomic Energy Agency (IAEA) has helped remove 27 disused highly radioactive sources from five South American countries in a significant step forward for nuclear safety and security in the region. It was the largest such project ever facilitated by the IAEA. The material, mainly used for medical purposes such as treating cancer and sterilizing instruments, was transported to Germany and the United States for recycling. Canada, where some of the sources were manufactured, funded the project upon requests for IAEA support from Bolivia, Ecuador, Paraguay, Peru and Uruguay. The sealed Cobalt-60 and Caesium-137 sources pose safety and security risks when no longer in use, according to Raja Adnan, Director of the IAEA’s Division of Nuclear Security. “The removal of this large number of radioactive sources has significantly reduced those risks in the five countries,” Adnan said. In recent years, the IAEA has assisted Bosnia and Herzegovina, Cameroon, Costa Rica, Honduras, Lebanon, Morocco, Tunisia and Uzbekistan in the removal of disused sources. The South American operation was the largest the IAEA has so far coordinated in terms of both the number of highly radioactive sources and countries involved. While nuclear safety and security are national responsibilities, the IAEA helps Member States upon request to meet these responsibilities through training, technical advice, peer reviews and other advisory services. Such efforts may include support for Member States in implementing the safe and cost-effective recovery, conditioning, storage, disposal or transportation of disused sealed radioactive sources (DSRS).

  4. Manual cleaning of hospital mattresses: an observational study comparing high- and low-resource settings.

    Science.gov (United States)

    Hopman, J; Hakizimana, B; Meintjes, W A J; Nillessen, M; de Both, E; Voss, A; Mehtar, S

    2016-01-01

    Hospital-associated infections (HAIs) are more frequently encountered in low- than in high-resource settings. There is a need to identify and implement feasible and sustainable approaches to strengthen HAI prevention in low-resource settings. To evaluate the biological contamination of routinely cleaned mattresses in both high- and low-resource settings. In this two-stage observational study, routine manual bed cleaning was evaluated at two university hospitals using adenosine triphosphate (ATP). Standardized training of cleaning personnel was achieved in both high- and low-resource settings. Qualitative analysis of the cleaning process was performed to identify predictors of cleaning outcome in low-resource settings. Mattresses in low-resource settings were highly contaminated prior to cleaning. Cleaning significantly reduced biological contamination of mattresses in low-resource settings (P cleaning in both the high- and low-resource settings seemed comparable. Cleaning with appropriate type of cleaning materials reduced the contamination of mattresses adequately. Predictors for mattresses that remained contaminated in a low-resource setting included: type of product used, type of ward, training, and the level of contamination prior to cleaning. In low-resource settings mattresses were highly contaminated as noted by ATP levels. Routine manual cleaning by trained staff can be as effective in a low-resource setting as in a high-resource setting. We recommend a multi-modal cleaning strategy that consists of training of domestic services staff, availability of adequate time to clean beds between patients, and application of the correct type of cleaning products. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  5. Boundary Conditions of the High-Investment Human Resource Systems-Small-Firm Labor Productivity Relationship

    Science.gov (United States)

    Chadwick, Clint; Way, Sean A.; Kerr, Gerry; Thacker, James W.

    2013-01-01

    Although a few published, multiindustry, firm-level, empirical studies have linked systems of high-investment or high-performance human resource management practices to enhanced small-firm performance, this stream of strategic human resource management research is underdeveloped and equivocal. Accordingly, in this study, we use a sample of…

  6. Comparative efficiency of technologies for conversion and transportation of energy resources of Russia's eastern regions to NEA countries

    Science.gov (United States)

    Kler, Aleksandr; Tyurina, Elina; Mednikov, Aleksandr

    2018-01-01

    The paper presents perspective technologies for combined conversion of fossil fuels into synthetic liquid fuels and electricity. The comparative efficiency of various process flows of conversion and transportation of energy resources of Russia's east that are aimed at supplying electricity to remote consumers is presented. These also include process flows based on production of synthetic liquid fuel.

  7. Local and landscape-level floral resources explain effects of wildflower strips on wild bees across four European countries

    NARCIS (Netherlands)

    Scheper, J.A.; Bommarco, R.; Holzschuh, A.; Potts, S.G.; Riedinger, V.; Roberts, S.P.M.; Rundlöf, M.; Smith, H.G.; Steffan-Dewenter, I.; Wickens, J.B.; Wickens, V.J.; Kleijn, D.

    2015-01-01

    1.Growing evidence for declines in wild bees calls for the development and implementation of effective mitigation measures. Enhancing floral resources is a widely accepted measure for promoting bees in agricultural landscapes, but effectiveness varies considerably between landscapes and regions. We

  8. Local and landscape-level floral resources explain effects of wildflower strips on wild bees across four European countries

    NARCIS (Netherlands)

    Scheper, J.A.; Bommarco, R.; Holzschuh, A.; Potts, S.G.; Riedinger, V.; Roberts, S.P.M.; Rundlöf, M.; Smith, H.G.; Steffan-Dewenter, I.; Wickens, J.B.; Wickens, V.J.; Kleijn, D.

    2015-01-01

    1. Growing evidence for declines in wild bees calls for the development and implementation of effective mitigation measures. Enhancing floral resources is a widely accepted measure for promoting bees in agricultural landscapes, but effectiveness varies considerably between landscapes and regions. We

  9. Sustaining innovation and improvement in the treatment of childhood cancer: lessons from high-income countries.

    Science.gov (United States)

    Pritchard-Jones, Kathy; Pieters, Rob; Reaman, Gregory H; Hjorth, Lars; Downie, Peter; Calaminus, Gabriele; Naafs-Wilstra, Marianne C; Steliarova-Foucher, Eva

    2013-03-01

    Cancer in children and adolescents is rare and biologically very different from cancer in adults. It accounts for 1·4% of all cancers worldwide, although this proportion ranges from 0·5% in Europe to 4·8% in Africa, largely because of differences in age composition and life expectancy. In high-income countries, survival from childhood cancer has reached 80% through a continuous focus on the integration of clinical research into front-line care for nearly all children affected by malignant disease. However, further improvement must entail new biology-driven approaches, since optimisation of conventional treatments has in many cases reached its limits. In many instances, such approaches can only be achieved through international collaborative research, since rare cancers are being subdivided into increasingly smaller subgroups on the basis of their molecular characteristics. The long-term effect of anticancer treatment on quality of life must also be taken into account because more than one in 1000 adults in high-income countries are thought to be survivors of cancer in childhood or adolescence. The introduction of drugs that are less toxic and more targeted than those currently used necessitates a partnership between clinical and translational researchers, the pharmaceutical industry, drug regulators, and patients and their families. This therapeutic alliance will ensure that efforts are focused on the unmet clinical needs of young people with cancer. Most children with cancer live in low-income and middle-income countries, and these countries account for 94% of all deaths from cancer in people aged 0-14 years. The immediate priority for these children is to improve access to an affordable, best standard of care in each country. Every country should have a national cancer plan that recognises the unique demographic characteristics and care needs of young people with cancer. Centralisation of the complex components of treatment of these rare diseases is essential

  10. Laboratory capacity building for the International Health Regulations (IHR[2005]) in resource-poor countries: the experience of the African Field Epidemiology Network (AFENET).

    Science.gov (United States)

    Masanza, Monica Musenero; Nqobile, Ndlovu; Mukanga, David; Gitta, Sheba Nakacubo

    2010-12-03

    Laboratory is one of the core capacities that countries must develop for the implementation of the International Health Regulations (IHR[2005]) since laboratory services play a major role in all the key processes of detection, assessment, response, notification, and monitoring of events. While developed countries easily adapt their well-organized routine laboratory services, resource-limited countries need considerable capacity building as many gaps still exist. In this paper, we discuss some of the efforts made by the African Field Epidemiology Network (AFENET) in supporting laboratory capacity development in the Africa region. The efforts range from promoting graduate level training programs to building advanced technical, managerial and leadership skills to in-service short course training for peripheral laboratory staff. A number of specific projects focus on external quality assurance, basic laboratory information systems, strengthening laboratory management towards accreditation, equipment calibration, harmonization of training materials, networking and provision of pre-packaged laboratory kits to support outbreak investigation. Available evidence indicates a positive effect of these efforts on laboratory capacity in the region. However, many opportunities exist, especially to support the roll-out of these projects as well as attending to some additional critical areas such as biosafety and biosecuity. We conclude that AFENET's approach of strengthening national and sub-national systems provide a model that could be adopted in resource-limited settings such as sub-Saharan Africa.

  11. High School Physics Textbooks, Resources and Teacher Resourcefulness: Results from the 2012-13 Nationwide Survey of High School Physics Teachers. Focus On

    Science.gov (United States)

    Tesfaye, Casey Langer; White, Susan

    2014-01-01

    What textbooks are physics teachers using? How highly do they rate those textbooks? What other types of materials do teachers use? The textbooks and other resources used by high school physics teachers in the US have evolved along with the changing demands of physics classes and the evolving set of options available to teachers. In this report,…

  12. Using European travellers as an early alert to detect emerging pathogens in countries with limited laboratory resources

    Directory of Open Access Journals (Sweden)

    Grais Rebecca

    2007-01-01

    Full Text Available Abstract Background The volume, extent and speed of travel have dramatically increased in the past decades, providing the potential for an infectious disease to spread through the transportation network. By collecting information on the suspected place of infection, existing surveillance systems in industrialized countries may provide timely information for areas of the world without adequate surveillance currently in place. We present the results of a case study using reported cases of Shigella dysenteriae serotype 1 (Sd1 in European travellers to detect "events" of Sd1, related to either epidemic cases or endemic cases in developing countries. Methods We identified papers from a Medline search for reported events of Sd1 from 1940 to 2002. We requested data on shigella infections reported to the responsible surveillance entities in 17 European countries. Reports of Sd1 from the published literature were then compared with Sd1 notified cases among European travellers from 1990 to 2002. Results Prior to a large epidemic in 1999–2000, no cases of Sd1 had been identified in West Africa. However, if travellers had been used as an early warning, Sd1 could have been identified in this region as earlier as 1992. Conclusion This project demonstrates that tracking diseases in European travellers could be used to detect emerging disease in developing countries. This approach should be further tested with a view to the continuous improvement of national health surveillance systems and existing European networks, and may play a significant role in aiding the international public health community to improve infectious disease control.

  13. Chapitre 14. Networking Project: available S&T resources in the United States for networking with home countries

    OpenAIRE

    Johnson, Jean

    2013-01-01

    Some science and technology (S&T) policies and programs of the United States would facilitate the networking of the foreign-born scientists and engineers (S&Es) with their home countries to contribute to development. These policies and programs would mainly facilitate networking to build up S&T infrastructure. The Director of the National Science Foundation (NSF) has encouraged the U.S. science community to become even further engaged in the world, and has elevated international science withi...

  14. European Energy Integration in East European Countries: Real Necessity to Assure Fair Market prices for Energy Resources

    Directory of Open Access Journals (Sweden)

    Augustin IGNATOV

    2016-06-01

    Full Text Available In order to assure energy, and therefore, economic stability of East European States (hereafter EES there should be undertaken visible steps towards deeper energetic integration of the region under the coordination of EU. In such a way there will be considerably strengthened the regional economic security through creating functional mechanisms of solving current and potential energy issues including diversification of supplies and fairer market prices. Moreover, it will be possible to develop and implement more effectively energy infrastructure projects. Deeper and more functional energy integration in EES will create favorable preconditions of fostering the states’ economic development. Also, there will be considerably reduced the macroeconomic risks which could possible occur as a result of the struggle of interests of importing and supplying countries. The current paper is intended to underline the most important weaknesses in terms of energy security of EES and exemplify how efficient these problems could be tackled by cumulating common countries’ efforts in the sector. Also, it highlights the shortcomings of EU energy policy in EES and how these affect the economic prospective of the countries. Finally, it is remarked that EES need a common energy market in order to strengthen their negotiation positions in relation with supplying countries.

  15. Effects of Pelvic and Core Strength Training on High School Cross-Country Race Times.

    Science.gov (United States)

    Clark, Anne W; Goedeke, Maggie K; Cunningham, Saengchoy R; Rockwell, Derek E; Lehecka, Bryan J; Manske, Robert C; Smith, Barbara S

    2017-08-01

    Clark, AW, Goedeke, MK, Cunningham, SR, Rockwell, DE, Lehecka, BJ, Manske, RC, and Smith, BS. Effects of pelvic and core strength training on high school cross-country race times. J Strength Cond Res 31(8): 2289-2295, 2017-There is only limited research examining the effect of pelvic and core strength training on running performance. Pelvic and core muscle fatigue is believed to contribute to excess motion along frontal and transverse planes which decreases efficiency in normal sagittal plane running motions. The purpose of this study was to determine whether adding a 6-week pelvic and core strengthening program resulted in decreased race times in high school cross-country runners. Thirty-five high school cross-country runners (14-19 years old) from 2 high schools were randomly assigned to a strengthening group (experimental) or a nonstrengthening group (control). All participants completed 4 standardized isometric strength tests for hip abductors, adductors, extensors, and core musculature in a test-retest design. The experimental group performed a 6-week pelvic and core strengthening program along with their normal training. Participants in the control group performed their normal training without additional pelvic and core strengthening. Baseline, 3-week, and 6-week race times were collected using a repeated measures design. No significant interaction between experimental and control groups regarding decreasing race times and increasing pelvic and core musculature strength occurred over the 6-week study period. Both groups increased strength and decreased overall race times. Clinically significant findings reveal a 6-week pelvic and core stability strengthening program 3 times a week in addition to coach led team training may help decrease race times.

  16. Knowledge Organisations and High-Tech Regional Innovation Systems in Developing Countries: Evidence from Argentina

    Directory of Open Access Journals (Sweden)

    Carolina Pasciaroni

    2016-06-01

    Full Text Available In the globally and knowledge based economy, the universities and other knowledge organisations are valued for their ability to contribute to the regional innovation processes. This is particularly relevant for the developing countries in South America since their R&D spending is highly concentrated on the public knowledge infrastructure. However, there are few studies examining the role of knowledge organizations at regional level in Latin America. The proposed study aims to analyse the role played by knowledge organisations in the formation of a high-tech Regional Innovation Systems in Argentina. This country has a number of attractive features relative to the positive evolution of its R&D spending and the recent implementation of a policy that promotes cooperation between firms and knowledge organisations among high-tech sectors. As evidenced in developed regions, the organisations under study play a key role in the promotion of a high-tech Regional Innovation Systems. However, this prominent role is not based on those local factors identified in the literature, such as organisational and institutional local assets, but on national science and technology policies and individual initiatives conducted by the faculties involved.

  17. Utilization of farm animal genetic resources in a changing agro-ecological environment in the Nordic countries

    Directory of Open Access Journals (Sweden)

    Juha eKantanen

    2015-02-01

    Full Text Available Livestock production is the most important component of northern European agriculture and contributes to and will be affected by climate change. Nevertheless, the role of farm animal genetic resources in the adaptation to new agro-ecological conditions and mitigation of animal production’s effects on climate change has been inadequately discussed despite there being several important associations between animal genetic resources and climate change issues. The sustainability of animal production systems and future food security require access to a wide diversity of animal genetic resources.There are several genetic questions that should be considered in strategies promoting adaptation to climate change and mitigation of environmental effects of livestock production. For example, it may become important to choose among breeds and even among farm animal species according to their suitability to a future with altered production systems. Some animals with useful phenotypes and genotypes may be more useful than others in the changing environment.Robust animal breeds with the potential to adapt to new agro-ecological conditions and tolerate new diseases will be needed. The key issue in mitigation of harmful greenhouse gas effects induced by livestock production is the reduction of methane (CH4 emissions from ruminants. There are differences in CH4 emissions among breeds and among individual animals within breeds that suggest a potential for improvement in the trait through genetic selection.Characterization of breeds and individuals with modern genomic tools should be applied to identify breeds that have genetically adapted to marginal conditions and to get critical information for breeding and conservation programmes for farm animal genetic resources. We conclude that phenotyping and genomic technologies and adoption of new breeding approaches, such as genomic selection introgression, will promote breeding for useful characters in livestock species.

  18. Utilization of farm animal genetic resources in a changing agro-ecological environment in the Nordic countries

    Science.gov (United States)

    Kantanen, Juha; Løvendahl, Peter; Strandberg, Erling; Eythorsdottir, Emma; Li, Meng-Hua; Kettunen-Præbel, Anne; Berg, Peer; Meuwissen, Theo

    2015-01-01

    Livestock production is the most important component of northern European agriculture and contributes to and will be affected by climate change. Nevertheless, the role of farm animal genetic resources in the adaptation to new agro-ecological conditions and mitigation of animal production’s effects on climate change has been inadequately discussed despite there being several important associations between animal genetic resources and climate change issues. The sustainability of animal production systems and future food security require access to a wide diversity of animal genetic resources. There are several genetic questions that should be considered in strategies promoting adaptation to climate change and mitigation of environmental effects of livestock production. For example, it may become important to choose among breeds and even among farm animal species according to their suitability to a future with altered production systems. Some animals with useful phenotypes and genotypes may be more useful than others in the changing environment. Robust animal breeds with the potential to adapt to new agro-ecological conditions and tolerate new diseases will be needed. The key issue in mitigation of harmful greenhouse gas effects induced by livestock production is the reduction of methane (CH4) emissions from ruminants. There are differences in CH4 emissions among breeds and among individual animals within breeds that suggest a potential for improvement in the trait through genetic selection. Characterization of breeds and individuals with modern genomic tools should be applied to identify breeds that have genetically adapted to marginal conditions and to get critical information for breeding and conservation programs for farm animal genetic resources. We conclude that phenotyping and genomic technologies and adoption of new breeding approaches, such as genomic selection introgression, will promote breeding for useful characters in livestock species. PMID:25767477

  19. Principlism, medical individualism, and health promotion in resource-poor countries: can autonomy-based bioethics promote social justice and population health?

    Science.gov (United States)

    Azétsop, Jacquineau; Rennie, Stuart

    2010-01-18

    Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy.

  20. Prospects of development of highly mineralized high-temperature resources of the Tarumovskoye geothermal field

    Science.gov (United States)

    Alkhasov, A. B.; Alkhasova, D. A.; Ramazanov, A. Sh.; Kasparova, M. A.

    2016-06-01

    The promising nature of integrated processing of high-temperature geothermal brines of the Tarumovskoye geothermal field is shown. Thermal energy of a geothermal brine can be converted to the electric power at a binary geothermal power plant (GPP) based on low-boiling working substance. The thermodynamic Rankine cycles are considered which are implemented in the GPP secondary loop at different evaporation temperatures of the working substance―isobutane. Among them, the most efficient cycle from the standpoint of attaining a maximum power is the supercritical one which is close to the so-called triangular cycle with an evaporation pressure of p e = 5.0 MPa. The used low-temperature brine is supplied from the GPP to a chemical plant, where main chemical components (lithium carbonate, burnt magnesia, calcium carbonate, and sodium chloride) are extracted from it according to the developed technology of comprehensive utilization of geothermal brines of chloride-sodium type. The waste water is delivered to the geotechnological complex and other consumers. For producing valuable inorganic materials, the electric power generated at the GPP is used. Owing to this, the total self-sufficiency of production and independence from external conditions is achieved. The advantages of the proposed geotechnological complex are the full utilization of the heat potential and the extraction of main chemical components of multiparameter geothermal resources. In this case, there is no need for reverse pumping, which eliminates the significant capital costs for building injection wells and a pumping station and the operating costs for their service. A characteristic of the modern state of the field and estimated figures of the integrated processing of high-temperature brines of well no. 6 are given, from which it follows that the proposed technology has a high efficiency. The comprehensive development of the field resources will make it possible to improve the economic structure of the

  1. Eye care utilization by older adults in low, middle, and high income countries

    Directory of Open Access Journals (Sweden)

    Vela Claudia

    2012-04-01

    Full Text Available Abstract Background The risk of visual impairment increases dramatically with age and therefore older adults should have their eyes examined at least every 1 to 2 years. Using a world-wide, population-based dataset, we sought to determine the frequency that older people had their eyes examined. We also examined factors associated with having a recent eye exam. Methods The World Health Surveys were conducted in 70 countries throughout the world in 2002-2003 using a random, multi-stage, stratified, cluster sampling design. Participants 60 years and older from 52 countries (n = 35,839 were asked "When was the last time you had your eyes examined by a medical professional?". The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank website. Prevalence estimates were adjusted to account for the complex sample design. Results Overall, only 18% (95% CI 17, 19 of older adults had an eye exam in the last year. The rate of an eye exam in the last year in low, lower middle, upper middle, and high income countries was 10%, 24%, 22%, and 37% respectively. Factors associated with having an eye exam in the last year included older age, female gender, more education, urban residence, greater wealth, worse self-reported health, having diabetes, and wearing glasses or contact lenses (p Conclusions Given that older adults often suffer from age-related but treatable conditions, they should be seen on a regular basis to prevent visual impairment and its disabling consequences.

  2. Potential for Zika virus introduction and transmission in resource-limited countries in Africa and the Asia-Pacific region: a modelling study.

    Science.gov (United States)

    Bogoch, Isaac I; Brady, Oliver J; Kraemer, Moritz U G; German, Matthew; Creatore, Maria I; Brent, Shannon; Watts, Alexander G; Hay, Simon I; Kulkarni, Manisha A; Brownstein, John S; Khan, Kamran

    2016-11-01

    As the epidemic of Zika virus expands in the Americas, countries across Africa and the Asia-Pacific region are becoming increasingly susceptible to the importation and possible local spread of the virus. To support public health readiness, we aim to identify regions and times where the potential health, economic, and social effects from Zika virus are greatest, focusing on resource-limited countries in Africa and the Asia-Pacific region. Our model combined transportation network analysis, ecological modelling of mosquito occurrences, and vector competence for flavivirus transmission, using data from the International Air Transport Association, entomological observations from Zika's primary vector species, and climate conditions using WorldClim. We overlaid monthly flows of airline travellers arriving to Africa and the Asia-Pacific region from areas of the Americas suitable for year-round transmission of Zika virus with monthly maps of climatic suitability for mosquito-borne transmission of Zika virus within Africa and the Asia-Pacific region. An estimated 2·6 billion people live in areas of Africa and the Asia-Pacific region where the presence of competent mosquito vectors and suitable climatic conditions could support local transmission of Zika virus. Countries with large volumes of travellers arriving from Zika virus-affected areas of the Americas and large populations at risk of mosquito-borne Zika virus infection include India (67 422 travellers arriving per year; 1·2 billion residents in potential Zika transmission areas), China (238 415 travellers; 242 million residents), Indonesia (13 865 travellers; 197 million residents), Philippines (35 635 travellers; 70 million residents), and Thailand (29 241 travellers; 59 million residents). Many countries across Africa and the Asia-Pacific region are vulnerable to Zika virus. Strategic use of available health and human resources is essential to prevent or mitigate the health, economic, and social

  3. The importance of using simple and indigenous technologies for the exploitation of water resources in rural areas of developing countries

    Science.gov (United States)

    Faillace, C.

    Taking care of thousands of village water supply systems requires a large organization and large financial inputs which most developing countries cannot afford. The author, after having briefly outlined the main points to be considered for the implementation of successful rural water programs, stresses the need to introduce simple, low-cost technologies for supplying safe water to small rural villages. The risk of failure is greatly reduced if there is an active participation of villagers in the various phases of the project. Health education village sanitation and training in the use and repair of equipment are essential for the long life of the water systems.

  4. Performance of high technology industries. The Science Park of Basque Country

    International Nuclear Information System (INIS)

    Blanco Valbuena, C.; Pena Legazkue, I.

    2007-01-01

    We examine the performance of high technology based SMEs located in the three Science Parks of the Basque Country. Our findings suggest that intangible assets representing the human capital and organizational learning capacity of firms are positively related to business growth. We found that about 80% of sample firms established a collaborative agreement with partner firms. Results show that the formation of a larger number of formal alliances with R and D firms (i.e., universities, innovation centers, was positively associated with firm growth. (Author) 21 refs

  5. Psychological and psychosocial interventions for refugee children resettled in high-income countries.

    Science.gov (United States)

    Fazel, M

    2018-04-01

    Large numbers of refugee children are arriving in high-income countries. The evidence to date suggests that they have mental health needs that are higher than for the general population and that these are exacerbated by the numbers of traumatic events they have experienced and the post-migration stressors they continue to be exposed to. The importance of a thorough and thoughtful assessment is discussed. Treatments of note are described for post-traumatic stress disorder, family functioning, general mental health problems and school environments. Future opportunities to operationalise outcome measures, develop multimodal interventions and utilise implementation science methodology are considered.

  6. High-Speed Rail for Central and Eastern European Countries: A Conference Report

    Directory of Open Access Journals (Sweden)

    Jandová Monika

    2016-09-01

    Full Text Available The European transport strategy promotes the role of railways and expects that the key role in passenger transport should be played by high-speed rail (HSR. Although the core network of high-speed lines has already been built and is operating in Western Europe, there has been little coverage so far in Central and Eastern Europe (CEE. The aim of the conference “High-Speed Rail for CEE Countries” that took place in Prague in June 2016 was to put together academics, policy-makers, and practitioners interested in HSR and to formulate recommendations for CEE countries based on West European countries’ experience. Based on the conference presentations and subsequent discussion, the following conclusions were formulated. Firstly, there are many crucial differences in national HSR build-up and operation, which means that former experience of Western Europe is not directly applicable to CEE countries. Secondly, in comparing presentations discussing experiences in France, Britain, Italy, and Germany, it was concluded that the German approach-upgrading existing lines where possible and only building new lines for bottleneck sections-was the most likely appropriate solution in CEE. Lastly, CEE has the additional problem of many border crossings, with a reduction of traffic in comparison with purely domestic routes, and this effect has to be taken into account.

  7. Supportive care during treatment for breast cancer: resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement.

    Science.gov (United States)

    Cardoso, Fatima; Bese, Nuran; Distelhorst, Sandra R; Bevilacqua, Jose Luiz B; Ginsburg, Ophira; Grunberg, Steven M; Gralla, Richard J; Steyn, Ann; Pagani, Olivia; Partridge, Ann H; Knaul, Felicia Marie; Aapro, Matti S; Andersen, Barbara L; Thompson, Beti; Gralow, Julie R; Anderson, Benjamin O

    2013-10-01

    Breast cancer patients may have unmet supportive care needs during treatment, including symptom management of treatment-related toxicities, and educational, psychosocial, and spiritual needs. Delivery of supportive care is often a low priority in low- and middle-income settings, and is also dependent on resources available. This consensus statement describes twelve key recommendations for supportive care during treatment in low- and middle-income countries, identified by an expert international panel as part of the 5th Breast Health Global Initiative (BHGI) Global Summit for Supportive Care, which was held in October 2012, in Vienna, Austria. Panel recommendations are presented in a 4-tier resource-stratified table to illustrate how health systems can provide supportive care services during treatment to breast cancer patients, starting at a basic level of resource allocation and incrementally adding program resources as they become available. These recommendations include: health professional and patient and family education; management of treatment related toxicities, management of treatment-related symptoms of fatigue, insomnia and non-specific pain, and management of psychosocial and spiritual issues related to breast cancer treatment. Establishing supportive care during breast cancer treatment will help ensure that breast cancer patients receive comprehensive care that can help 1) improve adherence to treatment recommendations, 2) manage treatment-related toxicities and other treatment related symptoms, and 3) address the psychosocial and spiritual aspects of breast cancer and breast cancer treatments. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Utilization of farm animal genetic resources in a changing agro-ecological environment in the Nordic countries

    DEFF Research Database (Denmark)

    Kantanen, Juha; Løvendahl, Peter; Strandberg, Erling

    2015-01-01

    Livestock production is the most important component of northern European agriculture and contributes to and will be affected by climate change. Nevertheless, the role of farm animal genetic resources in the adaptation to new agro-ecological conditions and mitigation of animal production’s effects...... to a future with altered production systems. Some animals with useful phenotypes and genotypes may be more useful than others in the changing environment. Robust animal breeds with the potential to adapt to new agro-ecological conditions and tolerate new diseases will be needed. The key issue in mitigation...

  9. Exploration strategy for high temperature geothermal resources in the Philippines - an update

    International Nuclear Information System (INIS)

    Bayrante, L.F.; Ferrer, H.P.; Barnett, P.R.

    1992-01-01

    After nearly two decades of geoscientific-exploration at 45 geothermal areas in the Philippines, the Philippine National Oil Company-Energy Development Corporation (PNOC-EDC) has developed a multi-disciplinary approach for exploring country's geothermal resources. It suitability for crater-hosted magmatic geothermal systems is currently being evaluated in the light of new data from six recently drilled prospects. New techniques are under consideration for future exploration programmes. (auth.). 59 refs.; 5 figs

  10. Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries.

    Science.gov (United States)

    Stenberg, Karin; Hanssen, Odd; Edejer, Tessa Tan-Torres; Bertram, Melanie; Brindley, Callum; Meshreky, Andreia; Rosen, James E; Stover, John; Verboom, Paul; Sanders, Rachel; Soucat, Agnès

    2017-09-01

    The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive health service delivery towards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published. We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries' advancement towards global targets is constrained by their health system's assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability. We estimate that an additional $274 billion spending on health is needed per year by 2030 to make progress towards the SDG 3 targets (progress scenario), whereas US$371 billion would be needed to reach health system targets in the ambitious scenario-the equivalent of an additional $41 (range 15-102) or $58 (22-167) per person, respectively, by the final years of scale-up. In the ambitious scenario, total health-care spending would increase to a population-weighted mean of $271 per person (range 74-984) across country contexts, and the share of gross

  11. The variation of acute treatment costs of trauma in high-income countries

    Directory of Open Access Journals (Sweden)

    Willenberg Lynsey

    2012-08-01

    Full Text Available Abstract Background In order to assist health service planning, understanding factors that influence higher trauma treatment costs is essential. The majority of trauma costing research reports the cost of trauma from the perspective of the receiving hospital. There has been no comprehensive synthesis and little assessment of the drivers of cost variation, such as country, trauma, subgroups and methods. The aim of this review is to provide a synthesis of research reporting the trauma treatment costs and factors associated with higher treatment costs in high income countries. Methods A systematic search for articles relating to the cost of acute trauma care was performed and included studies reporting injury severity scores (ISS, per patient cost/charge estimates; and costing methods. Cost and charge values were indexed to 2011 cost equivalents and converted to US dollars using purchasing power parities. Results A total of twenty-seven studies were reviewed. Eighty-one percent of these studies were conducted in high income countries including USA, Australia, Europe and UK. Studies either reported a cost (74.1% or charge estimate (25.9% for the acute treatment of trauma. Across studies, the median per patient cost of acute trauma treatment was $22,448 (IQR: $11,819-$33,701. However, there was variability in costing methods used with 18% of studies providing comprehensive cost methods. Sixty-three percent of studies reported cost or charge items incorporated in their cost analysis and 52% reported items excluded in their analysis. In all publications reviewed, predictors of cost included Injury Severity Score (ISS, surgical intervention, hospital and intensive care, length of stay, polytrauma and age. Conclusion The acute treatment cost of trauma is higher than other disease groups. Research has been largely conducted in high income countries and variability exists in reporting costing methods as well as the actual costs. Patient populations studied

  12. The variation of acute treatment costs of trauma in high-income countries.

    Science.gov (United States)

    Willenberg, Lynsey; Curtis, Kate; Taylor, Colman; Jan, Stephen; Glass, Parisa; Myburgh, John

    2012-08-21

    In order to assist health service planning, understanding factors that influence higher trauma treatment costs is essential. The majority of trauma costing research reports the cost of trauma from the perspective of the receiving hospital. There has been no comprehensive synthesis and little assessment of the drivers of cost variation, such as country, trauma, subgroups and methods. The aim of this review is to provide a synthesis of research reporting the trauma treatment costs and factors associated with higher treatment costs in high income countries. A systematic search for articles relating to the cost of acute trauma care was performed and included studies reporting injury severity scores (ISS), per patient cost/charge estimates; and costing methods. Cost and charge values were indexed to 2011 cost equivalents and converted to US dollars using purchasing power parities. A total of twenty-seven studies were reviewed. Eighty-one percent of these studies were conducted in high income countries including USA, Australia, Europe and UK. Studies either reported a cost (74.1%) or charge estimate (25.9%) for the acute treatment of trauma. Across studies, the median per patient cost of acute trauma treatment was $22,448 (IQR: $11,819-$33,701). However, there was variability in costing methods used with 18% of studies providing comprehensive cost methods. Sixty-three percent of studies reported cost or charge items incorporated in their cost analysis and 52% reported items excluded in their analysis. In all publications reviewed, predictors of cost included Injury Severity Score (ISS), surgical intervention, hospital and intensive care, length of stay, polytrauma and age. The acute treatment cost of trauma is higher than other disease groups. Research has been largely conducted in high income countries and variability exists in reporting costing methods as well as the actual costs. Patient populations studied and the cost methods employed are the primary drivers for the

  13. Oral Health Behaviour and Social and Health Factors in University Students from 26 Low, Middle and High Income Countries

    OpenAIRE

    Peltzer, Karl; Pengpid, Supa

    2014-01-01

    Poor oral health is still a major burden for populations throughout the world, particularly in developing countries. The aim of this study was investigate oral health behaviour (tooth brushing and dental attendance) and associated factors in low, middle and high income countries. Using anonymous questionnaires, data were collected from 19,560 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Results indicate...

  14. To kill a kangaroo: understanding the decision to pursue high-risk/high-gain resources.

    Science.gov (United States)

    Jones, James Holland; Bird, Rebecca Bliege; Bird, Douglas W

    2013-09-22

    In this paper, we attempt to understand hunter-gatherer foraging decisions about prey that vary in both the mean and variance of energy return using an expected utility framework. We show that for skewed distributions of energetic returns, the standard linear variance discounting (LVD) model for risk-sensitive foraging can produce quite misleading results. In addition to creating difficulties for the LVD model, the skewed distributions characteristic of hunting returns create challenges for estimating probability distribution functions required for expected utility. We present a solution using a two-component finite mixture model for foraging returns. We then use detailed foraging returns data based on focal follows of individual hunters in Western Australia hunting for high-risk/high-gain (hill kangaroo) and relatively low-risk/low-gain (sand monitor) prey. Using probability densities for the two resources estimated from the mixture models, combined with theoretically sensible utility curves characterized by diminishing marginal utility for the highest returns, we find that the expected utility of the sand monitors greatly exceeds that of kangaroos despite the fact that the mean energy return for kangaroos is nearly twice as large as that for sand monitors. We conclude that the decision to hunt hill kangaroos does not arise simply as part of an energetic utility-maximization strategy and that additional social, political or symbolic benefits must accrue to hunters of this highly variable prey.

  15. Manual cleaning of hospital mattresses: an observational study comparing high- and low-resource settings

    NARCIS (Netherlands)

    Hopman, J.; Hakizimana, B.; Meintjes, W.A.; Nillessen, M.; Both, E. de; Voss, A.; Mehtar, S.

    2016-01-01

    BACKGROUND: Hospital-associated infections (HAIs) are more frequently encountered in low- than in high-resource settings. There is a need to identify and implement feasible and sustainable approaches to strengthen HAI prevention in low-resource settings. AIM: To evaluate the biological contamination

  16. A comparative analysis of avoidable causes of childhood blindness in Malaysia with low income, middle income and high income countries.

    Science.gov (United States)

    Koay, C L; Patel, D K; Tajunisah, I; Subrayan, V; Lansingh, V C

    2015-04-01

    To determine the avoidable causes of childhood blindness in Malaysia and to compare this to other middle income countries, low income countries and high income countries. Data were obtained from a school of the blind study by Patel et al. and analysed for avoidable causes of childhood blindness. Six other studies with previously published data on childhood blindness in Bangladesh, Ethiopia, Nigeria, Indonesia, China and the United Kingdom were reviewed for avoidable causes. Comparisons of data and limitations of the studies are described. Prevalence of avoidable causes of childhood blindness in Malaysia is 50.5 % of all the cases of childhood blindness, whilst in the poor income countries such as Bangladesh, Ethiopia, Nigeria and Indonesia, the prevalence was in excess of 60 %. China had a low prevalence, but this is largely due to the fact that most schools were urban, and thus did not represent the situation of the country. High income countries had the lowest prevalence of avoidable childhood blindness. In middle income countries, such as Malaysia, cataract and retinopathy of prematurity are the main causes of avoidable childhood blindness. Low income countries continue to struggle with infections such as measles and nutritional deficiencies, such as vitamin A, both of which are the main contributors to childhood blindness. In high income countries, such as the United Kingdom, these problems are almost non-existent.

  17. Social cost of heavy drinking and alcohol dependence in high-income countries.

    Science.gov (United States)

    Mohapatra, Satya; Patra, Jayadeep; Popova, Svetlana; Duhig, Amy; Rehm, Jürgen

    2010-06-01

    A comprehensive review of cost drivers associated with alcohol abuse, heavy drinking, and alcohol dependence for high-income countries was conducted. The data from 14 identified cost studies were tabulated according to the potential direct and indirect cost drivers. The costs associated with alcohol abuse, alcohol dependence, and heavy drinking were calculated. The weighted average of the total societal cost due to alcohol abuse as percent gross domestic product (GDP)--purchasing power parity (PPP)--was 1.58%. The cost due to heavy drinking and/or alcohol dependence as percent GDP (PPP) was estimated to be 0.96%. On average, the alcohol-attributable indirect cost due to loss of productivity is more than the alcohol-attributable direct cost. Most of the countries seem to incur 1% or more of their GDP (PPP) as alcohol-attributable costs, which is a high toll for a single factor and an enormous burden on public health. The majority of alcohol-attributable costs incurred as a consequence of heavy drinking and/or alcohol dependence. Effective prevention and treatment measures should be implemented to reduce these costs.

  18. A high resolution global wind atlas - improving estimation of world wind resources

    DEFF Research Database (Denmark)

    Badger, Jake; Ejsing Jørgensen, Hans

    2011-01-01

    to population centres, electrical transmission grids, terrain types, and protected land areas are important parts of the resource assessment downstream of the generation of wind climate statistics. Related to these issues of integration are the temporal characteristics and spatial correlation of the wind...... resources. These aspects will also be addressed by the Global Wind Atlas. The Global Wind Atlas, through a transparent methodology, will provide a unified, high resolution, and public domain dataset of wind energy resources for the whole world. The wind atlas data will be the most appropriate wind resource...

  19. Radiation Therapy Infrastructure and Human Resources in Low- and Middle-Income Countries: Present Status and Projections for 2020

    Energy Technology Data Exchange (ETDEWEB)

    Datta, Niloy R., E-mail: niloyranjan.datta@ksa.ch [Centre for Radiation Oncology, Kantonsspital Aarau - Kantonsspital Baden, Kantonsspital Aarau, Aarau (Switzerland); Samiei, Massoud [Consultancy Practice, Vienna (Austria); Bodis, Stephan [Centre for Radiation Oncology, Kantonsspital Aarau - Kantonsspital Baden, Kantonsspital Aarau, Aarau, Switzerland, and Department of Radiation Oncology, University Hospital Zurich (Switzerland)

    2014-07-01

    Purpose: Radiation therapy, a key component of cancer management, is required in more than half of new cancer patients, particularly in low- and middle-income countries (LMICs). The projected rise in cancer incidence over the next decades in LMICs will result in an increasing demand for radiation therapy services. Considering the present cancer incidence and that projected for 2020 (as listed in GLOBOCAN), we evaluated the current and anticipated needs for radiation therapy infrastructure and staffing by 2020 for each of the LMICs. Methods and Materials: Based on World Bank classification, 139 countries fall in the category of LMICs. Details of teletherapy, radiation oncologists, medical physicists, and radiation therapy technologists were available for 84 LMICs from the International Atomic Energy Agency–Directory of Radiotherapy Centres (IAEA-DIRAC) database. Present requirements and those for 2020 were estimated according to recommendations from the IAEA and European Society for Radiotherapy and Oncology (ESTRO-QUARTS). Results: Only 4 of the 139 LMICs have the requisite number of teletherapy units, and 55 (39.5%) have no radiation therapy facilities at present. Patient access to radiation therapy in the remaining 80 LMICs ranges from 2.3% to 98.8% (median: 36.7%). By 2020, these 84 LMICs would additionally need 9169 teletherapy units, 12,149 radiation oncologists, 9915 medical physicists, and 29,140 radiation therapy technologists. Moreover, de novo radiation therapy facilities would have to be considered for those with no services. Conclusions: Twelve pragmatic steps are proposed for consideration at national and international levels to narrow the gap in radiation therapy access. Multipronged and coordinated action from all national and international stakeholders is required to develop realistic strategies to curb this impending global crisis.

  20. Radiation Therapy Infrastructure and Human Resources in Low- and Middle-Income Countries: Present Status and Projections for 2020

    International Nuclear Information System (INIS)

    Datta, Niloy R.; Samiei, Massoud; Bodis, Stephan

    2014-01-01

    Purpose: Radiation therapy, a key component of cancer management, is required in more than half of new cancer patients, particularly in low- and middle-income countries (LMICs). The projected rise in cancer incidence over the next decades in LMICs will result in an increasing demand for radiation therapy services. Considering the present cancer incidence and that projected for 2020 (as listed in GLOBOCAN), we evaluated the current and anticipated needs for radiation therapy infrastructure and staffing by 2020 for each of the LMICs. Methods and Materials: Based on World Bank classification, 139 countries fall in the category of LMICs. Details of teletherapy, radiation oncologists, medical physicists, and radiation therapy technologists were available for 84 LMICs from the International Atomic Energy Agency–Directory of Radiotherapy Centres (IAEA-DIRAC) database. Present requirements and those for 2020 were estimated according to recommendations from the IAEA and European Society for Radiotherapy and Oncology (ESTRO-QUARTS). Results: Only 4 of the 139 LMICs have the requisite number of teletherapy units, and 55 (39.5%) have no radiation therapy facilities at present. Patient access to radiation therapy in the remaining 80 LMICs ranges from 2.3% to 98.8% (median: 36.7%). By 2020, these 84 LMICs would additionally need 9169 teletherapy units, 12,149 radiation oncologists, 9915 medical physicists, and 29,140 radiation therapy technologists. Moreover, de novo radiation therapy facilities would have to be considered for those with no services. Conclusions: Twelve pragmatic steps are proposed for consideration at national and international levels to narrow the gap in radiation therapy access. Multipronged and coordinated action from all national and international stakeholders is required to develop realistic strategies to curb this impending global crisis

  1. High-tech processing of secondary resources of winemaking

    Directory of Open Access Journals (Sweden)

    G. Kasyanov

    2017-04-01

    Full Text Available The information about problems and prospects of development of food production processes based on high-tech and knowledge-intensive technical solutions is presented. To accomplish these objectives the problems of rational growing of grapes, intensive methods of production of conventional and concentrated grape juice, application of CO2ditartration for the removal of wine stone were solved.White and red table grapes, grape pomace, grape seed oil, protein and CO2-meal are the objects of the research. To evaluate the quality of raw materials, intermediate and finished products such devices as gas-liquid and thin-layer chromatography, and spectrophotometer were used. Obtaining of grape juice of white and red grapes with content of tartaric acid salts less than 1 %, food drying products and products of processing of grape pomace are the intermediate results of the research. Grape juice in flexible packages of «Pure-Pak» and «Doy-pack» types, CO2-extracts of seeds and skins of grapes and protein CO2-meal are the final objects of the research. Performed research allows us to make conclusions about expediency of high-tech methods of processing of raw materials for obtaining food products.

  2. Stroke outcomes in Malawi, a country with high prevalence of HIV: a prospective follow-up study.

    Directory of Open Access Journals (Sweden)

    Terttu Heikinheimo

    Full Text Available BACKGROUND: Stroke contributes significantly to disability and mortality in developing countries yet little is known about the determinants of stroke outcomes in such countries. 12% of Malawian adults have HIV/AIDS. It is not known whether having HIV-infection alters the outcome of stroke. The aim of this study was to document the functional outcome and mortality at 1 year of first-ever acute stroke in Malawi. Also to find out if the baseline variables, including HIV-infection, affect the outcome of stroke. METHODS AND FINDINGS: 147 adult patients with first-ever acute stroke were prospectively followed up for 12 months. Conventional risk factors and HIV-infection were assessed at baseline. Stroke severity was evaluated with modified National Institute of Health Stroke Scale (mNIHSS and functional outcome with modified Rankin scale (mRS. Fifty (34% of patients were HIV-seropositive. 53.4% of patients had a poor outcome (severe disability or death, mRS 4-6 at 1 year. Poor outcome was related to stroke severity and female gender but not to presence of HIV-infection. HIV-seropositive patients were younger and had less often common risk factors for stroke. They suffer more often ischemic stroke than HIV-seronegative patients. CONCLUSIONS: Mild stroke and male gender were associated with favourable outcome. HIV-infection is common in stroke patients in Malawi but does not worsen the outcome of stroke. However, it may be a risk factor for ischemic stroke for young people, who do not have the common stroke risk factors. Our results are significant, because stroke outcome in HIV-seropositive patients has not been studied before in a setting such as ours, with very limited resources and a high prevalence of HIV.

  3. Higher Education R&D and Productivity Growth: An Empirical Study on High-Income OECD Countries

    Science.gov (United States)

    Eid, Ashraf

    2012-01-01

    This paper is a macro study on higher education R&D and its impact on productivity growth. I measure the social rate of return on higher education R&D in 17 high-income OECD countries using country level data on the percentage of gross expenditure on R&D performed by higher education, business, and government sectors over the period…

  4. International Programme for Resource Use in Critical Care (IPOC)--a methodology and initial results of cost and provision in four European countries.

    Science.gov (United States)

    Negrini, D; Sheppard, L; Mills, G H; Jacobs, P; Rapoport, J; Bourne, R S; Guidet, B; Csomos, A; Prien, T; Anderson, G; Edbrooke, D L

    2006-01-01

    A standardized top-down costing method is not currently available internationally. An internally validated method developed in the UK was modified for use in critical care in different countries. Costs could then be compared using the World Health Organization's Purchasing Power Parities (WHO PPPs). This was an observational, retrospective, cross-sectional, multicentre study set in four European countries: France, UK, Germany and Hungary. A total of 329 adult intensive care units (ICUs) participated in the study. The costs are reported in international dollars ($) derived from the WHO PPP programme. The results show significant differences in resource use and costs of ICUs over the four countries. On the basis of the sum of the means for the major components, the average cost per patient day in UK hospitals was $1512, in French hospitals $934, in German hospitals $726 and in Hungarian hospitals $280. The reasons for such differences are poorly understood but warrant further investigation. This information will allow us to better adjust our measures of international ICU costs.

  5. Reduced carbon intensity in highly developed countries: environmental kuznets curves for carbon dioxide

    Science.gov (United States)

    Kornhuber, Kai; Rybski, Diego; Costa, Luis; Reusser, Dominik E.; Kropp, Jürgen P.

    2014-05-01

    The Environmental Kuznets Curves (EKC) postulates that pollution increases with the income per capita up to a maximum, above which it decreases with the further increase in income per capita, i.e. following an inverse U-shape in the pollution vs. income per capita. It is commonly believed that EKC occurs for "local" pollutants such as nitrogen oxide and sulfur dioxide, but does not hold for CO2 emissions. This is attributed to the fact that while "local" pollutants cause a visible environmental damage on the local/regional scale (which authorities/governments seek to avoid), the consequences of CO2 emission have no immediate attributable local/regional consequences. We review EKC for CO2 exploring its relation between CO2 per capita and the Human Development Index (HDI) between 1990 and 2010 obtained from the World Bank database. We find evidence for a reduction in CO2 emissions per capita in highly developed countries. We propose a model according to which the emissions per capita of a country are composed of a component related to the actual state of development and a component related to the change of development. The model leads to four distinct cases of which two have EKC shape and two imply saturation. This outcome is in line with previously suggested qualitative relations. Our analysis indicates that the EKC shaped cases better describes the empirical values. We explore the less extreme version corresponding to the so-called conventional EKC and study the maximum of the fitted curve, providing a threshold-value for the HDI and a typical maximum value for the emissions per capita. We find that approx. 5 countries have crossed the CO2-HDI maximum, corresponding to approx. 1.5% of the world population.

  6. Explanatory Resources on Energy in High School Physics Classes: A Case Study

    Directory of Open Access Journals (Sweden)

    María Alejandra Domínguez

    2013-08-01

    Full Text Available This paper examines and reflects on the explanatory resources that are used in high school physics classes for studying the topic of energy. Explanatory resources are a means of constructing and negotiating meaning. The research is an instrumental case study focusing on four years of high school physics classes on energy. The theoretical principles of sociocultural approaches and conversation analysis are taken as benchmarks for understanding how we construct and reconstruct meanings (on energy. The identification of the resources used in the process of meaning construction is of importance for understanding certain scientific phenomena addressed in the curricula. Among the resources most commonly employed to enhance explanation were definitions and the causes of phenomena. We also found that teachers’ interventions, either through verbal explanations or instructional proposals, were crucial for certain kinds of explanations and for the presence or absence of other resources associated with explanations.

  7. Managing research and surveillance projects in real-time with a novel open-source eManagement tool designed for under-resourced countries.

    Science.gov (United States)

    Steiner, Andreas; Hella, Jerry; Grüninger, Servan; Mhalu, Grace; Mhimbira, Francis; Cercamondi, Colin I; Doulla, Basra; Maire, Nicolas; Fenner, Lukas

    2016-09-01

    A software tool is developed to facilitate data entry and to monitor research projects in under-resourced countries in real-time. The eManagement tool "odk_planner" is written in the scripting languages PHP and Python. The odk_planner is lightweight and uses minimal internet resources. It was designed to be used with the open source software Open Data Kit (ODK). The users can easily configure odk_planner to meet their needs, and the online interface displays data collected from ODK forms in a graphically informative way. The odk_planner also allows users to upload pictures and laboratory results and sends text messages automatically. User-defined access rights protect data and privacy. We present examples from four field applications in Tanzania successfully using the eManagement tool: 1) clinical trial; 2) longitudinal Tuberculosis (TB) Cohort Study with a complex visit schedule, where it was used to graphically display missing case report forms, upload digitalized X-rays, and send text message reminders to patients; 3) intervention study to improve TB case detection, carried out at pharmacies: a tablet-based electronic referral system monitored referred patients, and sent automated messages to remind pharmacy clients to visit a TB Clinic; and 4) TB retreatment case monitoring designed to improve drug resistance surveillance: clinicians at four public TB clinics and lab technicians at the TB reference laboratory used a smartphone-based application that tracked sputum samples, and collected clinical and laboratory data. The user friendly, open source odk_planner is a simple, but multi-functional, Web-based eManagement tool with add-ons that helps researchers conduct studies in under-resourced countries. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Critical assessment of progress of medical sciences in Iran and Turkey: the way developing countries with limited resources should make effective contributions to the production of science.

    Science.gov (United States)

    Massarrat, Sadegh; Kolahdoozan, Shadi

    2011-11-01

    Scientific progress is an important indicator for the social and economic developments of any country. According to various reports, worldwide, Iran has the most growth in the field of science due to a high increase in the numbers of publications during the past decade. The aim of this study is to assess not only the quantity, but also the quality of publications of indexed Iranian journals and compare them to Turkey, as an Islamic neighboring country, in addition to the contributions of these two countries to our knowledge. A number of international journals with high impact factors were selected to assess the contributions of scientists from Iran and Turkey to the medical sciences. English medical journals from Iran and Turkey indexed by the ISI Web of Sciences with known impact factors (IF) announced at the beginning of 2010 were included for evaluation. We calculated the number of all articles published from the beginning of 2007 until the October 2010, the number of total citations, and citations from authors outside both countries for each journal. In addition, we selected all articles cited at least six times by authors outside of both countries and discussed their content with regard to originality and novelty, as well as their contributions to current knowledge. Furthermore, 60 international journals in basic or clinical research with IF greater than 6 were selected for the magnitude of contributions of both countries to our scientific knowledge. In 2010, out of a total of 21 Iranian journals indexed in ISI since 2007, only 12 have a known IF with a mean of 0.39 (range: 0.07-0.97), whereas out of 28 Turkish medical journals indexed in ISI, 15 have a known IF (mean: 0.35, range: 0.05-0.82). The total number of articles published since 2007 from Iran, total citations and total citations by authors from outside Iran were 2080, 1218, and 463, respectively. The same data related to Turkish journals were 4876, 2036, and 1331, respectively. Indeed, the mean

  9. Community Hospitals in Selected High Income Countries: A Scoping Review of Approaches and Models

    Directory of Open Access Journals (Sweden)

    Eleanor M Winpenny

    2016-11-01

    Full Text Available Background: There is no single definition of a community hospital in the UK, despite its long history. We sought to understand the nature and scope of service provision in community hospitals, within the UK and other high-income countries. Methods: We undertook a scoping review of literature on community hospitals published from 2005 to 2014. Data were extracted on features of the hospital model and the services provided, with results presented as a narrative synthesis. Results: 75 studies were included from ten countries. Community hospitals provide a wide range of services, with wide diversity of provision appearing to reflect local needs. Community hospitals are staffed by a mixture of general practitioners (GPs, nurses, allied health professionals and healthcare assistants. We found many examples of collaborative working arrangements between community hospitals and other health care organisations, including colocation of services, shared workforce with primary care and close collaboration with acute specialists. Conclusions: Community hospitals are able to provide a diverse range of services, responding to geographical and health system contexts. Their collaborative nature may be particularly important in the design of future models of care delivery, where emphasis is placed on integration of care with a key focus on patient-centred care.

  10. Medial tibial stress syndrome in high school cross-country runners: incidence and risk factors.

    Science.gov (United States)

    Plisky, Melody S; Rauh, Mitchell J; Heiderscheit, Bryan; Underwood, Frank B; Tank, Robert T

    2007-02-01

    Prospective cohort. To determine (1) the cumulative seasonal incidence and overall injury rate of medial tibial stress syndrome (MTSS) and (2) risk factors for MTSS with a primary focus on the relationship between navicular drop values and MTSS in high school cross-country runners. MTSS is a common injury among runners. However, few studies have reported the injury rate and risk factors for MTSS among adolescent runners. Data collected included measurement of bilateral navicular drop and foot length, and a baseline questionnaire regarding the runner's height, body mass, previous running injury, running experience, and orthotic or tape use. Runners were followed during the season to determine athletic exposures (AEs) and occurrence of MTSS. The overall injury rate for MTSS was 2.8/1000 AEs. Although not statistically different, girls had a higher rate (4.3/1000 AEs) than boys (1.7/1000 AEs) (P = .11). Logistic regression modeling indicated that only gender and body mass index (BMI) were significantly associated with the occurrence of MTSS. However, when controlled for orthotic use, only BMI was associated with risk of MTSS. No significant associations were found between MTSS and navicular drop or foot length. Our findings suggest that navicular drop may not be an appropriate measure to identify runners who may develop MTSS during a cross-country season; thus, additional studies are needed to identify appropriate preseason screening tools.

  11. Religiosity and Health Risk Behaviour Among University Students in 26 Low, Middle and High Income Countries.

    Science.gov (United States)

    Peltzer, Karl; Pengpid, Supa; Amuleru-Marshall, Omowale; Mufune, Pempelani; Zeid, Alaa Abou

    2016-12-01

    The aim of this study was to assess religiosity and health risk behaviours among university students from 26 low, middle and high income countries. Using anonymous questionnaires, data were collected from 20,222 undergraduate university students (mean age 20.8, SD = 2. 8) from 27 universities in 26 countries across Asia, Africa and the Americas. Among all students, 41.1 % engaged at least once a week in organized religious activity, 35.8 % practised a non-organized religious activity daily or more than once daily, and more or less two-thirds of the students agreed to the three different statements on intrinsic of subjective religiosity. In multivariate logistic regression analysis, higher reported involvement in organized religious activity was associated with addictive, injury, sexual and oral health risk behaviour, while lower reported involvement in organized religious activity was associated with physical inactivity and oral health risk behaviour. Lower reported involvement in non-organized religious activity was associated with addictive, nutrition risk, injury, sexual and oral health risk behaviour, while higher reported involvement in non-organized religious activity was associated with physical inactivity. Finally, lower reported intrinsic religiosity was associated with addictive and sexual risk behaviour, while higher reported intrinsic religiosity was associated with nutrition risk behaviour, physical inactivity and oral health risk behaviour.

  12. Drivers of maternity care in high-income countries: can health systems support woman-centred care?

    Science.gov (United States)

    Shaw, Dorothy; Guise, Jeanne-Marie; Shah, Neel; Gemzell-Danielsson, Kristina; Joseph, K S; Levy, Barbara; Wong, Fontayne; Woodd, Susannah; Main, Elliott K

    2016-11-05

    In high-income countries, medical interventions to address the known risks associated with pregnancy and birth have been largely successful and have resulted in very low levels of maternal and neonatal mortality. In this Series paper, we present the main care delivery models, with case studies of the USA and Sweden, and examine the main drivers of these models. Although nearly all births are attended by a skilled birth attendant and are in an institution, practice, cadre, facility size, and place of birth vary widely; for example, births occur in homes, birth centres, midwifery-led birthing units in hospitals, and in high intervention hospital birthing facilities. Not all care is evidenced-based, and some care provision may be harmful. Fear prevails among subsets of women and providers. In some settings, medical liability costs are enormous, human resource shortages are common, and costs of providing care can be very high. New challenges linked to alteration of epidemiology, such as obesity and older age during pregnancy, are also present. Data are often not readily available to inform policy and practice in a timely way and surveillance requires greater attention and investment. Outcomes are not equitable, and disadvantaged segments of the population face access issues and substantially elevated risks. At the same time, examples of excellence and progress exist, from clinical interventions to models of care and practice. Labourists (who provide care for all the facility's women for labour and delivery) are discussed as a potential solution. Quality and safety factors are informed by women's experiences, as well as medical evidence. Progress requires the ability to normalise birth for most women, with integrated services available if complications develop. We also discuss mechanisms to improve quality of care and highlight areas where research can address knowledge gaps with potential for impact. Evaluation of models that provide woman-centred care and the best

  13. Multi-Cultural Adaptations of International Heliophysical Year (IHY) Education Resources: A Perspective of a Developing Country

    Science.gov (United States)

    Faiyetole, A. A.

    2006-12-01

    The world is made up of people of varied cultures and we speak different languages. In Africa and, to be more specific, in Nigeria, we have a wide diversity of languages and customs. Nigeria has over 200 tribes and ethnic social units, to the extent that just a few of the populace have an effective understanding of English, the nation's official language. Hence, most communications are carried out in our local languages. In order to efficiently communicate the heliophysical and other scientific and technological phenomena to the general public, quite a lot would have to be done in the cultural and language context. In a nutshell, there shall be a need to adequately involve the social scientists in the education and public outreach programmes relating to space science and technology. This paper will therefore attempt to look at various ways in which languages, and diversity in cultures can be harnessed to more effectively communicate science. The paper will also discuss how the various IHY education resources can be adapted to a multi-cultural society, therefore, able to reach all the people in the world.

  14. Impact of high ambient temperature on unintentional injuries in high-income countries: a narrative systematic literature review

    Science.gov (United States)

    Otte im Kampe, Eveline; Kovats, Sari; Hajat, Shakoor

    2016-01-01

    Objectives Given the likelihood of increased hot weather due to climate change, it is crucial to have prevention measures in place to reduce the health burden of high temperatures and heat waves. The aim of this review is to summarise and evaluate the evidence on the effects of summertime weather on unintentional injuries in high-income countries. Design 3 databases (Global Public Health, EMBASE and MEDLINE) were searched by using related keywords and their truncations in the title and abstract, and reference lists of key studies were scanned. Studies reporting heatstroke and intentional injuries were excluded. Results 13 studies met our inclusion criteria. 11 out of 13 studies showed that the risk of unintentional injuries increases with increasing ambient temperatures. On days with moderate temperatures, the increased risk varied between 0.4% and 5.3% for each 1°C increase in ambient temperature. On extreme temperature days, the risk of injuries decreased. 2 out of 3 studies on occupational accidents found an increase in work-related accidents during high temperatures. For trauma hospital admissions, 6 studies reported an increase during hot weather, whereas 1 study found no association. The evidence for impacts on injuries by subgroups such as children, the elderly and drug users was limited and inconsistent. Conclusions The present review describes a broader range of types of unintentional fatal and non-fatal injuries (occupational, trauma hospital admissions, traffic, fire entrapments, poisoning and drug overdose) than has previously been reported. Our review confirms that hot weather can increase the risk of unintentional injuries and accidents in high-income countries. The results are useful for injury prevention strategies. PMID:26868947

  15. Challenges of Treating Childhood Medulloblastoma in a Country With Limited Resources: 20 Years of Experience at a Single Tertiary Center in Malaysia.

    Science.gov (United States)

    Rajagopal, Revathi; Abd-Ghafar, Sayyidatul; Ganesan, Dharmendra; Bustam Mainudin, Anita Zarina; Wong, Kum Thong; Ramli, Norlisah; Jawin, Vida; Lum, Su Han; Yap, Tsiao Yi; Bouffet, Eric; Qaddoumi, Ibrahim; Krishnan, Shekhar; Ariffin, Hany; Abdullah, Wan Ariffin

    2017-04-01

    Pediatric medulloblastoma (MB) treatment has evolved over the past few decades; however, treating children in countries with limited resources remains challenging. Until now, the literature regarding childhood MB in Malaysia has been nonexistent. Our objectives were to review the demographics and outcome of pediatric MB treated at the University Malaya Medical Center between January 1994 and December 2013 and describe the challenges encountered. Fifty-one patients with childhood MB were seen at University Malaya Medical Center. Data from 43 patients were analyzed; eight patients were excluded because their families refused treatment after surgery. Headache and vomiting were the most common presenting symptoms, and the mean interval between symptom onset and diagnosis was 4 weeks. Fourteen patients presented with metastatic disease. Five-year progression-free survival (± SE) for patients ≥ 3 years old was 41.7% ± 14.2% (95% CI, 21.3% to 81.4%) in the high-risk group and 68.6% ± 18.6% (95% CI, 40.3% to 100%) in the average-risk group, and 5-year overall survival (± SE) in these two groups was 41.7% ± 14.2% (95% CI, 21.3% to 81.4%) and 58.3% ± 18.6% (95% CI, 31.3% to 100%), respectively. Children younger than 3 years old had 5-year progression-free and overall survival rates (± SE) of 47.6% ± 12.1% (95% CI, 28.9% to 78.4%) and 45.6% ± 11.7% (95% CI, 27.6% to 75.5%), respectively. Time to relapse ranged from 4 to 132 months. Most patients who experienced relapse died within 1 year. Febrile neutropenia, hearing loss, and endocrinopathy were the most common treatment-related complications. The survival rate of childhood MB in Malaysia is inferior to that usually reported in the literature. We postulate that the following factors contribute to this difference: lack of a multidisciplinary neuro-oncology team, limited health care facilities, inconsistent risk assessment, insufficient data in the National Cancer Registry and pathology reports, inadequate long

  16. Challenges of Treating Childhood Medulloblastoma in a Country With Limited Resources: 20 Years of Experience at a Single Tertiary Center in Malaysia

    Directory of Open Access Journals (Sweden)

    Revathi Rajagopal

    2017-04-01

    Full Text Available Purpose: Pediatric medulloblastoma (MB treatment has evolved over the past few decades; however, treating children in countries with limited resources remains challenging. Until now, the literature regarding childhood MB in Malaysia has been nonexistent. Our objectives were to review the demographics and outcome of pediatric MB treated at the University Malaya Medical Center between January 1994 and December 2013 and describe the challenges encountered. Methods: Fifty-one patients with childhood MB were seen at University Malaya Medical Center. Data from 43 patients were analyzed; eight patients were excluded because their families refused treatment after surgery. Results: Headache and vomiting were the most common presenting symptoms, and the mean interval between symptom onset and diagnosis was 4 weeks. Fourteen patients presented with metastatic disease. Five-year progression-free survival (± SE for patients ≥ 3 years old was 41.7% ± 14.2% (95% CI, 21.3% to 81.4% in the high-risk group and 68.6% ± 18.6% (95% CI, 40.3% to 100% in the average-risk group, and 5-year overall survival (± SE in these two groups was 41.7% ± 14.2% (95% CI, 21.3% to 81.4% and 58.3% ± 18.6% (95% CI, 31.3% to 100%, respectively. Children younger than 3 years old had 5-year progression-free and overall survival rates (± SE of 47.6% ± 12.1% (95% CI, 28.9% to 78.4% and 45.6% ± 11.7% (95% CI, 27.6% to 75.5%, respectively. Time to relapse ranged from 4 to 132 months. Most patients who experienced relapse died within 1 year. Febrile neutropenia, hearing loss, and endocrinopathy were the most common treatment-related complications. Conclusion: The survival rate of childhood MB in Malaysia is inferior to that usually reported in the literature. We postulate that the following factors contribute to this difference: lack of a multidisciplinary neuro-oncology team, limited health care facilities, inconsistent risk assessment, insufficient data in the National Cancer

  17. Adult BMI and Access to Built Environment Resources in a High-Poverty, Urban Geography.

    Science.gov (United States)

    Tung, Elizabeth L; Peek, Monica E; Makelarski, Jennifer A; Escamilla, Veronica; Lindau, Stacy T

    2016-11-01

    The purpose of this study is to examine the relationship between BMI and access to built environment resources in a high-poverty, urban geography. Participants (aged ≥35 years) were surveyed between November 2012 and July 2013 to examine access to common health-enabling resources (grocers, outpatient providers, pharmacies, places of worship, and physical activity resources). Survey data were linked to a contemporaneous census of built resources. Associations between BMI and access to resources (potential and realized) were examined using independent t-tests and multiple linear regression. Data analysis was conducted in 2014-2015. Median age was 53.8 years (N=267, 62% cooperation rate). Obesity (BMI ≥30) prevalence was 54.9%. BMI was not associated with potential access to resources located nearest to home. Nearly all participants (98.1%) bypassed at least one nearby resource type; half bypassed nearby grocers (realized access >1 mile from home). Bypassing grocers was associated with a higher BMI (p=0.03). Each additional mile traveled from home to a grocer was associated with a 0.9-higher BMI (95% CI=0.4, 1.3). Quality and affordability were common reasons for bypassing resources. Despite potential access to grocers in a high-poverty, urban region, half of participants bypassed nearby grocers to access food. Bypassing grocers was associated with a higher BMI. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  18. High Resource Utilization Does Not Affect Mortality in Acute Respiratory Failure Patients Managed With Tracheostomy

    Science.gov (United States)

    Freeman, Bradley D; Stwalley, Dustin; Lambert, Dennis; Edler, Joshua; Morris, Peter E; Medvedev, Sofia; Hohmann, Samuel F; Kymes, Steven M

    2015-01-01

    BACKGROUND Tracheostomy practice in patients with acute respiratory failure (ARF) varies greatly among institutions. This variability has the potential to be reflected in the resources expended providing care. In various healthcare environments, increased resource expenditure has been associated with a favorable effect on outcome. OBJECTIVE To examine the association between institutional resource expenditure and mortality in ARF patients managed with tracheostomy. METHODS We developed analytic models employing the University Health Systems Consortium (Oakbrook, Illinois) database. Administrative coding data were used to identify patients with the principal diagnosis of ARF, procedures, complications, post-discharge destination, and survival. Mean resource intensity of participating academic medical centers was determined using risk-adjusted estimates of costs. Mortality risk was determined using a multivariable approach that incorporated patient-level demographic and clinical variables and institution-level resource intensity. RESULTS We analyzed data from 44,124 ARF subjects, 4,776 (10.8%) of whom underwent tracheostomy. Compared to low-resource-intensity settings, treatment in high-resource-intensity academic medical centers was associated with increased risk of mortality (odds ratio 1.11, 95% CI 1.05–1.76), including those managed with tracheostomy (odds ratio high-resource-intensity academic medical center with tracheostomy 1.10, 95% CI 1.04 –1.17). We examined the relationship between complication development and outcome. While neither the profile nor number of complications accumulated differed comparing treatment environments (P > .05 for both), mortality for tracheostomy patients experiencing complications was greater in high-resource-intensity (95/313, 30.3%) versus low-resource-intensity (552/2,587, 21.3%) academic medical centers (P tracheostomy. PMID:23650434

  19. Asylum seekers, violence and health: a systematic review of research in high-income host countries.

    Science.gov (United States)

    Kalt, Anne; Hossain, Mazeda; Kiss, Ligia; Zimmerman, Cathy

    2013-03-01

    We performed a systematic review of literature on violence and related health concerns among asylum seekers in high-income host countries. We extracted data from 23 peer-reviewed studies. Prevalence of torture, variably defined, was above 30% across all studies. Torture history in clinic populations correlated with hunger and posttraumatic stress disorder, although in small, nonrepresentative samples. One study observed that previous exposure to interpersonal violence interacted with longer immigration detention periods, resulting in higher depression scores. Limited evidence suggests that asylum seekers frequently experience violence and health problems, but large-scale studies are needed to inform policies and services for this vulnerable group often at the center of political debate.

  20. Can scenario-planning support community-based natural resource management? Experiences from three countries in Latin America

    Directory of Open Access Journals (Sweden)

    Kerry A. Waylen

    2015-12-01

    Full Text Available Community-based natural resource management (CBNRM is a concept critical to managing social-ecological systems but whose implementation needs strengthening. Scenario planning is one approach that may offer benefits relevant to CBNRM but whose potential is not yet well understood. Therefore, we designed, trialed, and evaluated a scenario-planning method intended to support CBNRM in three cases, located in Colombia, Mexico, and Argentina. Implementing scenario planning was judged as worthwhile in all three cases, although aspects of it were challenging to facilitate. The benefits generated were relevant to strengthening CBNRM: encouraging the participation of local people and using their knowledge, enhanced consideration of and adaptation to future change, and supporting the development of systems thinking. Tracing exactly when and how these benefits arose was challenging, but two elements of the method seemed particularly useful. First, using a systematic approach to discuss how drivers of change may affect local social-ecological systems helped to foster systems thinking and identify connections between issues. Second, explicitly focusing on how to use and respond to scenarios helped identify specific practical activities, or "response options," that would support CBNRM despite the pressures of future change. Discussions about response options also highlighted the need for support by other actors, e.g., policy groups: this raised the question of when and how other actors and other sources of knowledge should be involved in scenario planning, so as to encourage their buy-in to actions identified by the process. We suggest that other CBNRM initiatives may benefit from adapting and applying scenario planning. However, these initiatives should be carefully monitored because further research is required to understand how and when scenario-planning methods may produce benefits, as well as their strengths and weaknesses versus other methods.

  1. Public Health Responses to and Challenges for the Control of Dengue Transmission in High-Income Countries: Four Case Studies.

    Directory of Open Access Journals (Sweden)

    Elvina Viennet

    2016-09-01

    Full Text Available Dengue has a negative impact in low- and lower middle-income countries, but also affects upper middle- and high-income countries. Despite the efforts at controlling this disease, it is unclear why dengue remains an issue in affluent countries. A better understanding of dengue epidemiology and its burden, and those of chikungunya virus and Zika virus which share vectors with dengue, is required to prevent the emergence of these diseases in high-income countries in the future. The purpose of this review was to assess the relative burden of dengue in four high-income countries and to appraise the similarities and differences in dengue transmission. We searched PubMed, ISI Web of Science, and Google Scholar using specific keywords for articles published up to 05 May 2016. We found that outbreaks rarely occur where only Aedes albopictus is present. The main similarities between countries uncovered by our review are the proximity to dengue-endemic countries, the presence of a competent mosquito vector, a largely nonimmune population, and a lack of citizens' engagement in control of mosquito breeding. We identified important epidemiological and environmental issues including the increase of local transmission despite control efforts, population growth, difficulty locating larval sites, and increased human mobility from neighboring endemic countries. Budget cuts in health and lack of practical vaccines contribute to an increased risk. To be successful, dengue-control programs for high-income countries must consider the epidemiology of dengue in other countries and use this information to minimize virus importation, improve the control of the cryptic larval habitat, and engage the community in reducing vector breeding. Finally, the presence of a communicable disease center is critical for managing and reducing future disease risks.

  2. Public Health Responses to and Challenges for the Control of Dengue Transmission in High-Income Countries: Four Case Studies.

    Science.gov (United States)

    Viennet, Elvina; Ritchie, Scott A; Williams, Craig R; Faddy, Helen M; Harley, David

    2016-09-01

    Dengue has a negative impact in low- and lower middle-income countries, but also affects upper middle- and high-income countries. Despite the efforts at controlling this disease, it is unclear why dengue remains an issue in affluent countries. A better understanding of dengue epidemiology and its burden, and those of chikungunya virus and Zika virus which share vectors with dengue, is required to prevent the emergence of these diseases in high-income countries in the future. The purpose of this review was to assess the relative burden of dengue in four high-income countries and to appraise the similarities and differences in dengue transmission. We searched PubMed, ISI Web of Science, and Google Scholar using specific keywords for articles published up to 05 May 2016. We found that outbreaks rarely occur where only Aedes albopictus is present. The main similarities between countries uncovered by our review are the proximity to dengue-endemic countries, the presence of a competent mosquito vector, a largely nonimmune population, and a lack of citizens' engagement in control of mosquito breeding. We identified important epidemiological and environmental issues including the increase of local transmission despite control efforts, population growth, difficulty locating larval sites, and increased human mobility from neighboring endemic countries. Budget cuts in health and lack of practical vaccines contribute to an increased risk. To be successful, dengue-control programs for high-income countries must consider the epidemiology of dengue in other countries and use this information to minimize virus importation, improve the control of the cryptic larval habitat, and engage the community in reducing vector breeding. Finally, the presence of a communicable disease center is critical for managing and reducing future disease risks.

  3. Factors influencing trainee doctor emigration in a high income country: a mixed methods study.

    Science.gov (United States)

    Clarke, Nicholas; Crowe, Sophie; Humphries, Niamh; Conroy, Ronan; O'Hare, Simon; Kavanagh, Paul; Brugha, Ruairi

    2017-09-25

    The Global Code of Practice on the International Recruitment of Health Personnel focuses particularly on migration of doctors from low- and middle-income countries. Less is understood about migration from high-income countries. Recession has impacted several European countries in recent years, and in some cases emigration has reached unprecedented levels. This study measures and explores the predictors of trainee doctor emigration from Ireland. Using a partially mixed sequential dominant (quantitative) study design, a nationally representative sample of 893 trainee doctors was invited to complete an online survey. Of the 523 who responded (58.6% response rate), 423 were still in Ireland and responded to questions on factors influencing intention to practice medicine abroad and are the subjects of this study. Explanatory factors for intention to practice medicine in Ireland in the foreseeable future, the primary outcome, included demographic variables and experiences of working within the Irish health system. Associations were examined using univariable and multivariable logistic regression to estimate odds ratios for factors influencing the primary outcome. Qualitative interviews were conducted with 50 trainee doctors and analysed thematically, exploring issues associated with intention to practice medicine abroad. There were high levels of dissatisfaction among trainee doctors around working conditions, training and career progression opportunities in Ireland. However, most factors did not discriminate between intention to leave or stay. Factors that did predict intention to leave included dissatisfaction with one's work-life balance (odds ratio (OR) 2.51; 95% confidence interval (CI) 1.53-4.10; P < 0.001); feeling that the quality of training in Ireland was poor (OR 1.82; 95% CI 1.09-3.05; P = 0.002) and leaving for family or personal reasons (OR 1.85; 95% CI 1.08-3.17; P = 0.027). Qualitative findings illustrated the stress of doing postgraduate

  4. Cost-effectiveness of national health insurance programs in high-income countries: A systematic review.

    Directory of Open Access Journals (Sweden)

    Son Nghiem

    Full Text Available National health insurance is now common in most developed countries. This study reviews the evidence and synthesizes the cost-effectiveness information for national health insurance or disability insurance programs across high-income countries.A literature search using health, economics and systematic review electronic databases (PubMed, Embase, Medline, Econlit, RepEc, Cochrane library and Campbell library, was conducted from April to October 2015.Two reviewers independently selected relevant studies by applying screening criteria to the title and keywords fields, followed by a detailed examination of abstracts.Studies were selected for data extraction using a quality assessment form consisting of five questions. Only studies with positive answers to all five screening questions were selected for data extraction. Data were entered into a data extraction form by one reviewer and verified by another.Data on costs and quality of life in control and treatment groups were used to draw distributions for synthesis. We chose the log-normal distribution for both cost and quality-of-life data to reflect non-negative value and high skew. The results were synthesized using a Monte Carlo simulation, with 10,000 repetitions, to estimate the overall cost-effectiveness of national health insurance programs.Four studies from the United States that examined the cost-effectiveness of national health insurance were included in the review. One study examined the effects of medical expenditure, and the remaining studies examined the cost-effectiveness of health insurance reforms. The incremental cost-effectiveness ratio (ICER ranged from US$23,000 to US$64,000 per QALY. The combined results showed that national health insurance is associated with an average incremental cost-effectiveness ratio of US$51,300 per quality-adjusted life year (QALY. Based on the standard threshold for cost-effectiveness, national insurance programs are cost-effective interventions

  5. Smartphone Use for Cervical Cancer Screening in Low-Resource Countries: A Pilot Study Conducted in Madagascar.

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    Rosa Catarino

    Full Text Available Visual inspection of the cervix after application of 5% acetic acid (VIA is a screening technique for cervical cancer used widely in low and middle-income countries (LMIC. To improve VIA screening performance, digital images after acid acetic application (D-VIA are taken. The aim of this study was to evaluate the use of a smartphone for on- and off-site D-VIA diagnosis.Women aged 30-65 years, living in the city of Ambanja, Madagascar, were recruited through a cervical cancer screening campaign. Each performed a human papillomavirus (HPV self-sample as a primary screen. Women testing positive for HPV were referred for VIA followed by D-VIA, cervical biopsy and endocervical curettage according to routine protocol. In addition, the same day, the D-VIA was emailed to a tertiary care center for immediate assessment. Results were scored as either D-VIA normal or D-VIA abnormal, requiring immediate therapy or referral to a tertiary center. Each of the three off-site physicians were blinded to the result reported by the one on-site physician and each gave their individual assessment followed by a consensus diagnosis. Statistical analyses were conducted using STATA software.Of the 332 women recruited, 137 (41.2% were HPV-positive and recalled for VIA triage; compliance with this invitation was 69.3% (n = 95. Cervical intraepithelial neoplasia was detected in 17.7% and 21.7% of digital images by on-site and off-site physicians, respectively. The on-site physician had a sensitivity of 66.7% (95%CI: 30.0-90.3 and a specificity of 85.7% (95%CI: 76.7-91.6; the off-site physician consensus sensitivity was 66.7% (95%CI: 30.0-90.3 with a specificity of 82.3% (95%CI: 72.4-89.1.This pilot study supports the use of telemedicine for off-site diagnosis of cervical intraepithelial neoplasia, with diagnostic performance similar to those achieved on-site. Further studies need to determine if smartphones can improve cervical cancer screening efficiency in LMIC.

  6. Implementation of microsource high dose rate (mHDR) brachytherapy in developing countries

    International Nuclear Information System (INIS)

    2001-11-01

    Brachytherapy using remote afterloading of a single high dose rate 192 Ir microsource was developed in the 1970s. After its introduction to clinics, this system has spread rapidly among developed Member States and has become a highly desirable modality in cancer treatment. This technique is now gradually being introduced to the developing Member States. The 192 Ir sources are produced with a high specific activity. This results in a high dose rate (HDR) to the tumour and shorter treatment times. The high specific activity simultaneously results in a much smaller source (so-called micro source, around I mm in diameter) which may be easily inserted into tissue through a thin delivery tube, the so-called interstitial treatment, as well as easily inserted into body cavities, the so-called intracavitary or endoluminal treatment. Another advantage is the ability to change dwell time (the time a source remains in one position) of the stepping source which allows dose distribution to match the target volume more closely. The purpose of this TECDOC is to advise radiation oncologists, medical physicists and hospital administrators in hospitals which are planning to introduce 192 Ir microsource HDR (mHDR) remote afterloading systems. The document supplements IAEA-TECDOC-1040, Design and Implementation of a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects, and will facilitate implementation of this new brachytherapy technology, especially in developing countries. The operation of the system, 'how to use the system', is not within the scope of this document. This TECDOC is based on the recommendations of an Advisory Group meeting held in Vienna in April 1999

  7. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates

    Science.gov (United States)

    2011-01-01

    Background Tuberculosis (TB) in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Methods Descriptive study of immigration TB screening programs Results 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. Conclusions In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas outlined in this study should

  8. Failing to retain a new generation of doctors: qualitative insights from a high-income country.

    Science.gov (United States)

    Humphries, Niamh; Crowe, Sophie; Brugha, Ruairí

    2018-02-27

    The failure of high-income countries, such as Ireland, to achieve a self-sufficient medical workforce has global implications, particularly for low-income, source countries. In the past decade, Ireland has doubled the number of doctors it trains annually, but because of its failure to retain doctors, it remains heavily reliant on internationally trained doctors to staff its health system. To halve its dependence on internationally trained doctors by 2030, in line with World Health Organisation (WHO) recommendations, Ireland must become more adept at retaining doctors. This paper presents findings from in-depth interviews conducted with 50 early career doctors between May and July 2015. The paper explores the generational component of Ireland's failure to retain doctors and makes recommendations for retention policy and practice. Interviews revealed that a new generation of doctors differ from previous generations in several distinct ways. Their early experiences of training and practice have been in an over-stretched, under-staffed health system and this shapes their decision to remain in Ireland, or to leave. Perhaps as a result of the distinct challenges they have faced in an austerity-constrained health system and their awareness of the working conditions available globally, they challenge the traditional view of medicine as a vocation that should be prioritised before family and other commitments. A new generation of doctors have career options that are also strongly shaped by globalisation and by the opportunities presented by emigration. Understanding the medical workforce from a generational perspective requires that the health system address the issues of concern to a new generation of doctors, in terms of working conditions and training structures and also in terms of their desire for a more acceptable balance between work and life. This will be an important step towards future-proofing the medical workforce and is essential to achieving medical workforce

  9. Centre-based day care for children younger than five years of age in high-income countries.

    Science.gov (United States)

    van Urk, Felix C; Brown, Taylor W; Waller, Rebecca; Mayo-Wilson, Evan

    2014-09-23

    A large proportion of children younger than five years of age in high-income countries experience significant non-parental care. Centre-based day care services may influence the development of children and the economic situation of parents. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development and well-being of children and families in high-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, the Education Resources Information Center (ERIC) and eight other databases. We also searched two trials registers and the reference lists of relevant studies. We included randomised and quasi-randomised controlled trials of centre-based day care for children younger than five years of age. We excluded studies that involved co-interventions not directed toward children (e.g. parent programmes, home visits, teacher training). We included the following outcomes: child cognitive development (primary outcome), child psychosocial development, maternal and family outcomes and child long-term outcomes. Two review authors independently assessed the risk of bias and extracted data from the single included study. We contacted investigators to obtain missing information. We included in the review one trial, involving 120 families and 143 children. Risk of bias was high because of contamination between groups, as 63% of control group participants accessed day care services separate from those offered within the intervention. No evidence suggested that centre-based day care, rather than no treatment (care at home), improved or worsened children's cognitive ability (Griffiths Mental Development Scale, standardised mean difference (SMD) 0.34, 95% confidence interval (CI) -0.01 to 0.69, 127 participants, 1 study, very low-quality evidence) or psychosocial development (parental report of abnormal development, risk ratio (RR

  10. Examining gender equity in health policies in a low- (Peru), middle- (Colombia), and high- (Canada) income country in the Americas.

    Science.gov (United States)

    Stewart, Donna E; Dorado, Linda M; Diaz-Granados, Natalia; Rondon, Marta; Saavedra, Javier; Posada-Villa, Jose; Torres, Yolanda

    2009-12-01

    Gender inequities in health prevail in most countries despite ongoing attempts to eliminate them. Assessment of gender-sensitive health policies can be used to identify country specific progress as well as gaps and issues that need to be addressed to meet health equity goals. This study selected and measured the existence of gender-sensitive health policies in a low- (Peru), middle- (Colombia), and high (Canada)-income country in the Americas. Investigators selected 10 of 20 gender-sensitive health policy indicators and found eight to be feasible to measure in all three countries, although the wording and scope varied. The results from this study inform policy makers and program planners who aim to develop, improve, implement, and monitor national gender-sensitive health policies. Future studies should assess the implementation of policy indicators within countries and assess their performance in increasing gender equity.

  11. How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS.

    Science.gov (United States)

    Jenniskens, Françoise; Tiendrebeogo, Georges; Coolen, Anne; Blok, Lucie; Kouanda, Seni; Sataru, Fuseini; Ralisimalala, Andriamampianina; Mwapasa, Victor; Kiyombo, Mbela; Plummer, David

    2012-12-11

    Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders' perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this. A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi). Key background documents were analysed and semi-structured interviews (n = 258) and focus group discussions (n = 45) were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level. Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana) identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs). Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs) and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi-stakeholder processes were increasingly used to identify

  12. How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS

    Directory of Open Access Journals (Sweden)

    Jenniskens Françoise

    2012-12-01

    Full Text Available Abstract Background Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders′ perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this. Methods A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi. Key background documents were analysed and semi-structured interviews (n = 258 and focus group discussions (n = 45 were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level. Results Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs. Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi

  13. EGI-EUDAT integration activity - Pair data and high-throughput computing resources together

    Science.gov (United States)

    Scardaci, Diego; Viljoen, Matthew; Vitlacil, Dejan; Fiameni, Giuseppe; Chen, Yin; sipos, Gergely; Ferrari, Tiziana

    2016-04-01

    EGI (www.egi.eu) is a publicly funded e-infrastructure put together to give scientists access to more than 530,000 logical CPUs, 200 PB of disk capacity and 300 PB of tape storage to drive research and innovation in Europe. The infrastructure provides both high throughput computing and cloud compute/storage capabilities. Resources are provided by about 350 resource centres which are distributed across 56 countries in Europe, the Asia-Pacific region, Canada and Latin America. EUDAT (www.eudat.eu) is a collaborative Pan-European infrastructure providing research data services, training and consultancy for researchers, research communities, research infrastructures and data centres. EUDAT's vision is to enable European researchers and practitioners from any research discipline to preserve, find, access, and process data in a trusted environment, as part of a Collaborative Data Infrastructure (CDI) conceived as a network of collaborating, cooperating centres, combining the richness of numerous community-specific data repositories with the permanence and persistence of some of Europe's largest scientific data centres. EGI and EUDAT, in the context of their flagship projects, EGI-Engage and EUDAT2020, started in March 2015 a collaboration to harmonise the two infrastructures, including technical interoperability, authentication, authorisation and identity management, policy and operations. The main objective of this work is to provide end-users with a seamless access to an integrated infrastructure offering both EGI and EUDAT services and, then, pairing data and high-throughput computing resources together. To define the roadmap of this collaboration, EGI and EUDAT selected a set of relevant user communities, already collaborating with both infrastructures, which could bring requirements and help to assign the right priorities to each of them. In this way, from the beginning, this activity has been really driven by the end users. The identified user communities are

  14. High level radioactive waste management policies and reflections of citizens' opinions in selected European countries

    International Nuclear Information System (INIS)

    Nagano, Koji

    2002-01-01

    This report considered on policy decision aiming at practice of landfill disposal and process at disposal site forward practice of high level radioactive wastes (HLWs) disposal by adopting Finland and Sweden, for examples among European countries showing their own efforts, to attempt to absorb some instructions for Japan planning to promote practice of unique process in future. As a result performing information collection and analysis at a center of surveys at sites, conclusion shown as follows were obtained: (1) Characteristics of nuclear policy decision making at Finland are confirmation of decision making based on decision in principle (DiP) procedure, participation of nations, especially congress, and high reliability of citizens to social systems. (2) At Oskarshamn in Sweden, positive efforts and decision making on disposal site problem are progressed as results of leading by local assembly, construction planning on decision making competence on HLWs, and planning preparation on presence of troubles and decision with responsibility to citizens. (3) As when promoting disposal site process, failure of loss on reliability relation brings large time and economical losses, for its success conditions, it was proposed that psychological refusal feelings of residents at sites on nuclear energy were small, the sites had some capacities and well-informed capable of understanding and judging on nuclear troubles, and decision not only present facility and trouble proposing construction, but also through discussion on future images for local society. (G.K.)

  15. Life satisfaction in 6 European countries: the relationship to health, self-esteem, and social and financial resources among people (Aged 65-89) with reduced functional capacity.

    Science.gov (United States)

    Borg, Christel; Fagerström, Cecilia; Balducci, Cristian; Burholt, Vanessa; Ferring, Dieter; Weber, Germain; Wenger, Clare; Holst, Göran; Hallberg, Ingalill R

    2008-01-01

    The aim of this study was to investigate how overall health, participation in physical activities, self-esteem, and social and financial resources are related to life satisfaction among people aged 65 and older with reduced activities of daily living (ADL) capacity in 6 European countries. A subsample of the European Study of Adults' Well-Being (ESAW), consisting of 2,195 people with reduced ADL capacity from Sweden, the United Kingdom, the Netherlands, Luxembourg, Austria, and Italy, was included. The Older Americans' Resources Schedule (OARS), the Life Satisfaction Index Z, and the Self-Esteem Scale were used. In all national samples, overall health, self-esteem, and feeling worried, rather than ADL capacity, were significantly associated with life satisfaction. The findings indicate the importance of taking not only the reduction in functional capacity into account but also the individual's perception of health and self-esteem when outlining health care and nursing aimed at improving life satisfaction. The study thus suggests that personal rather than environmental factors are important for life satisfaction among people with reduced ADL capacity living in Europe.

  16. Mineral Taxation Policies in Developing Countries: An Application of Resource Rent Tax (L'imposition des ressources dans les pays en développement: application du concept de taxe sur la rente minière) (Políticas de impuestos a los minerales en los países en desarrollo: Aplicación del impuesto a la renta de recursos)

    OpenAIRE

    Keith F. Palmer

    1980-01-01

    The central problem of mineral taxation policy in developing countries is to establish a stable fiscal framework that, under conditions of uncertainty, both obtains a high share of mineral rent for the resource-owning country and ensures for the investor the prospect of a return on his investment commensurate with his risk. The main concern of the paper is to propose a practical fiscal framework, based on the resource rent tax concept, that meets these objectives. The resource rent tax is a p...

  17. Genetic sequencing for surveillance of drug resistance in tuberculosis in highly endemic countries: a multi-country population-based surveillance study.

    Science.gov (United States)

    Zignol, Matteo; Cabibbe, Andrea Maurizio; Dean, Anna S; Glaziou, Philippe; Alikhanova, Natavan; Ama, Cecilia; Andres, Sönke; Barbova, Anna; Borbe-Reyes, Angeli; Chin, Daniel P; Cirillo, Daniela Maria; Colvin, Charlotte; Dadu, Andrei; Dreyer, Andries; Driesen, Michèle; Gilpin, Christopher; Hasan, Rumina; Hasan, Zahra; Hoffner, Sven; Hussain, Alamdar; Ismail, Nazir; Kamal, S M Mostofa; Khanzada, Faisal Masood; Kimerling, Michael; Kohl, Thomas Andreas; Mansjö, Mikael; Miotto, Paolo; Mukadi, Ya Diul; Mvusi, Lindiwe; Niemann, Stefan; Omar, Shaheed V; Rigouts, Leen; Schito, Marco; Sela, Ivita; Seyfaddinova, Mehriban; Skenders, Girts; Skrahina, Alena; Tahseen, Sabira; Wells, William A; Zhurilo, Alexander; Weyer, Karin; Floyd, Katherine; Raviglione, Mario C

    2018-03-21

    In many countries, regular monitoring of the emergence of resistance to anti-tuberculosis drugs is hampered by the limitations of phenotypic testing for drug susceptibility. We therefore evaluated the use of genetic sequencing for surveillance of drug resistance in tuberculosis. Population-level surveys were done in hospitals and clinics in seven countries (Azerbaijan, Bangladesh, Belarus, Pakistan, Philippines, South Africa, and Ukraine) to evaluate the use of genetic sequencing to estimate the resistance of Mycobacterium tuberculosis isolates to rifampicin, isoniazid, ofloxacin, moxifloxacin, pyrazinamide, kanamycin, amikacin, and capreomycin. For each drug, we assessed the accuracy of genetic sequencing by a comparison of the adjusted prevalence of resistance, measured by genetic sequencing, with the true prevalence of resistance, determined by phenotypic testing. Isolates were taken from 7094 patients with tuberculosis who were enrolled in the study between November, 2009, and May, 2014. In all tuberculosis cases, the overall pooled sensitivity values for predicting resistance by genetic sequencing were 91% (95% CI 87-94) for rpoB (rifampicin resistance), 86% (74-93) for katG, inhA, and fabG promoter combined (isoniazid resistance), 54% (39-68) for pncA (pyrazinamide resistance), 85% (77-91) for gyrA and gyrB combined (ofloxacin resistance), and 88% (81-92) for gyrA and gyrB combined (moxifloxacin resistance). For nearly all drugs and in most settings, there was a large overlap in the estimated prevalence of drug resistance by genetic sequencing and the estimated prevalence by phenotypic testing. Genetic sequencing can be a valuable tool for surveillance of drug resistance, providing new opportunities to monitor drug resistance in tuberculosis in resource-poor countries. Before its widespread adoption for surveillance purposes, there is a need to standardise DNA extraction methods, recording and reporting nomenclature, and data interpretation. Bill & Melinda

  18. Social and financial resources and high-risk alcohol consumption among older adults.

    Science.gov (United States)

    Moos, Rudolf H; Brennan, Penny L; Schutte, Kathleen K; Moos, Bernice S

    2010-04-01

    This study examined long-term mutual predictive associations between social and financial resources and high-risk alcohol consumption in later life. A sample of 55- to 65-year-old older adults (n = 719) was surveyed at baseline and 10 years and 20 years later. At each contact point, participants completed an inventory that assessed social and financial resources and alcohol consumption. Over the 20-year interval, there was evidence of both social causation and social selection processes in relation to high-risk alcohol consumption. In support of a social causation perspective, higher levels of some social resources, such as participation in social activities, friends' approval of drinking, quality of relationship with spouse, and financial resources, were associated with a subsequent increased likelihood of high-risk alcohol consumption. Conversely, indicating the presence of social selection, high-risk alcohol consumption was associated with subsequent higher levels of friends' approval of drinking and quality of the spousal relationship, but lower quality of relationships with extended family members. These findings reflect mutual influence processes in which older adults' social resources and high-risk alcohol consumption can alter each other. Older adults may benefit from information about how social factors can affect their drinking habits; accordingly, information about social causation effects could be used to guide effective prevention and intervention efforts aimed at reducing the risk that late-life social factors may amplify their excessive alcohol consumption.

  19. Development of a checklist of quality indicators for clinical trials in resource-limited countries: the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) experience.

    Science.gov (United States)

    Hanna, Mina; Minga, Albert; Fao, Paulin; Borand, Laurence; Diouf, Assane; Mben, Jean-Marc; Gad, Rita R; Anglaret, Xavier; Bazin, Brigitte; Chene, Geneviève

    2013-04-01

    Since 1994, the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) has funded research sites in resource-limited countries (RLCs). These sites implement research on human immunodeficiency virus (HIV) infection and Hepatitis C. In parallel, international regulations and recommendations for clinical trials have evolved and proliferated. However, little guidance exists on how these should be interpreted and applied within academic trials and in the context of RLCs. After developing a specific Ethical Charter for research in developing countries in 2002, ANRS developed a set of quality indicators (QIs) as a monitoring tool for assessing compliance to international guidelines. We describe here the development process, QIs adopted, and areas for improvement. In 2008, a group of experts was convened that included a researcher representing each ANRS site (Cote d'Ivoire, Senegal, Cameroun, Burkina Faso, Egypt, and Cambodia). Our structuring interaction development process combined evidence and expert opinion in two nominal group meetings to identify (1) clinical trial processes involved, (2) issues specific to RLCs in terms of Good Clinical Practice (GCP) and the application of ethical recommendations, and (3) checklists of QIs adapted to clinical trials conducted in RLCs. The trial process reviewed and proposed for RLCs was mostly similar to the one produced in wealthier countries. The scheme generated by our work group added two further processes: 'drug management' and 'biological investigations'. Specific issues regarding trial management in RLCs were therefore described for eight trial steps (1) protocol conception and seeking authorizations, (2) participant enrollment and follow-up, (3) site monitoring, (4) drug management, (5) biological investigations, (6) record management, (7) data management, and (8) site closeout. A total of 58 indicators were identified with at least one indicator for each trial process. Some trial activities require further

  20. Aboriginal Consumption of Estuarine Food Resources and Potential Implications for Health through Trace Metal Exposure; A Study in Gumbaynggirr Country, Australia.

    Science.gov (United States)

    Russell, Shaina; Sullivan, Caroline A; Reichelt-Brushett, Amanda J

    2015-01-01

    Fishing and resource use continues to be an essential aspect of life for many Aboriginal communities throughout Australia. It is important for dietary sustenance, and also retains deep social, cultural and economic significance, playing a fundamental role in maintaining group cohesion, transferring cultural knowledge and affirming Indigenous identities. We surveyed approximately 20% of the Gumbaynggirr Aboriginal community of Nambucca Heads, New South Wales, Australia. This paper explores Gumbaynggirr Connection to Country and engagement in cultural practice. It quantifies fishing efforts and consumption of seafood within the community. We found 95% of the sample group fish, with the highest rate of fishing being 2-3 times a week (27%). Furthermore, 98% of participants eat seafood weekly or more frequently, up to more than once a day (24%). Survey results revealed that Myxus elongatus (Sand mullet) and naturally recruited Saccostrea glomerata (Sydney rock oysters) continue to be important wild resources to the Gumbaynggirr community. Trace metals were measured in M. elongatus and S. glomerata samples collected by community participants in this study. Maximum levels prescribed in the Australia New Zealand Food Standards Code were not exceeded in the edible tissue for either species, however both species exceeded the generally expected levels for zinc and copper and S. glomerata samples exceeded the generally expected level for selenium. Furthermore the average dietary exposure to trace metals from consuming seafood was calculated for the surveyed population. Trace metal intake was then compared to the provisional tolerable weekly intake prescribed by the Joint Expert Committee on Food Additives. This process revealed that copper and selenium intake were both within the provisional tolerable weekly intake, while there is no guideline for zinc. Furthermore, participants relying heavily on wild resources from the Nambucca River estuary may exceed the provisional

  1. Aboriginal Consumption of Estuarine Food Resources and Potential Implications for Health through Trace Metal Exposure; A Study in Gumbaynggirr Country, Australia.

    Directory of Open Access Journals (Sweden)

    Shaina Russell

    Full Text Available Fishing and resource use continues to be an essential aspect of life for many Aboriginal communities throughout Australia. It is important for dietary sustenance, and also retains deep social, cultural and economic significance, playing a fundamental role in maintaining group cohesion, transferring cultural knowledge and affirming Indigenous identities. We surveyed approximately 20% of the Gumbaynggirr Aboriginal community of Nambucca Heads, New South Wales, Australia. This paper explores Gumbaynggirr Connection to Country and engagement in cultural practice. It quantifies fishing efforts and consumption of seafood within the community. We found 95% of the sample group fish, with the highest rate of fishing being 2-3 times a week (27%. Furthermore, 98% of participants eat seafood weekly or more frequently, up to more than once a day (24%. Survey results revealed that Myxus elongatus (Sand mullet and naturally recruited Saccostrea glomerata (Sydney rock oysters continue to be important wild resources to the Gumbaynggirr community. Trace metals were measured in M. elongatus and S. glomerata samples collected by community participants in this study. Maximum levels prescribed in the Australia New Zealand Food Standards Code were not exceeded in the edible tissue for either species, however both species exceeded the generally expected levels for zinc and copper and S. glomerata samples exceeded the generally expected level for selenium. Furthermore the average dietary exposure to trace metals from consuming seafood was calculated for the surveyed population. Trace metal intake was then compared to the provisional tolerable weekly intake prescribed by the Joint Expert Committee on Food Additives. This process revealed that copper and selenium intake were both within the provisional tolerable weekly intake, while there is no guideline for zinc. Furthermore, participants relying heavily on wild resources from the Nambucca River estuary may exceed the

  2. Hepatitis C virus therapy with peg-interferon and ribavirin in Myanmar: A resource-constrained country.

    Science.gov (United States)

    Hlaing, Naomi Khaing Than; Banerjee, Debolina; Mitrani, Robert; Arker, Soe Htet; Win, Kyaw San; Tun, Nyan Lin; Thant, Zaw; Win, Khin Maung; Reddy, K Rajender

    2016-11-21

    To investigate peg-interferon (peg-IFN) and ribavirin (RBV) therapy in Myanmar and to predict sustained virologic response (SVR). This single-center, open-label, study was conducted in Myanmar between 2009 and 2014. A total of 288 patients infected with HCV genotypes 1, 2, 3 and 6 were treated with peg-IFN alpha-2a (180 μg/wk) or alpha-2b (50 to 100 μg as a weight-based dose) and RBV as a weight-based dose (15 mg/kg/d). Treatment duration was 48 wk for genotypes 1 and 6, 24 wk for genotype 2, and 24 or 48 wk for genotype 3 based on rapid virologic response (RVR). Those co-infected with hepatitis B received 48 wk of therapy. Overall, SVR was achieved for 82% of patients and the therapy was well tolerated. All patients achieved SVR at equivalent rates regardless of HCV genotype ( P = 0.314). Low fibrosis scores ( P 96% positive predictive value for achieving SVR. Treatment duration did not significantly impact the likelihood of achieving SVR for patients infected with genotype 3 HCV ( P = 0.371). The most common adverse events were fatigue (71%) and poor appetite (60%). Among patients with genotype 3 HCV, more patients in the 48-wk treatment group required erythropoietin than in the 24-wk treatment group (61.1% vs 49.2%). SVR rates were high with peg-IFN and RBV therapy in Myanmar. Fibrosis scores, baseline albumin, HCV RNA levels and RVR independently predicted SVR.

  3. Demand side resource operation on the Irish power system with high wind power penetration

    International Nuclear Information System (INIS)

    Keane, A.; Tuohy, A.; Meibom, P.; Denny, E.; Flynn, D.; Mullane, A.; O'Malley, M.

    2011-01-01

    The utilisation of demand side resources is set to increase over the coming years with the advent of advanced metering infrastructure, home area networks and the promotion of increased energy efficiency. Demand side resources are proposed as an energy resource that, through aggregation, can form part of the power system plant mix and contribute to the flexible operation of a power system. A model for demand side resources is proposed here that captures its key characteristics for commitment and dispatch calculations. The model is tested on the all island Irish power system, and the operation of the model is simulated over one year in both a stochastic and deterministic mode, to illustrate the impact of wind and load uncertainty. The results illustrate that demand side resources can contribute to the efficient, flexible operation of systems with high penetrations of wind by replacing some of the functions of conventional peaking plant. Demand side resources are also shown to be capable of improving the reliability of the system, with reserve capability identified as a key requirement in this respect. - Highlights: → Demand side resource model presented for use in unit commitment and dispatch calculations. → Benefits of demand side aggregation demonstrated specifically as a peaking unit and provider of reserve. → Potential to displace or defer construction of conventional peaking units.

  4. The need for nuclear knowledge management and human resources development in the nuclear technology in a least developed country: The Haiti case

    International Nuclear Information System (INIS)

    Belfort, A.

    2004-01-01

    Full text: As All specialist recognizes it knowledge management refers to issues related to organizational adaptation, survival and competence in the context of a discontinuous environmental change. It concerns also organizational process seeking synergistic combination of data and information processing capacity of the technologies of information with the capacity of human beings. Knowledge management in this sense implies not only organizational and technology processes but involves also human resources development. Our intervention in the context of this forum will focus around a planned INIS project that has been submitted to the Agency for the cycle 2005-2006 and the synergistic ties it can develop with a nuclear knowledge management policy for Haiti. Haiti is the sole least developed country of Latin America and the main challenge it faces is that of reducing poverty. The population of Haiti is around 7.900.000 inhabitants; In terms of annual per capita income the estimated indigency line for 1996 was $160 per year and the poverty line was around $ 220; 2/3 of the rural households fell under the indigency line and 20% only of the population exceeded the poverty line. Main causes of this situation are: land erosion, water scarcity, degradation of the environment, lack of the competitiveness of the economy, lack of electricity etc In all these areas the nuclear techniques can contribute to solve the problem of poverty in Haiti by fulfilling the need to sustain the valuable human resources under the dire circumstances of the local economic conditions. By taking account of the recent efforts of the Government to enhance the manpower capabilities there is a real need now to manage the scarce resources so that they can be retained, expanded and eventually multiplied. Under this perspective the Haitian Government is applying a strategy seeking to involve all the sectors concerned by the peaceful applications of nuclear techniques. After 3 years of diffusion of

  5. The need for nuclear knowledge management and human resources development in the nuclear technology in a least developed country: The Haiti case

    International Nuclear Information System (INIS)

    Belfort, A.

    2004-01-01

    Full text: As all specialist recognizes it knowledge management refers to issues related to organizational adaptation, survival and competence in the context of a discontinuous environmental change. It concerns also organizational process seeking synergistic combination of data and information processing capacity of the technologies of information with the capacity of human beings. Knowledge management in this sense implies not only organizational and technology processes but involves also human resources development. Our intervention in the context of this forum will focus around a planned INIS project that has been submitted to the Agency for the cycle 2005-2006 and the synergistic ties it can develop with a nuclear knowledge management policy for Haiti. Haiti is the sole least developed country of Latin America and the main challenge it faces is that of reducing poverty. The population of Haiti is around 7.900.000 inhabitants;In terms of annual per capita income the estimated indigency line for 1996 was $160 per year and the poverty line was around $ 220; 2/3 of the rural households fell under the indigency line and 20% only of the population exceeded the poverty line. Main causes of this situation are: land erosion, water scarcity, degradation of the environment, lack of the competitiveness of the economy, lack of electricity etc In all these areas the nuclear techniques can contribute to solve the problem of poverty in Haiti by fulfilling the need to sustain the valuable human resources under the dire circumstances of the local economic conditions. By taking account of the recent efforts of the Government to enhance the manpower capabilities there is a real need now to manage the scarce resources so that they can be retained, expanded and eventually multiplied. Under this perspective the Haitian Government is applying a strategy seeking to involve all the sectors concerned by the peaceful applications of nuclear techniques. After 3 years of diffusion of

  6. Quality tools and resources to support organisational improvement integral to high-quality primary care: a systematic review of published and grey literature.

    Science.gov (United States)

    Janamian, Tina; Upham, Susan J; Crossland, Lisa; Jackson, Claire L

    2016-04-18

    To conduct a systematic review of the literature to identify existing online primary care quality improvement tools and resources to support organisational improvement related to the seven elements in the Primary Care Practice Improvement Tool (PC-PIT), with the identified tools and resources to progress to a Delphi study for further assessment of relevance and utility. Systematic review of the international published and grey literature. CINAHL, Embase and PubMed databases were searched in March 2014 for articles published between January 2004 and December 2013. GreyNet International and other relevant websites and repositories were also searched in March-April 2014 for documents dated between 1992 and 2012. All citations were imported into a bibliographic database. Published and unpublished tools and resources were included in the review if they were in English, related to primary care quality improvement and addressed any of the seven PC-PIT elements of a high-performing practice. Tools and resources that met the eligibility criteria were then evaluated for their accessibility, relevance, utility and comprehensiveness using a four-criteria appraisal framework. We used a data extraction template to systematically extract information from eligible tools and resources. A content analysis approach was used to explore the tools and resources and collate relevant information: name of the tool or resource, year and country of development, author, name of the organisation that provided access and its URL, accessibility information or problems, overview of each tool or resource and the quality improvement element(s) it addresses. If available, a copy of the tool or resource was downloaded into the bibliographic database, along with supporting evidence (published or unpublished) on its use in primary care. This systematic review identified 53 tools and resources that can potentially be provided as part of a suite of tools and resources to support primary care practices in

  7. What Contributes Most to High Health Care Costs? Health Care Spending in High Resource Patients.

    Science.gov (United States)

    Pritchard, Daryl; Petrilla, Allison; Hallinan, Shawn; Taylor, Donald H; Schabert, Vernon F; Dubois, Robert W

    2016-02-01

    U.S. health care spending nearly doubled in the decade from 2000-2010. Although the pace of increase has moderated recently, the rate of growth of health care costs is expected to be higher than the growth in the economy for the near future. Previous studies have estimated that 5% of patients account for half of all health care costs, while the top 1% of spenders account for over 27% of costs. The distribution of health care expenditures by type of service and the prevalence of particular health conditions for these patients is not clear, and is likely to differ from the overall population. To examine health care spending patterns and what contributes to costs for the top 5% of managed health care users based on total expenditures. This retrospective observational study employed a large administrative claims database analysis of health care claims of managed care enrollees across the full age and care spectrum. Direct health care expenditures were compared during calendar year 2011 by place of service (outpatient, inpatient, and pharmacy), payer type (commercially insured, Medicare Advantage, and Medicaid managed care), and therapy area between the full population and high resource patients (HRP). The mean total expenditure per HRP during calendar year 2011 was $43,104 versus $3,955 per patient for the full population. Treatment of back disorders and osteoarthritis contributed the largest share of expenditures in both HRP and the full study population, while chronic renal failure, heart disease, and some oncology treatments accounted for disproportionately higher expenditures in HRP. The share of overall expenditures attributed to inpatient services was significantly higher for HRP (40.0%) compared with the full population (24.6%), while the share of expenditures attributed to pharmacy (HRP = 18.1%, full = 21.4%) and outpatient services (HRP = 41.9%, full = 54.1%) was reduced. This pattern was observed across payer type. While the use of physician

  8. Resource management for multimedia services in high data rate wireless networks

    CERN Document Server

    Zhang, Ruonan; Pan, Jianping

    2017-01-01

    This brief offers a valuable resource on principles of quality-of-service (QoS) provisioning and the related link-layer resource management techniques for high data-rate wireless networks. The primary emphasis is on protocol modeling and analysis. It introduces media access control (MAC) protocols, standards of wireless local area networks (WLANs), wireless personal area networks (WPANs), and wireless body area networks (WBANs), discussing their key technologies, applications, and deployment scenarios. The main analytical approaches and models for performance analysis of the fundamental resource scheduling mechanisms, including the contention-based, reservation-based, and hybrid MAC, are presented. To help readers understand and evaluate system performance, the brief contains a range of simulation results. In addition, a thorough bibliography provides an additional tool. This brief is an essential resource for engineers, researchers, students, and users of wireless networks.

  9. Prevalence of gastroesophageal reflux disease in a country with a high occurrence of Helicobacter pylori

    Science.gov (United States)

    Bor, Serhat; Kitapcioglu, Gul; Kasap, Elmas

    2017-01-01

    AIM To evaluate the prevalence of gastroesophageal reflux disease (GERD) with additional symptoms, relationship with Helicobacter pylori (H. pylori) of this country-wide study. METHODS Data from 3214 adults were obtained with validated questionnaire. Eight hundred and forty-one subjects were randomized to be tested for H. pylori via the urea breath test. "Frequent symptoms" were defined heartburn and/or regurgitation occurring at least weekly. RESULTS The prevalence of GERD was 22.8%, frequent and occasional heartburn were 9.3%-12.7%, regurgitation were 16.6%-18.7%, respectively. Body mass index (BMI) ≤ 18.5 showed a prevalence of 15%, BMI > 30 was 28.5%. The GERD prevalence was higher in women (26.2%) than men (18.9%) (P < 0001). Overall prevalence of H. pylori was 75.7%. The prevalence was 77.1% in subjects without symptoms vs 71.4% in subjects with GERD (χ2 = 2.6, P = 0.27). Underprivileged with the lowest income people exhibit a higher risk. CONCLUSION GERD is common in Turkey which reflects both Western and Eastern lifestyles with high rate of H. pylori. The presence of H. pylori had no effect on either the prevalence or the symptom profile of GERD. Subjects showing classical symptoms occasionally exhibit more additional symptoms compared with those without classical symptoms. PMID:28210089

  10. Socioeconomic status and response to antiretroviral therapy in high-income countries: a literature review.

    Science.gov (United States)

    Burch, Lisa S; Smith, Colette J; Phillips, Andrew N; Johnson, Margaret A; Lampe, Fiona C

    2016-05-15

    It has been shown that socioeconomic factors are associated with the prognosis of several chronic diseases; however, there is no recent systematic review of their effect on HIV treatment outcomes. We aimed to review the evidence regarding the existence of an association of socioeconomic status with virological and immunological response to antiretroviral therapy (ART). We systematically searched the current literature using the database PubMed. We identified and summarized original research studies in high-income countries that assessed the association between socioeconomic factors (education, employment, income/financial status, housing, health insurance, and neighbourhood-level socioeconomic factors) and virological response, immunological response, and ART nonadherence among people with HIV-prescribed ART. A total of 48 studies met the inclusion criteria (26 from the United States, six Canadian, 13 European, and one Australian), of which 14, six, and 35 analysed virological, immunological, and ART nonadherence outcomes, respectively. Ten (71%), four (67%), and 23 (66%) of these studies found a significant association between lower socioeconomic status and poorer response, and none found a significant association with improved response. Several studies showed that adjustment for nonadherence attenuated the association between socioeconomic status and ART response. Our review provides strong support that socioeconomic disadvantage is associated with poorer response to ART. However, most studies have been conducted in settings such as the United States without universal free healthcare access. Further study in settings with free access to ART could help assess the impact of socioeconomic status on ART outcomes and the mechanisms by which it operates.

  11. Pole lengths influence O2-cost during double poling in highly trained cross-country skiers.

    Science.gov (United States)

    Carlsen, Camilla Høivik; Rud, Bjarne; Myklebust, Håvard; Losnegard, Thomas

    2018-02-01

    In elite cross-country skiing, double poling is used in different terrain. This study compared O 2 -cost and kinematics during double poling with four different pole lengths [self-selected (SS), SS - 5 cm, SS + 5 cm, SS + 10 cm] at Low versus Moderate incline. Thirteen highly trained male cross-country skiers (mean ± SD 23 ± 3 years; 182 ± 4 cm; 77 ± 6 kg) completed eight submaximal trials with roller skis on a treadmill at two conditions: "Low incline" (1.7°; 4.5 m s -1 ) and "Moderate incline" (4.5°; 2.5 m s -1 ) with each of the four pole lengths. O 2 -cost and 3D body kinematics were assessed in each trial. In Low incline, SS + 10 cm induced a lower O 2 -cost than all the other pole lengths [P size (ES) 0.5-0.8], whereas no differences were found between the remaining pole lengths (P > 0.05; ES 0.2-0.4). In Moderate incline, significant differences between all pole lengths were found for O 2 -cost, with SS - 5 cm > SS > SS + 5 cm > SS + 10 cm (P differences in O 2 -cost between SS and the other pole lengths were greater in Moderate incline than Low incline (SS - 5 cm; 1.5%, ES 0.8, SS + 5 cm; 1.3%, ES 1.0, and SS + 10 cm; 1.9%, ES 1.0, all P difference was found in cycle, poling or reposition times between pole lengths. However, at both conditions a smaller total vertical displacement of center of mass was observed with SS + 10 cm compared to the other pole lengths. Increasing pole length from SS - 5 cm to SS + 10 cm during double poling induced lower O 2 -cost and this advantage was greater in Moderate compared to Low incline.

  12. Xpert MTB/RIF testing in a low tuberculosis incidence, high-resource setting: limitations in accuracy and clinical impact.

    Science.gov (United States)

    Sohn, Hojoon; Aero, Abebech D; Menzies, Dick; Behr, Marcel; Schwartzman, Kevin; Alvarez, Gonzalo G; Dan, Andrei; McIntosh, Fiona; Pai, Madhukar; Denkinger, Claudia M

    2014-04-01

    Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in low-income countries. However, little information is available on its performance in low-incidence, high-resource countries. We evaluated the accuracy of Xpert in a university hospital tuberculosis clinic in Montreal, Canada, for the detection of pulmonary tuberculosis on induced sputum samples, using mycobacterial cultures as the reference standard. We also assessed the potential reduction in time to diagnosis and treatment initiation. We enrolled 502 consecutive patients who presented for evaluation of possible active tuberculosis (most with abnormal chest radiographs, only 18% symptomatic). Twenty-five subjects were identified to have active tuberculosis by culture. Xpert had a sensitivity of 46% (95% confidence interval [CI], 26%-67%) and specificity of 100% (95% CI, 99%-100%) for detection of Mycobacterium tuberculosis. Sensitivity was 86% (95% CI, 42%-100%) in the 7 subjects with smear-positive results, and 28% (95% CI, 10%-56%) in the remaining subjects with smear-negative, culture-positive results; in this latter group, positive Xpert results were obtained a median 12 days before culture results. Subjects with positive cultures but negative Xpert results had minimal disease: 11 of 13 had no symptoms on presentation, and mean time to positive liquid culture results was 28 days (95% CI, 25-47 days) compared with 14 days (95% CI, 8-21 days) in Xpert/culture-positive cases. Our findings suggest limited potential impact of Xpert testing in high-resource, low-incidence ambulatory settings due to lower sensitivity in the context of less extensive disease, and limited potential to expedite diagnosis beyond what is achieved with the existing, well-performing diagnostic algorithm.

  13. Resources for Developing Country Researchers

    International Development Research Centre (IDRC) Digital Library (Canada)

    Melanie Brunet

    PLoS (Public Library of Science) (www.plos.org) Founded in 2000 by a group of ... world's largest collections of biomedical and health literature. ... Part of INASP's JOL Project, this database covers a wide range of academic disciplines.

  14. Resources for Developing Country Researchers

    International Development Research Centre (IDRC) Digital Library (Canada)

    Melanie Brunet

    fields of physics and mathematics. The service requires individual registration: http://ejds.ictp.it/ejds/faces/register.xhtml Language: Primarily English. Free Medical Journals (http://www.freemedicaljournals.com/) and Free Books4 Doctors · (http://www.freebooks4doctors.com/) Established by Flying Publishers, these two sites ...

  15. What Makes MNCs Succeed in Developing countries?

    DEFF Research Database (Denmark)

    Hansen, Michael W.; Gwozdz, Wencke

    MNCs are increasingly investing in developing countries to be part of rapid market growth, to enhance the efficiency of their value chains, and to access abundant resources and talent. The potential gains are high, however so are the risks. Some developing country subsidiaries become top performers...... regardless of location and industry. The findings of the study have important implications for the IB literature, for managers and for policy aimed at promoting FDI in developing countries....

  16. The Ethics of Medical Practitioner Migration From Low-Resourced Countries to the Developed World: A Call for Action by Health Systems and Individual Doctors.

    Science.gov (United States)

    Mpofu, Charles; Gupta, Tarun Sen; Hays, Richard

    2016-09-01

    Medical migration appears to be an increasing global phenomenon, with complex contributing factors. Although it is acknowledged that such movements are inevitable, given the current globalized economy, the movement of health professionals from their country of training raises questions about equity of access and quality of care. Concerns arise if migration occurs from low- and middle-income countries (LMICs) to high-income countries (HICs). The actions of HICs receiving medical practitioners from LMICs are examined through the global justice theories of John Rawls and Immanuel Kant. These theories were initially proposed by Pogge (1988) and Tan (1997) and, in this work, are extended to the issue of medical migration. Global justice theories propose that instead of looking at health needs and workforce issues within their national boundaries, HICs should be guided by principles of justice relevant to the needs of health systems on a global scale. Issues of individual justice are also considered within the framework of rights and social responsibilities of individual medical practitioners. Local and international policy changes are suggested based on both global justice theories and the ideals of individual justice.

  17. Survey of waste package designs for disposal of high-level waste/spent fuel in selected foreign countries

    International Nuclear Information System (INIS)

    Schneider, K.J.; Lakey, L.T.; Silviera, D.J.

    1989-09-01

    This report presents the results of a survey of the waste package strategies for seven western countries with active nuclear power programs that are pursuing disposal of spent nuclear fuel or high-level wastes in deep geologic rock formations. Information, current as of January 1989, is given on the leading waste package concepts for Belgium, Canada, France, Federal Republic of Germany, Sweden, Switzerland, and the United Kingdom. All but two of the countries surveyed (France and the UK) have developed design concepts for their repositories, but none of the countries has developed its final waste repository or package concept. Waste package concepts are under study in all the countries surveyed, except the UK. Most of the countries have not yet developed a reference concept and are considering several concepts. Most of the information presented in this report is for the current reference or leading concepts. All canisters for the wastes are cylindrical, and are made of metal (stainless steel, mild steel, titanium, or copper). The canister concepts have relatively thin walls, except those for spent fuel in Sweden and Germany. Diagrams are presented for the reference or leading concepts for canisters for the countries surveyed. The expected lifetimes of the conceptual canisters in their respective disposal environment are typically 500 to 1,000 years, with Sweden's copper canister expected to last as long as one million years. Overpack containers that would contain the canisters are being considered in some of the countries. All of the countries surveyed, except one (Germany) are currently planning to utilize a buffer material (typically bentonite) surrounding the disposal package in the repository. Most of the countries surveyed plan to limit the maximum temperature in the buffer material to about 100 degree C. 52 refs., 9 figs

  18. Small modular high temperature nuclear reactors: the perfect workhorse for Asean and developing countries

    International Nuclear Information System (INIS)

    Mohd Peter Davis

    2009-01-01

    The ten South East Asian countries of ASEAN with nearly 10% of the world's population need 18 times more electricity to lift the standard of living to the adequate levels enjoyed by Australians. Similarly, all developing countries except those in the humid tropics need enormous quantities of desalinated water, to replace rapidly depleting ground water left over from previous ice ages, to become self-sufficient in food. (Author)

  19. Diabetes mellitus and tuberculosis in countries with high tuberculosis burdens: individual risks and social determinants.

    Science.gov (United States)

    Goldhaber-Fiebert, Jeremy D; Jeon, Christie Y; Cohen, Ted; Murray, Megan B

    2011-04-01

    A growing body of evidence supports the role of type 2 diabetes as an individual-level risk factor for tuberculosis (TB), though evidence from developing countries with the highest TB burdens is lacking. In developing countries, TB is most common among the poor, in whom diabetes may be less common. We assessed the relationship between individual-level risk, social determinants and population health in these settings. We performed individual-level analyses using the World Health Survey (n = 124,607; 46 countries). We estimated the relationship between TB and diabetes, adjusting for gender, age, body mass index, education, housing quality, crowding and health insurance. We also performed a longitudinal country-level analysis using data on per-capita gross domestic product and TB prevalence and incidence and diabetes prevalence for 1990-95 and 2003-04 (163 countries) to estimate the relationship between increasing diabetes prevalence and TB, identifying countries at risk for disease interactions. In lower income countries, individuals with diabetes are more likely than non-diabetics to have TB [univariable odds ratio (OR): 2.39; 95% confidence interval (CI): 1.84-3.10; multivariable OR: 1.81; 95% CI: 1.37-2.39]. Increases in TB prevalence and incidence over time were more likely to occur when diabetes prevalence also increased (OR: 4.7; 95% CI: 1.0-22.5; OR: 8.6; 95% CI: 1.9-40.4). Large populations, prevalent TB and projected increases in diabetes make countries like India, Peru and the Russia Federation areas of particular concern. Given the association between diabetes and TB and projected increases in diabetes worldwide, multi-disease health policies should be considered.

  20. Robust analysis of the determinants of healthcare expenditure growth: evidence from panel data for low-, middle- and high-income countries.

    Science.gov (United States)

    Younsi, Moheddine; Chakroun, Mohamed; Nafla, Amine

    2016-10-01

    This paper examines the determinants of healthcare expenditure for low-, middle- and high-income countries, and it quantifies their influences in order to assess policies for achieving universal health coverage. We elaborate two models, a fixed-effect model and the dynamic panel model, to estimate the factors associated with the total health expenditure growth as well as its major components for 167 countries over the period of 1993-2013. The panel data on total health expenditure per capita and its components were taken from the World Development Indicators. Overall, our results showed that total health expenditure per capita is rising in all countries over time as a result of rising incomes. However, our estimates showed that the income elasticity of health expenditure ranged from 0.75 to 0.96 in the fixed-effect static panel model, while in the dynamic panel model, it was smaller and ranged from 0.16 to 0.47. Our empirical findings indicate that development assistance for health reduced government domestic spending on health but increased total government health spending. Our results also indicate that the trend in health expenditure growth is significantly depending with the country's economic development. In addition, out-of-pocket expenditure is powerfully influenced by a country's capacity to increase general government revenues and social insurance contributions. Knowledge of factors associated to health expenditure might help policy makers to make wise judgments, plan health reforms and allocate resources efficiently. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Invaders do not require high resource levels to maintain physiological advantages in a temperate deciduous forest.

    Science.gov (United States)

    Heberling, J Mason; Fridley, Jason D

    2016-04-01

    Non-native, invasive plants are commonly typified by trait strategies associated with high resource demands and plant invasions are often thought to be dependent upon site resource availability or disturbance. However, the invasion of shade-tolerant woody species into deciduous forests of the Eastern United States seems to contradict such generalization, as growth in this ecosystem is strongly constrained by light and, secondarily, nutrient stress. In a factorial manipulation of light and soil nitrogen availability, we established an experimental resource gradient in a secondary deciduous forest to test whether three common, woody, invasive species displayed increased metabolic performance and biomass production compared to six co-occurring woody native species, and whether these predicted differences depend upon resource supply. Using hierarchical Bayesian models of photosynthesis that included leaf trait effects, we found that invasive species exhibited functional strategies associated with higher rates of carbon gain. Further, invader metabolic and growth-related attributes were more responsive to increasing light availability than those of natives, but did not fall below average native responses even in low light. Surprisingly, neither group showed direct trait or growth responses to soil N additions. However, invasive species showed increased photosynthetic nitrogen use efficiencies with decreasing N availability, while that of natives remained constant. Although invader advantage over natives was amplified in higher resource conditions in this forest, our results indicate that some invasive species can maintain physiological advantages over co-occurring natives regardless of resource conditions.

  2. ASSOCIATION OF ISOMETRIC STRENGTH OF HIP AND KNEE MUSCLES WITH INJURY RISK IN HIGH SCHOOL CROSS COUNTRY RUNNERS.

    Science.gov (United States)

    Luedke, Lace E; Heiderscheit, Bryan C; Williams, D S Blaise; Rauh, Mitchell J

    2015-11-01

    High school cross country runners have a high incidence of overuse injuries, particularly to the knee and shin. As lower extremity strength is modifiable, identification of strength attributes that contribute to anterior knee pain (AKP) and shin injuries may influence prevention and management of these injuries. To determine if a relationship existed between isometric hip abductor, knee extensor and flexor strength and the incidence of AKP and shin injury in high school cross country runners. Sixty-eight high school cross country runners (47 girls, 21 boys) participated in the study. Isometric strength tests of hip abductors, knee extensors and flexors were performed with a handheld dynamometer. Runners were prospectively followed during the 2014 interscholastic cross country season for occurrences of AKP and shin injury. Bivariate logistic regression was used to examine risk relationships between strength values and occurrence of AKP and shin injury. During the season, three (4.4%) runners experienced AKP and 13 (19.1%) runners incurred a shin injury. Runners in the tertiles indicating weakest hip abductor (chi-square = 6.140; p=0.046), knee extensor (chi-square = 6.562; p=0.038), and knee flexor (chi-square = 6.140; p=0.046) muscle strength had a significantly higher incidence of AKP. Hip and knee muscle strength was not significantly associated with shin injury. High school cross country runners with weaker hip abductor, knee extensor and flexor muscle strength had a higher incidence of AKP. Increasing hip and knee muscle strength may reduce the likelihood of AKP in high school cross country runners. 2b.

  3. Impact of R&D expenditures on research publications, patents and high-tech exports among European countries.

    Science.gov (United States)

    Meo, S A; Usmani, A M

    2014-01-01

    This study aimed to compare the impact of Research&Development (R&D) expenditures on research publications, patents and high-tech exports among European countries. In this study, 47 European countries were included. The information regarding European countries, their per capita Gross Domestic Product (GDP), R&D spending, number of universities, indexed scientific journals, high technology exports and number of patents were collected. We recorded the total number of research documents in various science and social sciences subjects during the period 1996-2011. The main source for information was World Bank, Web of Science, Thomson Reuters and SCImago/Scopus. The mean GDP per capita for all the European countries is 23372.64 ± 3588.42 US$, yearly per capita spending on R&D 1.14 ± 0.13 US$, number of universities 48.17 ± 10.26, mean number of Institute of Scientific Information (ISI) indexed journal per country 90.72 ± 38.47, high technology exports 12.86 ± 1.59 and number of patent applications 61504.23 ± 22961.85. The mean of research documents published in various science and social science subjects among all the European countries during the period 1996-2011 is 213405.70 ± 56493.04. Spending on R&D, number of universities, indexed journals, high technology exports and number of patents have a positive correlation with number of published documents in various science and social science subjects. We found a positive correlation between patent application and high-tech exports. However, there was no association between GDP per capita and research outcomes. It is concluded that, the most important contributing factors towards a knowledge based economy are spending on R&D, number of universities, scientific indexed journals and research publications, which in turn give a boast to patents, high technology exports and ultimately GDP.

  4. Child contact management in high tuberculosis burden countries: A mixed-methods systematic review

    Science.gov (United States)

    Du Plessis, Lienki; Du Preez, Karen; Carr, Catherine; Mandalakas, Anna M.

    2017-01-01

    Tuberculosis (TB) remains a leading cause of morbidity and mortality worldwide. Considering the World Health Organization recommendation to implement child contact management (CCM) for TB, we conducted a mixed-methods systematic review to summarize CCM implementation, challenges, predictors, and recommendations. We searched the electronic databases of PubMed/MEDLINE, Scopus, and Web of Science for studies published between 1996–2017 that reported CCM data from high TB-burden countries. Protocol details for this systematic review were registered on PROSPERO: International prospective register of systematic reviews (#CRD42016038105). We formulated a search strategy to identify all available studies, published in English that specifically targeted a) population: child contacts (studied and compared in HBCs, and d) outcomes: monitoring and evaluation of CCM outcomes reported in the literature for each CCM cascade step. We included any quantitative, qualitative, mixed-methods study design except for randomized-controlled trials, editorials or commentaries. Thirty-seven studies were reviewed. Child contact losses varied greatly for screening, isoniazid preventive therapy initiation, and completion. CCM challenges included: infrastructure, knowledge, attitudes, stigma, access, competing priorities, and treatment. CCM recommendations included: health system strengthening, health education, and improved preventive therapy. Identified predictors included: index case and clinic characteristics, perceptions of barriers and risk, costs, and treatment characteristics. CCM lacks standardization resulting in common challenges and losses throughout the CCM cascade. Prioritization of a CCM-friendly healthcare environment with improved CCM processes and tools; health education; and active, evidence-based strategies can decrease barriers. A focused approach toward every aspect of the CCM cascade will likely diminish losses throughout the CCM cascade and ultimately decrease TB

  5. Nuclear energy consumption, oil prices, and economic growth: Evidence from highly industrialized countries

    International Nuclear Information System (INIS)

    Lee, Chien-Chiang; Chiu, Yi-Bin

    2011-01-01

    This study utilizes the Johansen cointegration technique, the Granger non-causality test of Toda and Yamamoto (1995), the generalized impulse response function, and the generalized forecast error variance decomposition to examine the dynamic interrelationship among nuclear energy consumption, real oil price, oil consumption, and real income in six highly industrialized countries for the period 1965-2008. Our empirical results indicate that the relationships between nuclear energy consumption and oil are as substitutes in the U.S. and Canada, while they are complementary in France, Japan, and the U.K. Second, the long-run income elasticity of nuclear energy is larger than one, indicating that nuclear energy is a luxury good. Third, the results of the Granger causality test find evidence of unidirectional causality running from real income to nuclear energy consumption in Japan. A bidirectional relationship appears in Canada, Germany and the U.K., while no causality exists in France and the U.S. We also find evidence of causality running from real oil price to nuclear energy consumption, except for the U.S., and causality running from oil consumption to nuclear energy consumption in Canada, Japan, and the U.K., suggesting that changes in price and consumption of oil influence nuclear energy consumption. Finally, the results observe transitory initial impacts of innovations in real income and oil consumption on nuclear energy consumption. In the long run the impact of real oil price is relatively larger compared with that of real income on nuclear energy consumption in Canada, Germany, Japan, and the U.S.

  6. Control of high natural activity building materials and land areas in the Nordic countries

    International Nuclear Information System (INIS)

    Mjoenes, L.

    1997-01-01

    Enhanced levels of natural radioactivity in the ground can cause problems with high concentrations of indoor 222 Rn, elevated levels of gamma radiation and natural radioactive elements in drinking water. Of the Nordic countries it is essentially Finland, Norway and Sweden that have problems with enhanced natural radioactivity in the ground and in building materials. Finland and Sweden have among the highest mean 222 Rn concentrations in dwellings in the world, 123 Bq m -3 and 108 Bq m -3 with a corresponding mean annual effective dose of about 2 mSv. In Sweden about 500,000 and in Finland and Norway about 200,000 persons get their drinking water from wells drilled in bedrock. The water from a large number of these wells contain elevated levels of naturally occurring radioactive elements, primarily 222 Rn. The action levels for 222 Rn in dwellings and above-ground workplaces are essentially the same in Finland, Norway and Sweden: 200 Bq m -3 for new buildings and 400 Bq m -3 for existing buildings. For mines and underground excavations, however, there are some differences. The treatment of gamma emitting natural radionuclides in building materials etc. is similar, although there are differences in the degree of control. The action levels for 222 Rn in drinking water differ from 100 Bq l -1 to 500 Bq l -1 . The action level in Finland has the form of an activity index that restricts also other radioactive nuclides. Denmark has not adopted a formal radon policy and has no recommended or legally binding action levels for 222 Rn or any other naturally occurring radionuclides. (author)

  7. Nuclear energy consumption, oil prices, and economic growth: Evidence from highly industrialized countries

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chien-Chiang, E-mail: cclee@cm.nsysu.edu.tw; Chiu, Yi-Bin

    2011-03-15

    This study utilizes the Johansen cointegration technique, the Granger non-causality test of Toda and Yamamoto (1995), the generalized impulse response function, and the generalized forecast error variance decomposition to examine the dynamic interrelationship among nuclear energy consumption, real oil price, oil consumption, and real income in six highly industrialized countries for the period 1965-2008. Our empirical results indicate that the relationships between nuclear energy consumption and oil are as substitutes in the U.S. and Canada, while they are complementary in France, Japan, and the U.K. Second, the long-run income elasticity of nuclear energy is larger than one, indicating that nuclear energy is a luxury good. Third, the results of the Granger causality test find evidence of unidirectional causality running from real income to nuclear energy consumption in Japan. A bidirectional relationship appears in Canada, Germany and the U.K., while no causality exists in France and the U.S. We also find evidence of causality running from real oil price to nuclear energy consumption, except for the U.S., and causality running from oil consumption to nuclear energy consumption in Canada, Japan, and the U.K., suggesting that changes in price and consumption of oil influence nuclear energy consumption. Finally, the results observe transitory initial impacts of innovations in real income and oil consumption on nuclear energy consumption. In the long run the impact of real oil price is relatively larger compared with that of real income on nuclear energy consumption in Canada, Germany, Japan, and the U.S.

  8. COUNTRY OF ORIGIN, BRAND IMAGE AND HIGH INVOLVEMENT PRODUCT TOWARDS CUSTOMER PURCHASE INTENTION: EMPIRICAL EVIDENCE OF EAST MALAYSIAN CONSUMER

    Directory of Open Access Journals (Sweden)

    Mohd Amirul Adenan

    2018-03-01

    Full Text Available This research strives to understand East Malaysian consumers’ purchase intention when being exposed to the effects of brand image and country of origin (COO image in the case of high involvement pro­ducts. Self-administered questionnaires were collected from 225 consumers in East Malaysia. The result of this study shows that East Malaysian consumers’ put a large importance on brand and country of origin image in high involvement products as they are more involved in information searching and decision ma­king when purchases these products. Implication and future research also discussed.

  9. High School Administrative Staffing in Washington State: Principal Perspectives on Resource Needs and Utilization

    Science.gov (United States)

    Steach, John C.

    2011-01-01

    This mixed methods study explored how high school principals prioritize their work and utilize available human resources to adjust to inadequate administrative staffing. Analysis of staffing levels across the state of Washington and specifically inside two eastern Washington districts framed interview questions for central office administration…

  10. Study on the Introduction of High-Quality Educational Resources for Sino-Foreign Cooperative Education

    Science.gov (United States)

    Jinhui, Lin

    2016-01-01

    In Sino-foreign cooperative education, high-quality introduced educational resources must benefit the growth and development of students, facilitate the school's capacity building and the improvement of overall educational standards, and promote national socioeconomic development. It is necessary to establish and perfect the various working…

  11. Determining the Supply of Material Resources for High-Rise Construction: Scenario Approach

    Science.gov (United States)

    Minnullina, Anna; Vasiliev, Vladimir

    2018-03-01

    This article presents a multi-criteria approach to determining the supply of material resources for high-rise construction under certain and uncertain conditions, which enables integrating a number of existing models into a fairly compact generalised economic and mathematical model developed for two extreme scenarios.

  12. Connecting Youth to High-Resource Adults: Lessons from Effective Youth Programs

    Science.gov (United States)

    Sullivan, Patrick J.; Larson, Reed W.

    2010-01-01

    Adolescents benefit from contact with high-resource community adults, but intergenerational obstacles make these interactions difficult, fragile, and rare. This qualitative research investigated the success of seven, primarily urban, leadership, and arts programs that attempted to facilitate these interactions within their programming. Program…

  13. High performance human resource management in Ireland and the Netherlands : adoption and effectiveness

    NARCIS (Netherlands)

    Horgan, Justine

    2003-01-01

    Does high performance human resource management deliver superior organisational performance and if so, how would this come about? Do these practices make a difference to employee work performance and cooperation? Could all companies, regardless of their context, benefit from these HR practices and

  14. Computer Processing 10-20-30. Teacher's Manual. Senior High School Teacher Resource Manual.

    Science.gov (United States)

    Fisher, Mel; Lautt, Ray

    Designed to help teachers meet the program objectives for the computer processing curriculum for senior high schools in the province of Alberta, Canada, this resource manual includes the following sections: (1) program objectives; (2) a flowchart of curriculum modules; (3) suggestions for short- and long-range planning; (4) sample lesson plans;…

  15. Ground-breaking research into Ghanaian sex-workers suggests high awareness. Country surveys.

    Science.gov (United States)

    1996-02-01

    The first nationwide research into prostitution in Ghana has been completed by Dr. Matilida Pappoe. She has found that there has been exponential growth in prostitution over the past three years in the country. While 10 years ago, people would not openly talk about prostitution, now that people's friends are increasingly entering the trade, people freely discuss prostitution. The research indicates that this growth is linked to the negative effects of macroeconomic policies aimed at economic growth, such as structural adjustment. For example, 39 of 121 sex workers studied claimed to have begun working as a prostitute after their trading businesses collapsed. Study findings suggest a high level of AIDS awareness among Ghanaian prostitutes. Prostitutes in Ghana are considered to be either seaters or roamers. Seaters are a loosely organized group of women who tend to work from a common compound, attracting customers by sitting in the doorway of their rooms. They typically report to an older retired sex worker who settles disputes and raises credit if one of the women must pay a police fine. Seaters are largely 30-45 years old and work in industrial centers. Roamers, however, tend to be 20-30 years old, work in coastal towns, and are usually better educated. They move from place to place and are probably at lower risk of contracting HIV due to the higher rates they charge and the correspondingly lower number of clients they entertain. Roamers seem to have higher rates of condom use and clients who are aware of the dangers. Roamers, too, are not organized as a group and may even often be highly competitive. Their work in the isolation of hotels makes them particularly vulnerable. Economic necessity has therefore increasingly drawn Ghanaian women into the sex trade, while Ghanaian men who typically support two or three women in exchange for sex, but can no longer do so due to current economic conditions, turn to occasional sex with prostitutes. This paper notes that

  16. Iatrogenic Dysnatremias in Children with Acute Gastroenteritis in High-Income Countries: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Silviu Grisaru

    2017-10-01

    Full Text Available BackgroundAcute gastroenteritis (AGE causing dehydration with or without dysnatremias is a common childhood health challenge. While it is accepted that oral rehydration therapy is preferred, clinical factors or parent and healthcare provider preferences may lead to intravenous rehydration (IVR. Isotonic solutions are increasingly recommended in most scenarios requiring IVR. Nevertheless, children with AGE, having ongoing losses of water and electrolytes, represent a unique population.ObjectivesTo evaluate the association between acquired dysnatremias and IVR in children with AGE.MethodsA systematic search of MEDLINE database was conducted through September 14, 2016. Observational studies and clinical trials conducted in high-income countries were included. The Grades of Recommendation, Assessment, Development, and Evaluation approach was used to evaluate the overall quality of evidence for each outcome.Results603 papers were identified of which 6 were included (3 randomized controlled trials and 3 observational studies. Pooling of patient data was not possible due to significantly different interventions or exposures. Single studies results demonstrated that within 24 h, administration of isotonic saline was not associated with a significant decline in serum sodium while hypotonic solutions (0.2–0.45% saline were associated, in one study, with mean serum sodium declines from 1.3 mEq/L (139.2, SD 2.9–137.9, SD 2.5 in 133 young infants (aged 1–28 months, to 5.7 (SD 3.1 mEq/L in a subgroup of 18 older children (age mean 5.8, SD 2.7 years. Both isotonic and hypotonic saline were shown to be associated with improvement of baseline hyponatremia in different studies. Baseline hypernatremia was corrected within 4–24 h in 81/83 (99.6% children using hypotonic saline IVR.ConclusionThere is a paucity of publications assessing the risk for acquired dysnatremias associated with IVR in children with AGE. Current high-quality evidence

  17. International outsourcing of medical research by high-income countries: changes from 1995 to 2005.

    Science.gov (United States)

    Belforti, Raquel K; Wall, Michal Sarah; Lindenauer, Peter K; Pekow, Penelope S; Rothberg, Michael B

    2010-02-01

    Medical research outsourcing provides a financial benefit to those conducting research and financial incentives to the developing countries hosting the research. Little is known about how frequently outsourcing occurs or the type of research that is outsourced. To document changes in medical research outsourcing over a 10-year period, we conducted a cross-sectional comparison of 3 medical journals: Lancet, The New England Journal of Medicine, and JAMA: The Journal of the American Medical Association in the last 6 months of 1995 and 2005. The main outcome measure was the 10-year change in proportion of studies including patients from low-income countries. We reviewed 598 articles. During the 10-year period, the proportion of first authors from low-income countries increased from 3% to 6% (P = 0.21), whereas studies with participants from low-income countries increased from 8% to 22% (P = Outsourcing of medical research seems to be increasing. Additional studies are required to know if subjects from low-income countries are being adequately protected.

  18. The cost of entry: An analysis of pharmaceutical registration fees in low-, middle-, and high-income countries.

    Directory of Open Access Journals (Sweden)

    Steven G Morgan

    Full Text Available Advances in pharmaceuticals offer improved health outcomes for a wide range of illnesses, yet medicines are often inaccessible for many patients worldwide. One potential barrier to making medicines available to all is the cost of product registration, the fees for regulatory review and licensing for the sale of medicines beyond the cost of clinical trials, if needed.We performed a cross-sectional analysis of pharmaceutical registration fees in low-, middle-, and high-income countries. We collected data on market authorization fees for new chemical entities and for generic drugs in 95 countries. We calculated measures of registration fee size relative to population, gross domestic product (GDP, and total health spending in each country. Each of the 95 countries had a fee for registering new chemical entities. On average, the ratio of registration fees to GDP was highest in Europe and North America and lowest in South and Central America. Across individual countries, the level of registration fees was positively correlated with GDP and total health spending, with relatively few outliers.We find that, generally speaking, the regulatory fees charged by medicines regulatory authorities are roughly proportional to the market size in their jurisdictions. The data therefore do not support the hypothesis that regulatory fees are a barrier to market entry in most countries.

  19. Resource utilization of symbiotic high-temperature gas-cooled reactor systems

    International Nuclear Information System (INIS)

    Borgonovi, G.M.; Brogli, R.H.

    1978-01-01

    The cumulative uranium requirements of different symbiotic combinations of high-temperature gas-cooled reactor (HTGR) prebreeders have been calculated assuming an open-end nuclear economy. The results obtained indicate that the combination of prebreeders and near-breeders does not save resources over a self-generated recycle case of comparable conversion ratio, and that it may take between 40 and 50 yr before the symbiotic system containing breeders starts saving resources over an HTGR with self-generated recycle and a conversion ratio of 0.83

  20. Analysis of inter-country input-output table based on bibliographic coupling network: How industrial sectors on the GVC compete for production resources

    Science.gov (United States)

    Guan, Jun; Xu, Xiaoyu; Xing, Lizhi

    2018-03-01

    The input-output table is comprehensive and detailed in describing national economic systems with abundance of economic relationships depicting information of supply and demand among industrial sectors. This paper focuses on how to quantify the degree of competition on the global value chain (GVC) from the perspective of econophysics. Global Industrial Strongest Relevant Network models are established by extracting the strongest and most immediate industrial relevance in the global economic system with inter-country input-output (ICIO) tables and then have them transformed into Global Industrial Resource Competition Network models to analyze the competitive relationships based on bibliographic coupling approach. Three indicators well suited for the weighted and undirected networks with self-loops are introduced here, including unit weight for competitive power, disparity in the weight for competitive amplitude and weighted clustering coefficient for competitive intensity. Finally, these models and indicators were further applied empirically to analyze the function of industrial sectors on the basis of the latest World Input-Output Database (WIOD) in order to reveal inter-sector competitive status during the economic globalization.

  1. Outcomes of Hematopoietic Stem Cell Transplantation at a Limited-Resource Center in Mexico Are Comparable to Those in Developed Countries.

    Science.gov (United States)

    Leon Rodriguez, Eucario; Rivera Franco, Monica M

    2017-11-01

    The first hematopoietic stem cell transplantation (HSCT) in Mexico was performed at our institution in 1980. Eighteen years later, our HSCT program was restructured to reduce transplantation-related mortality (TRM) and improve overall survival (OS). The aim of this study was to describe outcomes of HSCT at our institution despite limited resources. Consecutive patients undergoing HSCT, from November 1998 to February 2017, were retrospectively analyzed at the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City. Three hundred nine HSCT (59% autologous) were performed in 275 patients. From 114 patients (41%) undergoing an allogeneic HSCT, acute and chronic graft-versus-host disease developed in 21% and 33%, respectively. From the entire cohort, 98 patients relapsed after HSCT and at the last follow-up, 183 (67%) patients were alive. The 100-day TRM rates were 1.9% and 6.1% for autologous and allogeneic HSCT, respectively. Ten-year relapse/progression-free survival were 54% and 65%, for autologous and allogeneic HSCT, respectively. Ten-year OS rates in autologous and allogeneic HSCT were 61% and 57%, respectively. We highlight that HSCT is feasible in developing countries, despite financial and infrastructure limitations, and conclude that our results are comparable to international literature and probably better in terms of TRM and cost-effectiveness. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  2. Causes and temporal changes in nationally collected stillbirth audit data in high-resource settings.

    Science.gov (United States)

    Norris, Tom; Manktelow, Bradley N; Smith, Lucy K; Draper, Elizabeth S

    2017-06-01

    Few high-income countries have an active national programme of stillbirth audit. From the three national programmes identified (UK, New Zealand, and the Netherlands) steady declines in annual stillbirth rates have been observed over the audit period between 1993 and 2014. Unexplained stillbirth remains the largest group in the classification of stillbirths, with a decline in intrapartum-related stillbirths, which could represent improvements in intrapartum care. All three national audits of stillbirths suggest that up to half of all reviewed stillbirths have elements of care that failed to follow standards and guidance. Variation in the classification of stillbirth, cause of death and frequency of risk factor groups limit our ability to draw meaningful conclusions as to the true scale of the burden and the changing epidemiology of stillbirths in high-income countries. International standardization of these would facilitate direct comparisons between countries. The observed declines in stillbirth rates over the period of perinatal audit, a possible consequence of recommendations for improved antenatal care, should serve to incentivise other countries to implement similar audit programmes. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  3. The association between ownership of common household devices and obesity and diabetes in high, middle and low income countries.

    Science.gov (United States)

    Lear, Scott A; Teo, Koon; Gasevic, Danijela; Zhang, Xiaohe; Poirier, Paul P; Rangarajan, Sumathy; Seron, Pamela; Kelishadi, Roya; Tamil, Azmi Mohd; Kruger, Annamarie; Iqbal, Romaina; Swidan, Hani; Gómez-Arbeláez, Diego; Yusuf, Rita; Chifamba, Jephat; Kutty, V Raman; Karsıdag, Kubilay; Kumar, Rajesh; Li, Wei; Szuba, Andrzej; Avezum, Alvaro; Diaz, Rafael; Anand, Sonia S; Rosengren, Annika; Yusuf, Salim

    2014-03-04

    Household devices (e.g., television, car, computer) are common in high income countries, and their use has been linked to obesity and type 2 diabetes mellitus. We hypothesized that device ownership is associated with obesity and diabetes and that these effects are explained through reduced physical activity, increased sitting time and increased energy intake. We performed a cross-sectional analysis using data from the Prospective Urban Rural Epidemiology study involving 153,996 adults from high, upper-middle, lower-middle and low income countries. We used multilevel regression models to account for clustering at the community and country levels. Ownership of a household device increased from low to high income countries (4% to 83% for all 3 devices) and was associated with decreased physical activity and increased sitting, dietary energy intake, body mass index and waist circumference. There was an increased odds of obesity and diabetes with the ownership of any 1 household device compared to no device ownership (obesity: odds ratio [OR] 1.43, 95% confidence interval [CI] 1.32-1.55; diabetes: OR 1.38, 95% CI 1.28-1.50). Ownership of a second device increased the odds further but ownership of a third device did not. Subsequent adjustment for lifestyle factors modestly attenuated these associations. Of the 3 devices, ownership of a television had the strongest association with obesity (OR 1.39, 95% CI 1.29-1.49) and diabetes (OR 1.33, 95% CI 1.23-1.44). When stratified by country income level, the odds of obesity and diabetes when owning all 3 devices was greatest in low income countries (obesity: OR 3.15, 95% CI 2.33-4.25; diabetes: OR 1.97, 95% CI 1.53-2.53) and decreased through country income levels such that we did not detect an association in high income countries. The ownership of household devices increased the likelihood of obesity and diabetes, and this was mediated in part by effects on physical activity, sitting time and dietary energy intake. With

  4. High-resolution modeling assessment of tidal stream resource in Western Passage of Maine, USA

    Science.gov (United States)

    Yang, Zhaoqing; Wang, Taiping; Feng, Xi; Xue, Huijie; Kilcher, Levi

    2017-04-01

    Although significant efforts have been taken to assess the maximum potential of tidal stream energy at system-wide scale, accurate assessment of tidal stream energy resource at project design scale requires detailed hydrodynamic simulations using high-resolution three-dimensional (3-D) numerical models. Extended model validation against high quality measured data is essential to minimize the uncertainties of the resource assessment. Western Passage in the State of Maine in U.S. has been identified as one of the top ranking sites for tidal stream energy development in U.S. coastal waters, based on a number of criteria including tidal power density, market value and transmission distance. This study presents an on-going modeling effort for simulating the tidal hydrodynamics in Western Passage using the 3-D unstructured-grid Finite Volume Community Ocean Model (FVCOM). The model domain covers a large region including the entire the Bay of Fundy with grid resolution varies from 20 m in the Western Passage to approximately 1000 m along the open boundary near the mouth of Bay of Fundy. Preliminary model validation was conducted using existing NOAA measurements within the model domain. Spatial distributions of tidal power density were calculated and extractable tidal energy was estimated using a tidal turbine module embedded in FVCOM under different tidal farm scenarios. Additional field measurements to characterize resource and support model validation were discussed. This study provides an example of high resolution resource assessment based on the guidance recommended by the International Electrotechnical Commission Technical Specification.

  5. Alcohol taxes' contribution to prices in high and middle-income countries: Data from the International Alcohol Control Study.

    Science.gov (United States)

    Wall, Martin; Casswell, Sally; Callinan, Sarah; Chaiyasong, Surasak; Viet Cuong, Pham; Gray-Phillip, Gaile; Parry, Charles

    2017-11-22

    Taxation is increasingly being used as an effective means of influencing behaviour in relation to harmful products. In this paper we use data from six participating countries of the International Alcohol Control Study to examine and evaluate their comparative prices and tax regimes. We calculate taxes and prices for three high-income and three middle-income countries. The data are drawn from the International Alcohol Control survey and from the Alcohol Environment Protocol. Tax systems are described and then the rates of tax on key products presented. Comparisons are made using the Purchasing Power Parity rates. The price and purchase data from each country's International Alcohol Control survey is then used to calculate the mean percentage of retail price paid in tax weighted by actual consumption. Both ad valorem and specific per unit of alcohol taxation systems are represented among the six countries. The prices differ widely between countries even though presented in terms of Purchasing Power Parity. The percentage of tax in the final price also varies widely but is much lower than the 75% set by the World Health Organization as a goal for tobacco tax. There is considerable variation in tax systems and prices across countries. There is scope to increase taxation and this analysis provides comparable data, including the percentage of tax in final price, from some middle and high-income countries for consideration in policy discussion. © 2017 The Authors Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

  6. Demand side resource operation on the Irish power system with high wind power penetration

    DEFF Research Database (Denmark)

    Keane, A.; Tuohy, A.; Meibom, Peter

    2011-01-01

    part of the power system plant mix and contribute to the flexible operation of a power system. A model for demand side resources is proposed here that captures its key characteristics for commitment and dispatch calculations. The model is tested on the all island Irish power system, and the operation...... of the functions of conventional peaking plant. Demand side resources are also shown to be capable of improving the reliability of the system, with reserve capability identified as a key requirement in this respect....... of the model is simulated over one year in both a stochastic and deterministic mode, to illustrate the impact of wind and load uncertainty. The results illustrate that demand side resources can contribute to the efficient, flexible operation of systems with high penetrations of wind by replacing some...

  7. Breast-milk substitutes: a new old-threat for breastfeeding policy in developing countries. A case study in a traditionally high breastfeeding country.

    Directory of Open Access Journals (Sweden)

    Hubert Barennes

    Full Text Available BACKGROUND: Developing countries with traditionally breastfeeding are now experiencing the increasing pressure of formula milk marketing. This may endanger lives and undermine the efforts of national policies in achieving the objectives of the Millennium Development Goals. We examined the use of, and factors for use, of all available breast-milk substitutes (BMS in a country with a traditionally high rate of breastfeeding. METHODS: Randomised multi-stage sampling surveys in 90 villages in 12/17 provinces in Laos. PARTICIPANTS: 1057 mothers with infants under 24 months of age. TOOLS: 50-query questionnaire and a poster of 22 BMS (8 canned or powdered milk; 6 non-dairy; 6 formulas; 2 non-formulas. OUTCOME MEASURES INCLUDED: prevalence of use and age of starting BMS in relation to socio-demographic characteristics and information sources, by univariate and multivariate analyses. RESULTS: Of 1057 mothers: 72.5% currently breastfed; 25.4% gave BMS (10.6% infant formula; 19.6% gave BMS before 6 months of age (of them: 83% non-dairy or cereals; mean age: 2.9 months; 95% Confidence interval: 2.6-3.2. One formula and one non-formula product accounted for 85% of BMS. BMS were considered as milk by the majority of mothers. Thai TV was the main source of information on BMS for mothers. Lao Loum mothers (the main ethnic group living in concrete houses with good sanitary conditions, were more likely than others to use BMS before 6 months (OR: 1.79, (1.15-2.78, p<0.009. Mothers who fed their infants colostrum at birth were less likely to use BMS before 6 months of age (OR: 0.63, (0.41-0.99, p = 0.04. Unemployed mothers living in rural areas were less likely to consider BMS better than breast milk. CONCLUSION: In Laos, mothers with the highest socio-economic status are showing a tendency to give up breastfeeding. Successful educational strategies and advocacy measures should be urgently developed to promote and sustain breastfeeding in developing countries.

  8. Determinants of late and/or inadequate use of prenatal healthcare in high-income countries: a systematic review

    NARCIS (Netherlands)

    Feijen-de Jong, E.I.; Jansen, D.E.M.C.; Baarveld, F.; van der Schans, C.P.; Schellevis, F.G.; Reijneveld, S.A.

    2012-01-01

    Background: Prenatal healthcare is likely to prevent adverse outcomes, but an adequate review of utilization and its determinants is lacking. Objective: To review systematically the evidence for the determinants of prenatal healthcare utilization in high-income countries. Method: Search of

  9. Drug costs and benefits of medical treatments in high-unmet need solid tumours in the Nordic countries

    DEFF Research Database (Denmark)

    Osterlund, P; Sorbye, H; Pfeiffer, P.

    2016-01-01

    -unmet need solid tumour indications in Nordic countries (Sweden, Denmark, Finland, Norway and Sweden). Methods: For a selected number of cancer dugs, approved for metastatic cancer or non-curable treatment intention patients by the European Medicine Agency (EMA) after 2000, and indicated in high-unmet need...

  10. Genital Chlamydia Prevalence in Europe and Non-European High Income Countries: Systematic Review and Meta-Analysis

    DEFF Research Database (Denmark)

    Redmond, S; Woodhall, S; van den Broek, I

    2015-01-01

    /EEA) Member States and non-European high income countries from January 1990 to August 2012. We examined results in forest plots, explored heterogeneity using the I2 statistic, and conducted random effects meta-analysis if appropriate. Meta-regression was used to examine the relationship between study...

  11. Nothing Succeeds Like Success? Equity, Student Outcomes, and Opportunity to Learn in High- and Middle-Income Countries

    Science.gov (United States)

    Santibañez, Lucrecia; Fagioli, Loris

    2016-01-01

    A strong relationship between article background and educational outcomes fuels a negative inequality cycle. This paper explores the interplay between student socioeconomic status and educational outcomes, and the mediating role of Opportunity-to-Learn (OTL) in high- and middle-income countries. Using data from PISA 2012, we find that the…

  12. Genetic analysis of Phytophthora infestans populations in the Nordic European countries reveals high genetic variability

    DEFF Research Database (Denmark)

    Brurberg, May Bente; Elameen, Abdelhameed; Le, Ving Hong

    2011-01-01

    different fields using nine simple-sequence repeat (SSR) markers. Forty-nine alleles were detected among the nine SSR loci and isolates from all four Nordic countries shared the most common alleles across the loci. In total 169 multilocus genotypes (based on seven loci) were identified among 191 isolates...

  13. Barriers and facilitators to the quality use of essential medicines for maternal health in low-resource countries: An Ishikawa framework.

    Science.gov (United States)

    Tran, Dan N; Bero, Lisa A

    2015-06-01

    An estimated 800 women die every day due to complications related to pregnancy or childbirth. Complications such as postpartum haemorrhage (PPH) and pre-eclampsia and eclampsia can be prevented by the appropriate use of essential medicines. The objective of this study was to identify the common barriers and facilitators to the availability and use of oxytocin, ergometrine, and magnesium sulfate (MgSO4) - essential medicines indicated for the prevention and treatment of PPH and pre-eclampsia and eclampsia. We analyzed seven UNFPA/WHO reports published in 2008-2010. These reports summarized country-wide rapid assessments of access to and use of essential medicines for maternal health in Mongolia, Nepal, Laos, the Democratic People's Republic of Korea (DPRK), the Philippines, Vanuatu, and the Solomon Islands. We used a "fishbone" (Ishikawa) diagram as the analytic framework to identify facilitators and barriers at four health-system levels: government/regulatory, pharmaceutical supply, health facility, and health professional. Common facilitators to the quality use of essential medicines for maternal health were observed at the government/regulatory and health professional level. A majority of countries had these medicines listed in their essential medicines lists. Awareness of the medicines was generally high among health professionals. Common barriers were identified at all health-system levels. First, standard treatment guidelines were not available, updated, or standardized. Second, there was an inadequate capacity to forecast and procure medicines. Third, a required MgSO4 antidote was often not available and the storage conditions for oxytocin were deficient. The "fishbone" Ishikawa diagram is a useful tool for describing the findings of rapid assessments of quality use of essential medicines for maternal health across countries. The facilitators and barriers identified should guide the development of tailored intervention programs to improve and expand the use

  14. The role of enterprise resource planning (ERP system in advancing the country of Jordan towards international standard accounting practices and accounting mechanisms

    Directory of Open Access Journals (Sweden)

    Hussein Mohammed Alrabba

    2017-03-01

    Accounting sector. The proposition is thusly tested by the overall results from bucketing and ANOVA of Jordanian Bromine and Arab Potash companies conducted surveys. The research methodology quantitatively utilized Jordanian Bromine Company and Arab Potash Company companies to test whether the was any role played by Enterprise resource planning, commonly abbreviated as (ERP, system in advancing the country of Jordan towards universal standard accounting practices and accounting mechanisms. Notably, the data as per two studies relied on for feedback on the implementation and application of the ERP paradigm/system on the structure of the Jordanian Bromine Company and Arab Potash Company companies. The final result proved true the deduction that the overall ERP structure (Enterprise Resource Planning System greatly impacted the accounting mechanisms and standards in the Jordanian organizations. Recommendations aimed at integrating different sectors in Jordan, including the Jordanian Bromine Company and Arab Potash Company companies with the banking sector and financial institutions so that the entire system can work collaboratively under the protocols, rules and requirements of the universal standard accounting practices and accounting mechanisms.

  15. Diagnostic accuracy of touch imprint cytology for head and neck malignancies: a useful intra-operative tool in resource limited countries.

    Science.gov (United States)

    Naveed, Hania; Abid, Mariam; Hashmi, Atif Ali; Edhi, Muhammad Muzammamil; Sheikh, Ahmareen Khalid; Mudassir, Ghazala; Khan, Amir

    2017-01-01

    Intraoperative consultation is an important tool for the evaluation of the upper aerodigestive tract (UAT) malignancies. Although frozen section analysis is a preferred method of intra-operative consultation, however in resource limited countries like Pakistan, this facility is not available in most institutes; therefore, we aimed to evaluate the diagnostic accuracy of touch imprint cytology for UAT malignancies using histopathology of the same tissue as gold standard. The study involved 70 cases of UAT lesions operated during the study period. Intraoperatively, after obtaining the fresh biopsy specimen and prior to placing them in fixative, each specimen was imprinted on 4-6 glass slides, fixed immediately in 95% alcohol and stained with Hematoxylin and Eosin stain. After completion of the cytological procedure, the surgical biopsy specimen was processed. The slides of both touch Imprint cytology and histopathology were examined by two consultant histopathologists. The result of touch imprint cytology showed that touch imprint cytology was diagnostic in 68 cases (97.1%), 55 (78.6%) being malignant, 2 cases (2.9%) were suspicious for malignancy, 11 cases (15.7%) were negative for malignancy while 2 cases (2.9%) were false negative. Amongst the 70 cases, 55 cases (78.6%) were malignant showing squamous cell carcinoma in 49 cases (70%), adenoid cystic carcinoma in 2 cases (2.9%), non-Hodgkin lymphoma 2 cases (2.9%), Mucoepidermoid carcinoma 1 case (1.4%), spindle cell sarcoma in 1 case (1.4%). Two cases (2.9%) were suspicious of malignancy showing atypical squamoid cells on touch imprint cytology, while 13 cases (18.6%) were negative for malignancy, which also included 2 false negative cases. The overall diagnostic accuracy of touch imprint cytology came out to be 96.7% with a sensitivity and specificity of 96 and 100%, respectively while PPV and NPV of touch imprint cytology was found to be 100 and 84%, respectively. Our experience in this study has demonstrated

  16. Exploring the meteorological potential for planning a high performance European electricity super-grid: optimal power capacity distribution among countries

    Science.gov (United States)

    Santos-Alamillos, Francisco J.; Brayshaw, David J.; Methven, John; Thomaidis, Nikolaos S.; Ruiz-Arias, José A.; Pozo-Vázquez, David

    2017-11-01

    The concept of a European super-grid for electricity presents clear advantages for a reliable and affordable renewable power production (photovoltaics and wind). Based on the mean-variance portfolio optimization analysis, we explore optimal scenarios for the allocation of new renewable capacity at national level in order to provide to energy decision-makers guidance about which regions should be mostly targeted to either maximize total production or reduce its day-to-day variability. The results show that the existing distribution of renewable generation capacity across Europe is far from optimal: i.e. a ‘better’ spatial distribution of resources could have been achieved with either a ~31% increase in mean power supply (for the same level of day-to-day variability) or a ~37.5% reduction in day-to-day variability (for the same level of mean productivity). Careful planning of additional increments in renewable capacity at the European level could, however, act to significantly ameliorate this deficiency. The choice of where to deploy resources depends, however, on the objective being pursued—if the goal is to maximize average output, then new capacity is best allocated in the countries with highest resources, whereas investment in additional capacity in a north/south dipole pattern across Europe would act to most reduce daily variations and thus decrease the day-to-day volatility of renewable power supply.

  17. Causality between trade openness and energy consumption: What causes what in high, middle and low income countries

    International Nuclear Information System (INIS)

    Shahbaz, Muhammad; Nasreen, Samia; Ling, Chong Hui; Sbia, Rashid

    2014-01-01

    This paper explores the relationship between trade openness and energy consumption using data of 91 high, middle and low income countries. The study covers the period of 1980–2010. We have applied panel cointegration to examine long run relationship between the variables. The direction of causal relationship between trade openness is investigated by applying Homogenous non-causality, Homogenous causality and Heterogeneous causality tests. Our variables are integrated at I(1) confirmed by time series and panel unit root tests and cointegration is found between trade openness and energy consumption. The relationship between trade openness and energy consumption is inverted U-shaped in high income countries but U-shaped in middle and low income countries. The homogenous and non-homogenous causality analysis reveals the bidirectional causality between trade openness and energy consumption. This paper opens up new insights for policy makers to design a comprehensive economic, trade and policies for sustainable economic growth in long run following heterogeneous causality findings. - Highlights: • Trade openness and energy consumption are cointegrated for long run. • The feedback effect exists between trade openness and energy consumption. • The inverted U-shaped relationship is found between both variables in high income countries

  18. Effects of patient-reported non-severe hypoglycemia on healthcare resource use, work-time loss, and wellbeing in insulin-treated patients with diabetes in seven European countries

    DEFF Research Database (Denmark)

    Geelhoed-Duijvestijn, Petronella H; Pedersen-Bjergaard, Ulrik; Weitgasser, Raimund

    2013-01-01

    the effects of self-reported non-severe hypoglycemic events (NSHE) on use of healthcare resources and patient wellbeing. Methods: Patients with T1DM or insulin-treated T2DM diabetes from seven European countries were invited to complete four weekly questionnaires. Data were collected on patient demographics...

  19. Mitigating Negative Externalities Affecting Access and Equity of Education in Low-Resource Countries: A Study Exploring Social Marketing as a Potential Strategy for Planning School Food Programs in Malawi

    Science.gov (United States)

    Magreta-Nyongani, Martha

    2012-01-01

    School feeding programs enhance the efficiency of the education system by improving enrollment, reducing dropouts and increasing perseverance. They also have the potential to reach the poor, directly making them an effective social safety net. In many low-resource countries, school feeding programs are designed to protect children from the effects…

  20. Welfare state regimes, gender, and depression: a multilevel analysis of middle and high income countries.

    Science.gov (United States)

    Chung, Haejoo; Ng, Edwin; Ibrahim, Selahadin; Karlsson, Björn; Benach, Joan; Espelt, Albert; Muntaner, Carles

    2013-03-28

    Using the 2002 World Health Survey, we examine the association between welfare state regimes, gender and mental health among 26 countries classified into seven distinct regimes: Conservative, Southeast Asian, Eastern European, Latin American, Liberal, Southern/Ex-dictatorship, and Social Democratic. A two-level hierarchical model found that the odds of experiencing a brief depressive episode in the last 12 months was significantly higher for Southern/Ex- dictatorship countries than for Southeast Asian (odds ratio (OR) = 0.12, 95% confidence interval (CI) 0.05-0.27) and Eastern European (OR = 0.36, 95% CI 0.22-0.58) regimes after controlling for gender, age, education, marital status, and economic development. In adjusted interaction models, compared to Southern/Ex-dictatorship males (reference category), the odds ratios of depression were significantly lower among Southeast Asian males (OR = 0.16, 95% CI 0.08-0.34) and females (OR = 0.23, 95% CI 0.10-0.53) and Eastern European males (OR = 0.41, 95% CI 0.26-0.63) and significantly higher among females in Liberal (OR = 2.00, 95% CI 1.14-3.49) and Southern (OR = 2.42, 95% CI 1.86-3.15) regimes. Our results highlight the importance of incorporating middle-income countries into comparative welfare regime research and testing for interactions between welfare regimes and gender on mental health.

  1. Strengthening the Paediatricians Project 2: The effectiveness of a workshop to address the Priority Mental Health Disorders of adolescence in low-health related human resource countries

    Directory of Open Access Journals (Sweden)

    Russell Paul SS

    2010-02-01

    Full Text Available Abstract Background Paediatricians can be empowered to address the Priority Mental Health Disorders at primary care level. To evaluate the effectiveness of a collaborative workshop in enhancing the adolescent psychiatry knowledge among paediatricians. Methods A 3-day, 27-hours workshop was held for paediatricians from different regions of India under the auspices of the National Adolescent Paediatric Task Force of the Indian Academy of Paediatrics. A 5-item pretest-posttest questionnaire was developed and administered at the beginning and end of the workshop to evaluate the participants' knowledge acquisition in adolescent psychiatry. Bivariate and multivariate analyses were performed on an intention-to-participate basis. Results Forty-eight paediatricians completed the questionnaire. There was significant enhancement of the knowledge in understanding the phenomenology, identifying the psychopathology, diagnosing common mental disorder and selecting the psychotropic medication in the bivariate analysis. When the possible confounders of level of training in paediatrics and number of years spent as paediatrician were controlled, in addition to the above areas of adolescent psychiatry, the diagnostic ability involving multiple psychological concepts also gained significance. However, both in the bivariate and multivariate analyses, the ability to refer to appropriate psychotherapy remained unchanged after the workshop. Conclusions This workshop was effective in enhancing the adolescent psychiatry knowledge of paediatricians. Such workshops could strengthen paediatricians in addressing the priority mental health disorders at the primary-care level in countries with low-human resource for health as advocated by the World Health Organization. However, it remains to be seen if this acquisition of adolescent psychiatry knowledge results in enhancing their adolescent psychiatry practice.

  2. Systematic review on human resources for health interventions to improve maternal health outcomes: evidence from low- and middle-income countries.

    Science.gov (United States)

    Lassi, Zohra S; Musavi, Nabiha B; Maliqi, Blerta; Mansoor, Nadia; de Francisco, Andres; Toure, Kadidiatou; Bhutta, Zulfiqar A

    2016-03-12

    There is a broad consensus and evidence that shows qualified, accessible, and responsive human resources for health (HRH) can make a major impact on the health of the populations. At the same time, there is widespread recognition that HRH crises particularly in low- and middle-income countries (LMICs) impede the achievement of better health outcomes/targets. In order to achieve the Sustainable Development Goals (SDGs), equitable access to a skilled and motivated health worker within a performing health system is need to be ensured. This review contributes to the vast pool of literature towards the assessment of HRH for maternal health and is focused on interventions delivered by skilled birth attendants (SBAs). Studies were included if (a) any HRH interventions in management system, policy, finance, education, partnership, and leadership were implemented; (b) these were related to SBA; (c) reported outcomes related to maternal health; (d) the studies were conducted in LMICs; and (e) studies were in English. Studies were excluded if traditional birth attendants and/or community health workers were trained. The review identified 25 studies which revealed reasons for poor maternal health outcomes in LMICs despite the efforts and policies implemented throughout these years. This review suggested an urgent and immediate need for formative evidence-based research on effective HRH interventions for improved maternal health outcomes. Other initiatives such as education and empowerment of women, alleviating poverty, establishing gender equality, and provision of infrastructure, equipment, drugs, and supplies are all integral components that are required to achieve SDGs by reducing maternal mortality and improving maternal health.

  3. Promotion of energy conservation in developing countries through the combination of ESCO and CDM: A case study of introducing distributed energy resources into Chinese urban areas

    International Nuclear Information System (INIS)

    Ren Hongbo; Zhou Weisheng; Gao Weijun; Wu Qiong

    2011-01-01

    The implementation of an energy service company (ESCO) project in developing countries may result not only in reduced energy cost but also in considerable environmental benefits, including the reduction of CO 2 emissions, which can be assessed in an economic manner under the Clean Development Mechanism (CDM) scheme. In this way, the economic and environmental benefits of energy conservation activities can be enjoyed by both the investor and the end-user, which can reduce the investment risk and realize a rational profit allocation. This study presents a numerical analysis of the introduction of distributed energy resources (DER) into a Chinese urban area. An optimization model is developed to determine the energy system combination under the constraints on the electrical and thermal balances and equipment availability. According to the simulation results, the introduction of DER systems possesses considerable potential to reduce CO 2 emissions, especially when considering that the economic profit of the CO 2 credit will increase the incentive to adopt DER systems to an even greater extent. Furthermore, by sharing the energy cost savings with the investors under an ESCO framework, the investment risk can be further reduced, and the conditions required for the project to qualify for CDM can be relaxed. Highlights: ► An investor focused analytical model is developed to aid the investment of a DER system. ► The combination of ESCO and CDM enhances the incentive to introduce energy conservation measures. ► Electricity buy-back is effective in boosting the DER system adoption under the proposed framework. ► The increased energy cost savings allocated to the investor promotes the DER system adoption. ► The rational allocation of CER credits is of vital importance to the success of the project.

  4. A new concept of irrigation response units for effective management of surface and groundwater resources: a case study from the multi-country Fergana Valley, Central Asia

    KAUST Repository

    Awan, Usman Khalid

    2016-09-09

    When estimating canal water supplies for large-scale irrigation schemes and especially in arid regions worldwide, the impact of all factors affecting the gross irrigation requirements (GIR) are not properly accounted for, which results in inefficient use of precious freshwater resources. This research shows that the concept of irrigation response units (IRU)—areas having unique combinations of factors effecting the GIR—allows for more precise estimates of GIR. An overlay analysis of soil texture and salinity, depth and salinity of groundwater, cropping patterns and irrigation methods was performed in a GIS environment, which yielded a total of 17 IRUs combinations of the Oktepa Zilol Chashmasi water consumers’ association in multi-country Fergana Valley, Central Asia. Groundwater contribution, leaching requirements, losses in the irrigation system through field application and conveyance and effective rainfall were included in GIR estimates. The GIR varied significantly among IRUs [average of 851 mm (±143 mm)] with a maximum (1051 mm) in IRU-12 and a minimum (629 mm) in IRUs-15, 16. Owing to varying groundwater levels in each IRU, the groundwater contribution played a key role in the estimation of the GIR. The maximum groundwater contribution occurred in IRUs dominated by cotton–fallow rotations as evidenced by an average value of 159 mm but a maximum of 254 mm and a minimum of 97 mm. Percolation losses depended on irrigation methods for different crops in their respective IRUs. The novel approach can guide water managers in this and similar regions to increase the accuracy of irrigation demands based on all the factor effecting the GIR. © 2016 Springer-Verlag Berlin Heidelberg

  5. Initial Characterization of the Wave Resource at Several High Energy U.S. Sites

    OpenAIRE

    Dallman, Ann; Neary, Vincent S.

    2014-01-01

    Wave energy resource characterization efforts are critical for developing knowledge of the physical conditions experienced by wave energy converter (WEC) devices and arrays. Developers are lacking a consistent characterization of possible wave energy test sites, and therefore Sandia National Laboratories (SNL) has been tasked with developing a catalogue characterizing three high energy U.S. test sites. The initial results and framework for the catalogue are discussed in this paper. U.S. De...

  6. Effects of the Global Financial Crisis on Health in High-Income Oecd Countries: A Narrative Review.

    Science.gov (United States)

    Karanikolos, Marina; Heino, Pia; McKee, Martin; Stuckler, David; Legido-Quigley, Helena

    2016-01-01

    A growing body of evidence documents how economic crises impact aspects of health across countries and over time. We performed a systematic narrative review of the health effects of the latest economic crisis based on studies of high-income countries. Papers published between January 2009 and July 2015 were selected based on review of titles and abstracts, followed by a full text review conducted by two independent reviewers. Ultimately, 122 studies were selected and their findings summarized. The review finds that the 2008 financial crisis had negative effects on mental health, including suicide, and to a varying extent on some non-communicable and communicable diseases and access to care. Although unhealthy behaviors such as hazardous drinking and tobacco use appeared to decline during the crisis, there have been increases in some groups, typically those already at greatest risk. The health impact was greatest in countries that suffered the largest economic impact of the crisis or prolonged austerity. The Great Recessions in high-income countries have had mixed impacts on health. They tend to be worse when economic impacts are more severe, prolonged austerity measures are implemented, and there are pre-existing problems of substance use among vulnerable groups. © The Author(s) 2016.

  7. Socio-economic disadvantage is associated with heavier drinking in high but not middle-income countries participating in the International Alcohol Control (IAC) Study.

    Science.gov (United States)

    Huckle, Taisia; Romeo, Jose S; Wall, Martin; Callinan, Sarah; Holmes, John; Meier, Petra; Mackintosh, Anne-Maree; Piazza, Marina; Chaiyasong, Surasak; Cuong, Pham Viet; Casswell, Sally

    2018-04-30

    To investigate if socio-economic disadvantage, at the individual- and country-level, is associated with heavier drinking in some middle- and high-income countries. Surveys of drinkers were undertaken in some high- and middle-income countries. Participating countries were Australia, England, New Zealand, Scotland (high-income) and Peru, Thailand and Vietnam (middle-income). Disadvantage at the country-level was defined as per World Bank (categorised as middle-or high-income); individual-level measures were (i) years of education and (ii) whether and individual was under or over the poverty line in each country. Measures of heavier drinking were (i) proportion of drinkers that consumed 8+ drinks and (ii) three drinking risk groups (lower, increasing and higher). Multi-level logistic regression models were used. Individual-level measures of disadvantage, lower education and living in poverty, were associated with heavier drinking, consuming 8+ drinks on a typical occasion or drinking at the higher risk level, when all countries were considered together. Drinkers in the middle-income countries had a higher probability of consuming 8+ drinks on a typical occasion relative to drinkers in the high-income countries. Interactions between country-level income and individual-level disadvantage were undertaken: disadvantaged drinkers in the middle-income countries were less likely to be heavier drinkers relative to those with less disadvantage in the high-income countries. Associations between socio-economic disadvantage and heavier drinking vary depending on country-level income. These findings highlight the value of exploring cross-country differences in heavier drinking and disadvantage and the importance of including country-level measurements to better elucidate relationships. © 2018 Australasian Professional Society on Alcohol and other Drugs.

  8. Bilateral Anterior Knee Pain in a High School Cross-Country Runner: An Atypical Etiology.

    Science.gov (United States)

    MacDonald, James

    2017-09-01

    Anterior knee pain is a common complaint found in distance runners, and can be the end result of a variety of benign processes. A 17-year-old female cross-country runner presented to a sports medicine clinic with insidious onset of bilateral patellofemoral pain (PFP). In the workup of the significant quadriceps weakness discovered on her initial examination, a principal contributing cause of her PFP, she was found to have a form of spinal muscular atrophy, an uncommon neurodegenerative disease that typically requires multidisciplinary medical care. Her case provides a good example for clinicians to consider, at times, an in-depth assessment of the root causes of benign conditions.

  9. Barriers and facilitators to the quality use of essential medicines for maternal health in low–resource countries: An Ishikawa framework

    Directory of Open Access Journals (Sweden)

    Dan N. Tran

    2015-06-01

    Full Text Available Background An estimated 800 women die every day due to complications related to pregnancy or childbirth. Complications such as postpartum haemorrhage (PPH and pre–eclampsia and eclampsia can be prevented by the appropriate use of essential medicines. The objective of this study was to identify the common barriers and facilitators to the availability and use of oxytocin, ergometrine, and magnesium sulfate (MgSO4 – essential medicines indicated for the prevention and treatment of PPH and pre–eclampsia and eclampsia. Methods We analyzed seven UNFPA/WHO reports published in 2008–2010. These reports summarized country–wide rapid assessments of access to and use of essential medicines for maternal health in Mongolia, Nepal, Laos, the Democratic People's Republic of Korea (DPRK, the Philippines, Vanuatu, and the Solomon Islands. We used a “fishbone” (Ishikawa diagram as the analytic framework to identify facilitators and barriers at four health–system levels: government/regulatory, pharmaceutical supply, health facility, and health professional. Results Common facilitators to the quality use of essential medicines for maternal health were observed at the government/regulatory and health professional level. A majority of countries had these medicines listed in their essential medicines lists. Awareness of the medicines was generally high among health professionals. Common barriers were identified at all health–system levels. First, standard treatment guidelines were not available, updated, or standardized. Second, there was an inadequate capacity to forecast and procure medicines. Third, a required MgSO4 antidote was often not available and the storage conditions for oxytocin were deficient. Conclusions The “fishbone” Ishikawa diagram is a useful tool for describing the findings of rapid assessments of quality use of essential medicines for maternal health across countries. The facilitators and barriers identified should guide the

  10. Do alien plant species profit more from high resource supply than natives? : A trait-based analysis

    NARCIS (Netherlands)

    Ordonez, Alejandro; Olff, Han

    Aim Previous studies comparing conditions of high- versus low-resource environments have pointed at differences in key traits that would allow aliens to perform better than natives under high-resource conditions. We generalize and test the robustness of this idea by exploring how trait

  11. 2008 State-of-the-Art : High Level Radioactive Waste Disposal Facilities and Project Review of Proceding Countries

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Heui Joo; Choi, Jong Won; Lee, Jong Youl; Jung, Jong Tae; Kim, Sung Ki; Lee, Min Soo; Cho, Dong Keun; Kook, Dong Hak

    2008-11-15

    High level radioactive waste disposal system project for advanced nuclear fuel cycle produced this report which are dealing with the repository status of proceding countries as of 2008. This report has brief review on disposal facilities which are operating and will be operating and on future plan of those nations. The other report 'Development of the Geological Disposal System for High Level Waste' which was produced like this report time and this report would help the readers grasp the current repository status. Because our country is a latecomer in the HLW disposal world, it is strongly recommended to catch up with advanced disposal system and concepts of developed nations and this report is expected to make it possible. There are several nations which were the main survey target; Finland, USA, Sweden, Germany, France, Switzerland, and Japan. Recent information was applied to this report and our project team will produce annual state-of-the-art report with continuous updates.

  12. Cost allocation model for distribution networks considering high penetration of distributed energy resources

    DEFF Research Database (Denmark)

    Soares, Tiago; Pereira, Fábio; Morais, Hugo

    2015-01-01

    The high penetration of distributed energy resources (DER) in distribution networks and the competitive environment of electricity markets impose the use of new approaches in several domains. The network cost allocation, traditionally used in transmission networks, should be adapted and used...... in the distribution networks considering the specifications of the connected resources. The main goal is to develop a fairer methodology trying to distribute the distribution network use costs to all players which are using the network in each period. In this paper, a model considering different type of costs (fixed......, losses, and congestion costs) is proposed comprising the use of a large set of DER, namely distributed generation (DG), demand response (DR) of direct load control type, energy storage systems (ESS), and electric vehicles with capability of discharging energy to the network, which is known as vehicle...

  13. Energy-efficient two-hop LTE resource allocation in high speed trains with moving relays

    KAUST Repository

    Alsharoa, Ahmad M.

    2014-05-01

    High-speed railway system equipped with moving relay stations placed on the middle of the ceiling of each train wagon is investigated. The users inside the train are served in two hops via the 3GPP Long Term Evolution (LTE) technology. The objective of this work is to maximize the number of served users by respecting a specific quality-of-service constraint while minimizing the total power consumption of the eNodeB and the moving relays. We propose an efficient algorithm based on the Hungarian method to find the optimal resource allocation over the LTE resource blocks in order to serve the maximum number of users with the minimum power consumption. Moreover, we derive a closed-form expression for the power allocation problem. Our simulation results illustrate the performance of the proposed scheme and compare it with various previously developed algorithms as well as with the direct transmission scenario. © 2014 IFIP.

  14. High-level Programming and Symbolic Reasoning on IoT Resource Constrained Devices

    Directory of Open Access Journals (Sweden)

    Sal vatore Gaglio

    2015-05-01

    Full Text Available While the vision of Internet of Things (IoT is rather inspiring, its practical implementation remains challenging. Conventional programming approaches prove unsuitable to provide IoT resource constrained devices with the distributed processing capabilities required to implement intelligent, autonomic, and self-organizing behaviors. In our previous work, we had already proposed an alternative programming methodology for such systems that is characterized by high-level programming and symbolic expressions evaluation, and developed a lightweight middleware to support it. Our approach allows for interactive programming of deployed nodes, and it is based on the simple but e ective paradigm of executable code exchange among nodes. In this paper, we show how our methodology can be used to provide IoT resource constrained devices with reasoning abilities by implementing a Fuzzy Logic symbolic extension on deployed nodes at runtime.

  15. Sectorial and regional determinants of firm dynamics in developing countries: evidence for low, medium and high tech manufacturing in Argentina

    OpenAIRE

    Calá, Carla Daniela

    2018-01-01

    We analyse the determinants of firm dynamics in developing countries using Argentina as an illustrative case. We explain firm entry and exit at the regional level, distinguishing three groups of manufacturing activities: low, medium and high tech. We find that both region -and sector- specific determinants explain firm dynamics, but the impact is not homogeneous across sectors. In particular, for low tech industries, there is a need for explanatory variables that proxy for the specificities o...

  16. Should pharmacogenetics be incorporated in major depression treatment? Economic evaluation in high- and middle-income European countries.

    Science.gov (United States)

    Olgiati, Paolo; Bajo, Emanuele; Bigelli, Marco; De Ronchi, Diana; Serretti, Alessandro

    2012-01-10

    The serotonin transporter 5-HTTLPR polymorphism moderates response to SSRIs and side-effect burden. The aim of this study is to quantify the cost-utility of incorporating 5-HTTLPR genotyping in drug treatment of major depressive disorder (MDD). We previously reported a theoretical model to simulate antidepressant treatment with citalopram or bupropion for 12 weeks. The drugs were alternatively selected according to an 'as usual' algorithm or based on response and tolerability predicted by 5-HTTLPR profile. Here we apply this model to conduct a cost-utility analysis in three European regions with high GDP (Euro A), middle GDP (Euro B) and middle-high GDP (Euro C). In addition we test a verification scenario in which citalopram+bupropion augmentation is administered to individuals with the least favorable 5-HTTLPR genotype. Treatment outcomes are remission and Quality Adjusted-Life Weeks (QALW). Cost data (international $, year 2009) are retrieved from the World Health Organization (WHO) and national official sources. In base-case scenario incremental cost-effectiveness ratio (ICER) values are $1147 (Euro A), $1185 (Euro B) and $1178 (Euro C). From cost-effectiveness acceptability curve (CEAC), the probability of having an ICER value below WHO recommended cost-utility threshold (3 GDP per capita=$1926) is >90% in high-income countries (Euro A). In middle- income regions, these probabilities are <30% (Euro B) and <55% (Euro C) respectively. All estimates are robust against variations in treatment parameters, but if genetic test cost decreases to $100, pharmacogenetic approach becomes cost-effective in middle-income countries (Euro B). This simulation using data from 27 European states suggests that choosing antidepressant treatment from the results of 5-HTTLPR might be a cost-effective solution in high income countries. Its feasibility in middle income countries needs further research. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. High coverage needle/syringe programs for people who inject drugs in low and middle income countries: a systematic review

    Directory of Open Access Journals (Sweden)

    Des Jarlais Don C

    2013-01-01

    Full Text Available Abstract Background Persons who inject drugs (PWID are at an elevated risk for human immunodeficiency virus (HIV and hepatitis C virus (HCV infection. In many high-income countries, needle and syringe exchange programs (NSP have been associated with reductions in blood-borne infections. However, we do not have a good understanding of the effectiveness of NSP in low/middle-income and transitional-economy countries. Methods A systematic literature review based on PRISMA guidelines was utilized to collect primary study data on coverage of NSP programs and changes in HIV and HCV infection over time among PWID in low-and middle-income and transitional countries (LMICs. Included studies reported laboratory measures of either HIV or HCV and at least 50% coverage of the local injecting population (through direct use or through secondary exchange. We also included national reports on newly reported HIV cases for countries that had national level data for PWID in conjunction with NSP scale-up and implementation. Results Studies of 11 NSPs with high-coverage from Bangladesh, Brazil, China, Estonia, Iran, Lithuania, Taiwan, Thailand and Vietnam were included in the review. In five studies HIV prevalence decreased (range −3% to −15% and in three studies HCV prevalence decreased (range −4.2% to −10.2%. In two studies HIV prevalence increased (range +5.6% to +14.8%. HCV incidence remained stable in one study. Of the four national reports of newly reported HIV cases, three reported decreases during NSP expansion, ranging from −30% to −93.3%, while one national report documented an increase in cases (+37.6%. Estimated incidence among new injectors decreased in three studies, with reductions ranging from −11/100 person years at risk to −16/100 person years at risk. Conclusions While not fully consistent, the data generally support the effectiveness of NSP in reducing HIV and HCV infection in low/middle-income and transitional-economy countries. If

  18. Preventing preterm births: analysis of trends and potential reductions with interventions in 39 countries with very high human development index.

    Science.gov (United States)

    Chang, Hannah H; Larson, Jim; Blencowe, Hannah; Spong, Catherine Y; Howson, Christopher P; Cairns-Smith, Sarah; Lackritz, Eve M; Lee, Shoo K; Mason, Elizabeth; Serazin, Andrew C; Walani, Salimah; Simpson, Joe Leigh; Lawn, Joy E

    2013-01-19

    Every year, 1·1 million babies die from prematurity, and many survivors are disabled. Worldwide, 15 million babies are born preterm (rates in almost all countries with reliable data. The understanding of drivers and potential benefit of preventive interventions for preterm births is poor. We examined trends and estimate the potential reduction in preterm births for countries with very high human development index (VHHDI) if present evidence-based interventions were widely implemented. This analysis is to inform a rate reduction target for Born Too Soon. Countries were assessed for inclusion based on availability and quality of preterm prevalence data (2000-10), and trend analyses with projections undertaken. We analysed drivers of rate increases in the USA, 1989-2004. For 39 countries with VHHDI with more than 10,000 births, we did country-by-country analyses based on target population, incremental coverage increase, and intervention efficacy. We estimated cost savings on the basis of reported costs for preterm care in the USA adjusted using World Bank purchasing power parity. From 2010, even if all countries with VHHDI achieved annual preterm birth rate reductions of the best performers for 1990-2010 (Estonia and Croatia), 2000-10 (Sweden and Netherlands), or 2005-10 (Lithuania, Estonia), rates would experience a relative reduction of less than 5% by 2015 on average across the 39 countries. Our analysis of preterm birth rise 1989-2004 in USA suggests half the change is unexplained, but important drivers include non-medically indicated labour induction and caesarean delivery and assisted reproductive technologies. For all 39 countries with VHHDI, five interventions modelling at high coverage predicted a 5% relative reduction of preterm birth rate from 9·59% to 9·07% of livebirths: smoking cessation (0·01 rate reduction), decreasing multiple embryo transfers during assisted reproductive technologies (0·06), cervical cerclage (0·15), progesterone

  19. Breast-i Is an Effective and Reliable Adjunct Screening Tool for Detecting Early Tumour Related Angiogenesis of Breast Cancers in Low Resource Sub-Saharan Countries

    Directory of Open Access Journals (Sweden)

    Frank Naku Ghartey

    2018-01-01

    Full Text Available Background. What cheaper alternative breast screening procedures are available to younger women in addition to clinical breast examination (CBE in Sub-Saharan countries? In 2009, we first described BreastLight for screening and reported high sensitivity at detecting breast cancer. Due to limitations of BreastLight, we have since 2014 been using the more technologically advanced Breast-i to screen 2204 women to find cheaper screening alternatives. Methodology. First, the participant lies down for CBE and then, in a darkened room, Breast-i was placed underneath each breast and trained personnel confirm vein pattern and look out for dark spot(s to ascertain the presence of suspicious angiogenic lesion(s. Results. CBE detected 153 palpable breast masses and Breast-i, which detects angiogenesis, confirmed 136. However, Breast-i detected 22 more cases of which 7 had angiogenesis but were not palpable and 15 were missed by CBE due to large breast size. Overall confirmed cases were 26, with Breast-i detecting 7 cases missed by CBE. Breast-i and CBE gave sensitivities of 92.3% and 73%, respectively. Conclusion. Breast-i with its high sensitivity to angiogenesis, reliability, and affordability will be an effective adjunct detection device that can be used effectively to increase early detection in younger women, thereby increasing treatment success.

  20. Uranium market and resources

    International Nuclear Information System (INIS)

    Capus, G.; Arnold, Th.

    2004-01-01

    The controversy about the extend of the uranium resources worldwide is still important, this article sheds some light on this topic. Every 2 years IAEA and NEA (nuclear energy agency) edit an inventory of uranium resources as reported by contributing countries. It appears that about 4.6 millions tons of uranium are available at a recovery cost less than 130 dollars per kg of uranium and a total of 14 millions tons of uranium can be assessed when including all existing or supposed resources. In fact there is enough uranium to sustain a moderate growth of the park of nuclear reactors during next decades and it is highly likely that the volume of uranium resources can allow a more aggressive development of nuclear energy. It is recalled that a broad use of the validated breeder technology can stretch the durability of uranium resources by a factor 50. (A.C.)

  1. International variations in the gestational age distribution of births: an ecological study in 34 high-income countries.

    Science.gov (United States)

    Delnord, Marie; Mortensen, Laust; Hindori-Mohangoo, Ashna D; Blondel, Béatrice; Gissler, Mika; Kramer, Michael R; Richards, Jennifer L; Deb-Rinker, Paromita; Rouleau, Jocelyn; Morisaki, Naho; Nassar, Natasha; Bolumar, Francisco; Berrut, Sylvie; Nybo Andersen, Anne-Marie; Kramer, Michael S; Zeitlin, Jennifer

    2018-04-01

    Few studies have investigated international variations in the gestational age (GA) distribution of births. While preterm births (22-36 weeks GA) and early term births (37-38 weeks) are at greater risk of adverse health outcomes compared to full term births (39-40 weeks), it is not known if countries with high preterm birth rates also have high early term birth rates. We examined rate associations between preterm and early term births and mean term GA by mode of delivery onset. We used routine aggregate data on the GA distribution of singleton live births from up to 34 high-income countries/regions in 1996, 2000, 2004, 2008 and 2010 to study preterm and early term births overall and by spontaneous or indicated onset. Pearson correlation coefficients were adjusted for clustering in time trend analyses. Preterm and early term births ranged from 4.1% to 8.2% (median 5.5%) and 15.6% to 30.8% (median 22.2%) of live births in 2010, respectively. Countries with higher preterm birth rates in 2004-2010 had higher early term birth rates (r > 0.50, P birth rates suggest that common risk factors could underpin shifts in the GA distribution. Targeting modifiable population risk factors for delivery before 39 weeks GA may provide a useful preterm birth prevention paradigm.

  2. Frameworks to monitor and predict resource usage in the ATLAS High Level Trigger

    CERN Document Server

    Martin, Tim; The ATLAS collaboration

    2016-01-01

    The ATLAS High Level Trigger Farm consists of around 30,000 CPU cores which filter events at up to 100 kHz input rate. A costing framework is built into the high level trigger, this enables detailed monitoring of the system and allows for data-driven predictions to be made utilising specialist datasets. This talk will present an overview of how ATLAS collects in-situ monitoring data on both CPU usage and dataflow over the data-acquisition network during the trigger execution, and how these data are processed to yield both low level monitoring of individual selection-algorithms and high level data on the overall performance of the farm. For development and prediction purposes, ATLAS uses a special `Enhanced Bias' event selection. This mechanism will be explained along with how is used to profile expected resource usage and output event-rate of new physics selections, before they are executed on the actual high level trigger farm.

  3. Frameworks to monitor and predict rates and resource usage in the ATLAS High Level Trigger

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00219969; The ATLAS collaboration

    2017-01-01

    The ATLAS High Level Trigger Farm consists of around 40,000 CPU cores which filter events at an input rate of up to 100 kHz. A costing framework is built into the high level trigger thus enabling detailed monitoring of the system and allowing for data-driven predictions to be made utilising specialist datasets. An overview is presented in to how ATLAS collects in-situ monitoring data on CPU usage during the trigger execution, and how these data are processed to yield both low level monitoring of individual selection-algorithms and high level data on the overall performance of the farm. For development and prediction purposes, ATLAS uses a special ‘Enhanced Bias’ event selection. This mechanism is explained along with how it is used to profile expected resource usage and output event rate of new physics selections, before they are executed on the actual high level trigger farm.

  4. Power plant selection for medium to high enthalpy geothermal resources of Turkey

    International Nuclear Information System (INIS)

    Kivanc Ates, H.; Serpen, U.

    2016-01-01

    A geothermal power plant model depends on the variations not only the temperature, but also, geochemical, and physical features of resources. Most of the geothermal brines in the world and in our country contain dissolved minerals and NCGs (non-condensable gases). These minerals precipitate from the solution and non-condensable gases flash depending on the changes of temperature and pressure during production and re-injection processes. In this study, common geochemical characteristics of geothermal resources of Turkey are briefly mentioned; chemical conditions for operation and re-injection processes are discussed. Taking into account of the above features, “combined power plants” devised by a combination of single-double flash processes with atmospheric condenser and “binary” cycles are introduced. They are compared thermodynamically and economically with each other and the ones from previous studies. Power capacity and efficiency of Combined Cycle Model-2 have been found 38.13 MWe and 14.1%, respectively. Combined Cycle Model-3 with single flash atmospheric process and binary presents these figures as 37.20 MWe and 13.4%, respectively. Economically, although the previous model has a slight edge in ROR (rate of return) (27.5% over 27%) the second one should be preferred because of potential silica scaling potential problem in the first one. - Highlights: • Combined power plant designs have superiority over conventional ones both in efficiency and power production. • Economics on power plants point out similar results. • Reservoir chemistry (CO_2 content and silica scaling) largely favors the combined power plant selection.

  5. Resource partitioning within major bottom fish species in a highly productive upwelling ecosystem

    Science.gov (United States)

    Abdellaoui, Souad; El Halouani, Hassan; Tai, Imane; Masski, Hicham

    2017-09-01

    The Saharan Bank (21-26°N) is a wide subtropical continental shelf and a highly productive upwelling ecosystem. The bottom communities are dominated by octopus and sparid fish, which are the main targets of bottom-trawl fishing fleets. To investigate resource partitioning within the bottom fish community, adult fish from 14 of the most abundant species were investigated for stomach content analysis. Samples were collected during two periods: October 2003 and May 2007. The diet of the analysed species showed more variation between periods than between size classes, suggesting that temporal or spatial variability in prey availability appears to play a significant role in their diet. Multivariate analysis and subsequent clustering led to a grouping of the species within five trophic guilds. Two species were fish feeders, and the others mainly fed on benthic invertebrates, where epibenthic crustaceans, lamellibranchs and fish were the most important groups in defining trophic guilds. We found that the studied species had a high rate of overlapping spatial distributions and overlapping trophic niches. In this highly productive upwelling ecosystem, where food resources may not be a limiting factor, inter-specific competition did not appear to be an important factor in structuring bottom fish communities. For the species that showed differences in the proportions of prey categories in comparison with other ecosystems, the rise of the proportion of epibenthic crustaceans in their diet was a common feature; a possible consequence of the benthic productivity of this highly productive upwelling ecosystem.

  6. Impact of a psychoeducative intervention on adherence to HAART among low-literacy patients in a resource-limited setting: the case of an Arab country--Morocco.

    Science.gov (United States)

    Khachani, Imane; Harmouche, Hicham; Ammouri, Wafa; Rhoufrani, Fatima; Zerouali, Latifa; Abouqal, Redouane; Tazi-Mezalek, Zoubida; Adnaoui, Mohamed; Aouni, Mohamed; Maouni, Abdelaziz

    2012-01-01

    Research has demonstrated that strict adherence is necessary to maximize highly active antiretroviral therapy (HAART) benefits. This is particularly challenging for low-literacy populations in resource-limited settings like Morocco and motivated the implementation of a psychoeducative program for patients under HAART at Rabat University Hospital. The study aimed at assessing the program's impact on adherence to antiretroviral medication, knowledge of HIV/AIDS and HAART, quality of life, and biological parameters. It included patients under treatment for at least 2 months that benefited from 3 to 5 educational and psychological support sessions. Data were collected at baseline, 3 and 6 months. In all, 50 patients were included. The mean age was 38 years; 52% were illiterate and 62% unemployed. Adherence scores were high at baseline (98%) and showed no significant change throughout the study. Knowledge of HAART and HIV/AIDS, and quality of life improved significantly both at months 3 and 6. Significant increase for CD4 count rates and decrease for viral load rates were also reported. The program had no significant impact on adherence but substantively developed patients' knowledge of HIV/AIDS and HAART and improved their quality of life.

  7. Access to HIV/AIDS care: a systematic review of socio-cultural determinants in low and high income countries.

    Science.gov (United States)

    Gari, Sara; Doig-Acuña, Camilo; Smail, Tino; Malungo, Jacob R S; Martin-Hilber, Adriane; Merten, Sonja

    2013-05-28

    The role of socio-cultural factors in influencing access to HIV/AIDS treatment, care and support is increasingly recognized by researchers, international donors and policy makers. Although many of them have been identified through qualitative studies, the evidence gathered by quantitative studies has not been systematically analysed. To fill this knowledge gap, we did a systematic review of quantitative studies comparing surveys done in high and low income countries to assess the extent to which socio-cultural determinants of access, identified through qualitative studies, have been addressed in epidemiological survey studies. Ten electronic databases were searched (Cinahl, EMBASE, ISI Web of Science, IBSS, JSTOR, MedLine, Psyinfo, Psyindex and Cochrane). Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Meta-analysis was used to synthesize data comparing studies between low and high income countries. Thirty-four studies were included in the final review, 21 (62%) done in high income countries and 13 (38%) in low income countries. In low income settings, epidemiological research on access to HIV/AIDS services focused on socio-economic and health system factors while in high income countries the focus was on medical and psychosocial factors. These differences depict the perceived different barriers in the two regions. Common factors between the two regions were also found to affect HIV testing, including stigma, high risk sexual behaviours such as multiple sexual partners and not using condoms, and alcohol abuse. On the other hand, having experienced previous illness or other health conditions and good family communication was associated with adherence to ART uptake. Due to insufficient consistent data, a meta-analysis was only possible on adherence to treatment. This review offers evidence of the current challenges for interdisciplinary work in epidemiology and public health. Quantitative studies did not

  8. Preventing preterm births: trends and potential reductions with current interventionsin 39 very high human development index countries

    Science.gov (United States)

    Chang, Hannah H.; Larson, Jim; Blencowe, Hannah; Spong, Catherine Y.; Howson, Christopher P.; Cairns-Smith, Sarah; Lackritz, Eve M.; Lee, Shoo K.; Mason, Elizabeth; Serazin, Andrew C.; Walani, Salimah; Simpson, Joe Leigh; Lawn, Joy E.

    2013-01-01

    Summary Background Each year,1.1 million babies die from prematurity, andmany survivors are disabled. Worldwide, 15 million babies are preterm(10,000 births, country-by-country analyses were performed based on target population, incremental coverage increase,and intervention efficacy. Cost savings were estimated based on reported costs for preterm care in the USAadjusted usingWorld Bank purchasing power parity. Findings From 2010, even if all VHHDI countries achieved annual preterm birth rate reductions of the best performers, (Sweden and Netherlands), 2000-2010 or 2005-2010(Lithuania, Estonia)), rates would experience a relative reduction of<5% by 2015 on average across the 39 countries.Our analysis of preterm birth rise 1998-2004 in USA suggests half the change is unexplained, but important drivers includeinductions/cesareandelivery and ART.For all 39 VHHDI countries, five interventionsmodeling at high coveragepredicted 5%preterm birth rate relative reduction from 9.59 to 9.07% of live births:smoking cessation (0.01 rate reduction), decreasing multiple embryo transfers during assisted reproductive technologies (0.06), cervical cerclage (0.15), progesterone supplementation (0.01), and reduction of non-medically indicated labour induction or caesarean delivery (0.29).These translate to 58,000 preterm births averted and total annual economic cost savings of ~US$ 3 billion. Interpretation Even with optimal coverage of current interventions, many being complex to implement, the estimated potential reduction in preterm birth is tiny. Hence we recommenda conservative target of 5% preterm birth rate relative reductionby 2015. Our findings highlight the urgent need for discovery research into underlying mechanisms of preterm birth, and developmentof innovative interventions. Furthermore, the highest preterm birth rates occur in low-income settings where the causes of prematurity may differand have simpler solutions, such as birth spacing and treatment of infections in

  9. The role of antiretroviral therapy in reducing TB incidence and mortality in high HIV-TB burden countries

    Directory of Open Access Journals (Sweden)

    Anthony D Harries

    2016-03-01

    Full Text Available With the adoption of the new Sustainable Development Goals in 2016, all countries have committed to end the tuberculosis (TB epidemic by 2030, defined as dramatic reductions in TB incidence and mortality combined with zero TB-induced catastrophic costs for families. This paper explores how antiretroviral therapy (ART in high HIV-TB burden countries may help in reducing TB incidence and mortality and thus contribute to the ambitious goal of ending TB. ART in people living with HIV has a potent TB preventive effect, with this being most apparent in those with the most advanced immunodeficiency. Early ART also significantly reduces the risk of TB, and with new World Health Organization guidance released in 2015 about initiating ART in all persons living with HIV irrespective of CD4 count, there is the potential for enormous benefit at the population level. Already, several countries with high HIVTB burdens have seen dramatic declines in TB case notification rates since ART scale up started in 2004. In patients already diagnosed with HIV-associated TB, mortality can be significantly decreased by ART, especially if started within 2–8 weeks of anti-TB treatment. The benefits of ART on TB incidence and TB mortality can be further augmented respectively by the addition of isoniazid preventive therapy and cotrimoxazole preventive therapy. These interventions must be effectively implemented and scaled up in order to end the TB epidemic by 2030.

  10. Validating the WHO maternal near miss tool: comparing high- and low-resource settings.

    Science.gov (United States)

    Witteveen, Tom; Bezstarosti, Hans; de Koning, Ilona; Nelissen, Ellen; Bloemenkamp, Kitty W; van Roosmalen, Jos; van den Akker, Thomas

    2017-06-19

    WHO proposed the WHO Maternal Near Miss (MNM) tool, classifying women according to several (potentially) life-threatening conditions, to monitor and improve quality of obstetric care. The objective of this study is to analyse merged data of one high- and two low-resource settings where this tool was applied and test whether the tool may be suitable for comparing severe maternal outcome (SMO) between these settings. Using three cohort studies that included SMO cases, during two-year time frames in the Netherlands, Tanzania and Malawi we reassessed all SMO cases (as defined by the original studies) with the WHO MNM tool (five disease-, four intervention- and seven organ dysfunction-based criteria). Main outcome measures were prevalence of MNM criteria and case fatality rates (CFR). A total of 3172 women were studied; 2538 (80.0%) from the Netherlands, 248 (7.8%) from Tanzania and 386 (12.2%) from Malawi. Total SMO detection was 2767 (87.2%) for disease-based criteria, 2504 (78.9%) for intervention-based criteria and 1211 (38.2%) for organ dysfunction-based criteria. Including every woman who received ≥1 unit of blood in low-resource settings as life-threatening, as defined by organ dysfunction criteria, led to more equally distributed populations. In one third of all Dutch and Malawian maternal death cases, organ dysfunction criteria could not be identified from medical records. Applying solely organ dysfunction-based criteria may lead to underreporting of SMO. Therefore, a tool based on defining MNM only upon establishing organ failure is of limited use for comparing settings with varying resources. In low-resource settings, lowering the threshold of transfused units of blood leads to a higher detection rate of MNM. We recommend refined disease-based criteria, accompanied by a limited set of intervention- and organ dysfunction-based criteria to set a measure of severity.

  11. A 20-Year High-Resolution Wave Resource Assessment of Japan with Wave-Current Interactions

    Science.gov (United States)

    Webb, A.; Waseda, T.; Kiyomatsu, K.

    2016-02-01

    Energy harvested from surface ocean waves and tidal currents has the potential to be a significant source of green energy, particularly for countries with extensive coastlines such as Japan. As part of a larger marine renewable energy project*, The University of Tokyo (in cooperation with JAMSTEC) has conducted a state-of-the-art wave resource assessment (with uncertainty estimates) to assist with wave generator site identification and construction in Japan. This assessment will be publicly available and is based on a large-scale NOAA WAVEWATCH III (version 4.18) simulation using NCEP and JAMSTEC forcings. It includes several key components to improve model skill: a 20-year simulation to reduce aleatory uncertainty, a four-nested-layer approach to resolve a 1 km shoreline, and finite-depth and current effects included in all wave power density calculations. This latter component is particularly important for regions near strong currents such as the Kuroshio. Here, we will analyze the different wave power density equations, discuss the model setup, and present results from the 20-year assessment (with a focus on the role of wave-current interactions). Time permitting, a comparison will also be made with simulations using JMA MSM 5 km winds. *New Energy and Industrial Technology Development Organization (NEDO): "Research on the Framework and Infrastructure of Marine Renewable Energy; an Energy Potential Assessment"

  12. Remote Sensing Applications with High Reliability in Changjiang Water Resource Management

    Science.gov (United States)

    Ma, L.; Gao, S.; Yang, A.

    2018-04-01

    Remote sensing technology has been widely used in many fields. But most of the applications cannot get the information with high reliability and high accuracy in large scale, especially for the applications using automatic interpretation methods. We have designed an application-oriented technology system (PIR) composed of a series of accurate interpretation techniques,which can get over 85 % correctness in Water Resource Management from the view of photogrammetry and expert knowledge. The techniques compose of the spatial positioning techniques from the view of photogrammetry, the feature interpretation techniques from the view of expert knowledge, and the rationality analysis techniques from the view of data mining. Each interpreted polygon is accurate enough to be applied to the accuracy sensitive projects, such as the Three Gorge Project and the South - to - North Water Diversion Project. In this paper, we present several remote sensing applications with high reliability in Changjiang Water Resource Management,including water pollution investigation, illegal construction inspection, and water conservation monitoring, etc.

  13. REMOTE SENSING APPLICATIONS WITH HIGH RELIABILITY IN CHANGJIANG WATER RESOURCE MANAGEMENT

    Directory of Open Access Journals (Sweden)

    L. Ma

    2018-04-01

    Full Text Available Remote sensing technology has been widely used in many fields. But most of the applications cannot get the information with high reliability and high accuracy in large scale, especially for the applications using automatic interpretation methods. We have designed an application-oriented technology system (PIR composed of a series of accurate interpretation techniques,which can get over 85 % correctness in Water Resource Management from the view of photogrammetry and expert knowledge. The techniques compose of the spatial positioning techniques from the view of photogrammetry, the feature interpretation techniques from the view of expert knowledge, and the rationality analysis techniques from the view of data mining. Each interpreted polygon is accurate enough to be applied to the accuracy sensitive projects, such as the Three Gorge Project and the South - to - North Water Diversion Project. In this paper, we present several remote sensing applications with high reliability in Changjiang Water Resource Management,including water pollution investigation, illegal construction inspection, and water conservation monitoring, etc.

  14. Covariates of depression and high utilizers of healthcare: Impact on resource use and costs.

    Science.gov (United States)

    Robinson, Rebecca L; Grabner, Michael; Palli, Swetha Rao; Faries, Douglas; Stephenson, Judith J

    2016-06-01

    To characterize healthcare costs, resource use, and treatment patterns of survey respondents with a history of depression who are high utilizers (HUds) of healthcare and to identify factors associated with high utilization. Adults with two or more depression diagnoses identified from the HealthCore Integrated Research Database were invited to participate in the CODE study, which links survey data with 12-month retrospective claims data. Patient surveys provided data on demographics, general health, and symptoms and/or comorbidities associated with depression. Similar clinical conditions also were identified from the medical claims. Factors associated with high utilization were identified using logistic regression models. Of 3132 survey respondents, 1921 were included, 193 of whom were HUds (defined as those who incurred the top 10% of total all-cause costs in the preceding 12months). Mean total annual healthcare costs were eightfold greater for HUds than for non-HUds ($US56,145 vs. $US6,954; pcosts/resource use. HUds were prescribed twice as many medications (total mean: 16.86 vs. 8.32; psychotropic mean: 4.11 vs. 2.61; both pcosts in patients with depression. Copyright © 2016 Eli Lilly and Company. Published by Elsevier Inc. All rights reserved.

  15. THE MANAGEMENT OF HUMAN RESOURCE DEVELOPMENT IN AR RAIHAN BANDAR LAMPUNG JUNIOR HIGH SCHOOL

    Directory of Open Access Journals (Sweden)

    Betti Nuraini

    2014-11-01

    Full Text Available This case study portrays the human resources development management in Junior High School Ar Raihan Bandar Lampung. It was designed into five stages, i.e. planning, designing (determining, collecting data, analyzing data, and drawing conclusion. The study found that (1 the selection process the teachers’, librarians’ and laboratory personnels’ recruitment was nil; (2 the recruitment gave priority only to teachers, counselors, and administrative staff;; (3 the employment of librarians and laboratory assistants becomes a second priority compared to teachers, counselors, and administrative staff; (5 the school gave an equal renumeration to the teachers and the education personnel; (6 the focus of human development was on teachers.

  16. Comparing the burden of illness of haemophilia between resource-constrained and unconstrained countries: the São Paulo-Toronto Hemophilia Study.

    Science.gov (United States)

    Carneiro, J D A; Blanchette, V; Ozelo, M C; Antunes, S V; Villaca, P R; Young, N L; Castro, D; Brandão, L R; Carcao, M; Abad, A; Feldman, B M

    2017-09-01

    Although the regular replacement of clotting factor concentrates (prophylaxis) has been well established as the standard of care for severe haemophilia, the high cost of factor concentrates has limited access to prophylaxis in countries with under-developed or developing economies. We studied the health gap that could be addressed by providing unlimited access to clotting factor concentrates with implementation of long-term prophylaxis initiated from an early age in life. We performed a cross-sectional study of a random, representative sample of boys with moderate and severe haemophilia at three haemophilia treatment centres in Sao Paulo, Brazil, and one centre in Toronto, Canada. Canadian subjects were more often treated with prophylaxis, and began treatment at an earlier age. Fewer Canadian subjects had bleeds within the preceding 6 months (19 vs. 34, P = 0.003). Canadian subjects had lower (better) Pettersson radiographic scores (1.5 vs. 6.0, P = 0.0016), lower (better) Hemophilia Joint Health Scores (5.5 vs. 10.5, P = 0.0038), higher (better) Activity Scale for Kids scores (96.6 vs. 92.0, P = 0.033), more time spent in vigorous activity, and higher (better) social participation scores. Our findings suggest that increasing access to clotting factor concentrates for young boys with severe haemophilia is a global imperative. © 2017 John Wiley & Sons Ltd.

  17. The Work-Family Interface of Service Sector Workers : A Comparison of Work Resources and Professional Status across Five European Countries

    NARCIS (Netherlands)

    Beham, Barbara; Drobnic, Sonja; Praeg, Patrick

    The present paper examines cross-national differences in the utilisation of work-family resources at the organisational level and the relationships between these resources and work-to-home interference (WHI) and satisfaction with work-family balance (SWFB) among professional and non-professional

  18. Socioeconomic impact on device-associated infections in pediatric intensive care units of 16 limited-resource countries: international Nosocomial Infection Control Consortium findings.

    Science.gov (United States)

    Rosenthal, Victor D; Jarvis, William R; Jamulitrat, Silom; Silva, Cristiane Pavanello Rodrigues; Ramachandran, Bala; Dueñas, Lourdes; Gurskis, Vaidotas; Ersoz, Gulden; Novales, María Guadalupe Miranda; Khader, Ilham Abu; Ammar, Khaldi; Guzmán, Nayide Barahona; Navoa-Ng, Josephine Anne; Seliem, Zeinab Salah; Espinoza, Teodora Atencio; Meng, Cheong Yuet; Jayatilleke, Kushlani

    2012-07-01

    We report the results of the International Nosocomial Infection Control Consortium prospective surveillance study from January 2004 to December 2009 in 33 pediatric intensive care units of 16 countries and the impact of being in a private vs. public hospital and the income country level on device-associated health care-associated infection rates. Additionally, we aim to compare these findings with the results of the Centers for Disease Control and Prevention National Healthcare Safety Network annual report to show the differences between developed and developing countries regarding device-associated health care-associated infection rates. A prospective cohort, active device-associated health care-associated infection surveillance study was conducted on 23,700 patients in International Nosocomial Infection Control Consortium pediatric intensive care units. The protocol and methodology implemented were developed by International Nosocomial Infection Control Consortium. Data collection was performed in the participating intensive care units. Data uploading and analyses were conducted at International Nosocomial Infection Control Consortium headquarters on proprietary software. Device-associated health care-associated infection rates were recorded by applying Centers for Disease Control and Prevention National Healthcare Safety Network device-associated infection definitions, and the impact of being in a private vs. public hospital and the income country level on device-associated infection risk was evaluated. None. Central line-associated bloodstream infection rates were similar in private, public, or academic hospitals (7.3 vs. 8.4 central line-associated bloodstream infection per 1,000 catheter-days [p infection rates in lower middle-income countries were higher than low-income countries or upper middle-income countries (12.2 vs. 5.5 central line-associated bloodstream infections per 1,000 catheter-days [p infection rates were similar in academic, public and private

  19. Investigating High-Speed Railways In Terms Of The Economy For Our Country and The Region

    OpenAIRE

    Şahin, Onur; Altan, Mehmet Fatih

    2018-01-01

    High-speed railways have a history of more than 40 years. Railways continued to be popular especially in variousparts of Eastern Europe and Asia until the end of the 1980s. As of today, we can talk about a high-speed railway thatcontinues to develop in the continents of Africa, Asia and the Americas around the world. At this point, one of themost significant factors in railways, in particular high-speed railways, is planning. Planning determines the effect ofthe railway on the economy, as wel...

  20. Predictors of high healthcare resource utilization and liver disease progression among patients with chronic hepatitis C.

    Science.gov (United States)

    LaMori, Joyce; Tandon, Neeta; Laliberté, François; Germain, Guillaume; Pilon, Dominic; Lefebvre, Patrick; Prabhakar, Avinash

    2016-01-01

    Since hepatitis C virus therapy is typically prioritized for patients with more advanced disease, predicting which patients will progress could help direct scarce resources to those likely to benefit most. This study aims to identify demographics and clinical characteristics associated with high healthcare resource utilization (HRU) and liver disease progression among CHC patients. Using health insurance claims (January 2001-March 2013), adult patients with ≥2 CHC claims (ICD-9-CM: 070.44 or 070.54), and ≥6 months of continuous insurance coverage before and ≥36 months after the first CHC diagnosis were included. Patients with human immunodeficiency virus were excluded. Generalized estimating equations were used to identify the demographic and clinical characteristics of being in the 20% of patients with the highest HRU. Factors predicting liver disease progression were also identified. In the study population (n = 4898), liver disease severity and both CHC- and non-CHC-related comorbidities and conditions were strong predictors of high healthcare costs, with odds ratios (ORs; 95% confidence interval [CI]) for ≥2 CHC-related and ≥2 non-CHC-related comorbidities/conditions of 2.78 (2.48-3.12) and 2.19 (1.76-2.72), respectively. CHC- and non-CHC-related comorbidities and conditions were also strong predictors of liver disease progression with ORs (95% CI) for ≥2 CHC-related and ≥2 non-CHC-related comorbidities and conditions of 2.18 (1.83-2.60) and 1.50 (1.14-1.97), respectively. Potential inaccuracies in claims data, information or classification bias, and findings based on a privately insured population. This study suggests that CHC patients with high healthcare resource utilization have a high level of comorbidity at baseline and also that non-CHC comorbidities and conditions are strong predictors of high HRU. Non-cirrhotic CHC patients with one or more comorbidities are at high risk of progressing to cirrhosis or end-stage liver disease.

  1. Are teenage pregnancies at high risk? A comparison study in a developing country.

    Science.gov (United States)

    Sagili, Haritha; Pramya, N; Prabhu, Karthiga; Mascarenhas, Mariano; Reddi Rani, P

    2012-03-01

    The aim of this study was to compare obstetric and perinatal outcome in teenage and non-teenage pregnancies. We analyzed retrospective data of 15,498 pregnant patients who delivered from March 2008 to April 2009 in Jawaharlal Institute of Postgraduate Medical Education and Research, a referral tertiary care and teaching hospital in Pondicherry, South India. Girls aged ≤ 19 years were compared with pregnancy outcomes in women aged > 19 years who delivered in the same hospital during the study period. A total of 620 teenage pregnancies were compared with 14,878 non-teenage women. The obstetric and perinatal outcome was compared in the study and control groups using t test with Yates correction. We calculated Odds ratio (OR), 95% confidence intervals(CI) and p values; p teenage pregnancy in the study was 4%. A signicant proportion of teenage mothers were in their first pregnancies and their mean age was 18.04 years. Our study showed a significantly higher incidence of anaemia, past dates, premature rupture of membranes (PROM), normal vaginal delivery, episiotomy, low birth weight, and a significantly lower incidence of caesarean sections/perineal tears in teenage mothers compared to other mothers. In contrast, the incidence of hypertension, intrauterine growth restriction of fetus, pre-term labour and postpartum haemorrhage were similar in both the groups. The data in our study should throw more light on the current thinking of the obstetrical problems facing teenage mothers, in which some of our results support and others refute several long held beliefs about the risks in teenage pregnancy. Early booking, adequate antenatal care and delivery by trained people should improve the obstetric and perinatal outcome in teenage pregnancies, which is still an unresolved problem inspite of various government programmes in developing countries.

  2. Food subsidy programs and the health and nutritional status of disadvantaged families in high income countries: a systematic review.

    Science.gov (United States)

    Black, Andrew P; Brimblecombe, Julie; Eyles, Helen; Morris, Peter; Vally, Hassan; O Dea, Kerin

    2012-12-21

    Less healthy diets are common in high income countries, although proportionally higher in those of low socio-economic status. Food subsidy programs are one strategy to promote healthy nutrition and to reduce socio-economic inequalities in health. This review summarises the evidence for the health and nutritional impacts of food subsidy programs among disadvantaged families from high income countries. Relevant studies reporting dietary intake or health outcomes were identified through systematic searching of electronic databases. Cochrane Public Health Group guidelines informed study selection and interpretation. A narrative synthesis was undertaken due to the limited number of studies and heterogeneity of study design and outcomes. Fourteen studies were included, with most reporting on the Special Supplemental Nutrition Program for Women, Infants and Children in the USA. Food subsidy program participants, mostly pregnant or postnatal women, were shown to have 10-20% increased intake of targeted foods or nutrients. Evidence for the effectiveness of these programs for men or children was lacking. The main health outcome observed was a small but clinically relevant increase in mean birthweight (23-29g) in the two higher quality WIC studies. Limited high quality evidence of the impacts of food subsidy programs on the health and nutrition of adults and children in high income countries was identified. The improved intake of targeted nutrients and foods, such as fruit and vegetables, could potentially reduce the rate of non-communicable diseases in adults, if the changes in diet are sustained. Associated improvements in perinatal outcomes were limited and most evident in women who smoked during pregnancy. Thus, food subsidy programs for pregnant women and children should aim to focus on improving nutritional status in the longer term. Further prospective studies and economic analyses are needed to confirm the health benefits and justify the investment in food subsidy

  3. On the nature and scope of reported child maltreatment in high-income countries: Opportunities for improving the evidence-base.

    NARCIS (Netherlands)

    Jud, A.; Fluke, J.; Alink, L.R.A.; Allan, K.; Fallon, B.; Kindler, H.; Lee, B.J.; Mansell, J.; van Puyenbroek, H.

    2013-01-01

    Although high-income countries share and value the goal of protecting children from harm, national data on child maltreatment and the involvement of social services, the judiciary and health services remain relatively scarce. To explore potential reasons for this, a number of high-income countries

  4. Resistance pattern of mupirocin in methicillin-resistant Staphylococcus aureus in trauma patients and comparison between disc diffusion and E-test for better detection of resistance in low resource countries

    Directory of Open Access Journals (Sweden)

    Nonika Rajkumari

    2014-01-01

    Conclusions: All the MRSA isolates in our study were sensitive to mupirocin which is an encouraging finding. Though good screening for sensitivity can be done with 5 μg mupirocin disc, E-test provides a much clear and accurate results in clinical set-up. Hence, disc test can be used in resource poor countries and supplemented with E-test when needed.

  5. Impact of community-based support services on antiretroviral treatment programme delivery and outcomes in resource-limited countries: a synthetic review

    Directory of Open Access Journals (Sweden)

    Wouters Edwin

    2012-07-01

    Full Text Available Abstract Background Task-shifting to lay community health providers is increasingly suggested as a potential strategy to overcome the barriers to sustainable antiretroviral treatment (ART scale-up in high-HIV-prevalence, resource-limited settings. The dearth of systematic scientific evidence on the contributory role and function of these forms of community mobilisation has rendered a formal evaluation of the published results of existing community support programmes a research priority. Methods We reviewed the relevant published work for the period from November 2003 to December 2011 in accordance with the guidelines for a synthetic review. ISI Web of Knowledge, Science Direct, BioMed Central, OVID Medline, PubMed, Social Services Abstracts, and Sociological Abstracts and a number of relevant websites were searched. Results The reviewed literature reported an unambiguous positive impact of community support on a wide range of aspects, including access, coverage, adherence, virological and immunological outcomes, patient retention and survival. Looking at the mechanisms through which community support can impact ART programmes, the review indicates that community support initiatives are a promising strategy to address five often cited challenges to ART scale-up, namely (1 the lack of integration of ART services into the general health system; (2 the growing need for comprehensive care, (3 patient empowerment, (4 and defaulter tracing; and (5 the crippling shortage in human resources for health. The literature indicates that by linking HIV/AIDS-care to other primary health care programmes, by providing psychosocial care in addition to the technical-medical care from nurses and doctors, by empowering patients towards self-management and by tracing defaulters, well-organised community support initiatives are a vital part of any sustainable public-sector ART programme. Conclusions The review demonstrates that community support initiatives are a

  6. Integration of HIV care into maternal health services: a crucial change required in improving quality of obstetric care in countries with high HIV prevalence.

    Science.gov (United States)

    Madzimbamuto, Farai D; Ray, Sunanda; Mogobe, Keitshokile D

    2013-06-10

    The failure to reduce preventable maternal deaths represents a violation of women's right to life, health, non-discrimination and equality. Maternal deaths result from weaknesses in health systems: inadequate financing of services, poor information systems, inefficient logistics management and most important, the lack of investment in the most valuable resource, the human resource of health workers. Inadequate senior leadership, poor communication and low staff morale are cited repeatedly in explaining low quality of healthcare. Vertical programmes undermine other service areas by creating competition for scarce skilled staff, separate reporting systems and duplication of training and tasks. Confidential enquiries and other quality-improvement activities have identified underlying causes of maternal deaths, but depend on the health system to respond with remedies. Instead of separate vertical programmes for management of HIV, tuberculosis, and reproductive health, integration of care and joint management of pregnancy and HIV would be more effective. Addressing health system failures that lead to each woman's death would have a wider impact on improving the quality of care provided in the health service as a whole. More could be achieved if existing resources were used more effectively. The challenge for African countries is how to get into practice interventions known from research to be effective in improving quality of care. Advocacy and commitment to saving women's lives are crucial elements for campaigns to influence governments and policy -makers to act on the findings of these enquiries. Health professional training curricula should be updated to include perspectives on patients' rights, communication skills, and integrated approaches, while using adult learning methods and problem-solving techniques. In countries with high rates of Human Immunodeficiency Virus (HIV), indirect causes of maternal deaths from HIV-associated infections now exceed direct causes

  7. A collective phase in resource competition in a highly diverse ecosystem

    Science.gov (United States)

    Tikhonov, Mikhail; Monasson, Remi

    Recent technological advances uncovered that most habitats, including the human body, harbor hundreds of coexisting microbial ``species''. The problem of understanding such complex communities is currently at the forefront of medical and environmental sciences. A particularly intriguing question is whether the high-diversity regime (large number of species N) gives rise to qualitatively novel phenomena that could not be intuited from analysis of low-dimensional models (with few species). However, few existing approaches allow studying this regime, except in simulations. Here, we use methods of statistical physics to show that the large- N limit of a classic ecological model of resource competition introduced by MacArthur in 1969 can be solved analytically. Our results provide a tractable model where the implications of large dimensionality of eco-evolutionary problems can be investigated. In particular, we show that at high diversity, the MacArthur model exhibits a phase transition into a curious regime where the environment constructed by the community becomes a collective property, insensitive to the external conditions such as the total resource influx supplied to the community. Supported by Harvard Center of Mathematical Sciences and Applications, and the Simons Foundation. This work was completed at the Aspen Center for Physics, supported by National Science Foundation Grant PHY-1066293.

  8. Current and future availability of and need for human resources for sexual, reproductive, maternal and newborn health in 41 countries in Sub-Saharan Africa.

    Science.gov (United States)

    Guerra Arias, Maria; Nove, Andrea; Michel-Schuldt, Michaela; de Bernis, Luc

    2017-05-03

    The WHO African region, covering the majority of Sub-Saharan Africa, faces the highest rates of maternal and neonatal mortality in the world. This study uses data from the State of the World's Midwifery 2014 survey to cast a spotlight on the WHO African region, highlight the specific characteristics of its sexual, reproductive, maternal and newborn health (SRMNH) workforce and describe and compare countries' different trajectories in terms of meeting the population need for services. Using data from 41 African countries, this study used a mathematical model to estimate potential met need for SRMNH services, defined as "the percentage of a universal SRMNH package that could potentially be obtained by women and newborns given the composition, competencies and available working time of the SRMNH workforce." The model defined the 46 key interventions included in this universal SRMNH package and allocated them to the available health worker time and skill set in each country to estimate the potential met need. Based on the current and projected potential met need in the future, the countries were grouped into three categories: (1) 'making or maintaining progress' (expected to meet more, or the same level, of the need in the future than currently): 14 countries including Ghana, Senegal and South Africa, (2) 'at risk' (currently performing relatively well but expected to deteriorate due to the health workforce not keeping pace with population growth): 6 countries including Gabon, Rwanda and Zambia, and (3) 'low performing' (not performing well and not expected to improve): 21 countries including Burkina Faso, Eritrea and Sierra Leone. The three groups face different challenges, and policy solutions to increasing met need should be tailored to the specific context of the country. National health workforce accounts should be strengthened so that workforce planning can be evidence-informed.

  9. Models of resource planning during formation of calendar construction plans for erection of high-rise buildings

    Science.gov (United States)

    Pocebneva, Irina; Belousov, Vadim; Fateeva, Irina

    2018-03-01

    This article provides a methodical description of resource-time analysis for a wide range of requirements imposed for resource consumption processes in scheduling tasks during the construction of high-rise buildings and facilities. The core of the proposed approach and is the resource models being determined. The generalized network models are the elements of those models, the amount of which can be too large to carry out the analysis of each element. Therefore, the problem is to approximate the original resource model by simpler time models, when their amount is not very large.

  10. Physical inactivity and associated factors among university students in 23 low-, middle- and high-income countries.

    Science.gov (United States)

    Pengpid, Supa; Peltzer, Karl; Kassean, Hemant Kumar; Tsala Tsala, Jacques Philippe; Sychareun, Vanphanom; Müller-Riemenschneider, Falk

    2015-07-01

    The aim of this study was to determine estimates of the prevalence and social correlates of physical inactivity among university students in 23 low-, middle- and high-income countries. The International Physical Activity Questionnaire was used to collect data from 17,928 undergraduate university students (mean age 20.8, SD = 2.8) from 24 universities in 23 countries. The prevalence of physical inactivity was 41.4 %, ranging from 21.9 % in Kyrgyzstan to 80.6 % in Pakistan. In multivariate logistic regression, older age (22-30 years), studying in a low- or lower middle-income country, skipping breakfast and lack of social support were associated with physical inactivity. In men, being underweight, being overweight or obese, not avoiding fat and cholesterol, not having severe depression symptoms, low beliefs in the health benefits of physical activity, low personal control and knowledge of exercise-heart link, and in women, not trying to eat fibre, low personal mastery and medium personal control were additionally associated with physical inactivity. Four in each ten students are physically inactive, calling for strategic interventions by relevant professionals in higher educational institutions.

  11. Country of birth and other factors associated with hepatitis B prevalence in a population with high levels of immigration.

    Science.gov (United States)

    Reekie, Joanne; Gidding, Heather F; Kaldor, John M; Liu, Bette

    2013-09-01

    While hepatitis B virus (HBV) prevalence is known to vary greatly between countries, systematically collected population-level prevalence data from some countries is limited. Antenatal HBV screening programs in countries with substantial migrant populations provide the opportunity to systematically examine HBV prevalence in order to inform local and regional HBV estimates. A comprehensive register of Australian mothers giving birth from January 2000 to December 2008 was linked to a register of HBV notifications. Age-standardized prevalence of chronic HBV were calculated overall and by the mother's country of birth. Multiple logistic regression was used to investigate other factors associated with HBV prevalence. Five hundred twenty-three thousand six hundred sixty-five women were included and linked to 3861 HBV notifications. The age-standardized HBV prevalence was low (0.75%, 95% confidence interval 0.72-0.79). The highest HBV prevalence rates were observed in women born in Cambodia (8.60%), Taiwan (8.10%), Vietnam (7.49%), China (6.80%), and Tonga (6.51%). Among Australia-born women, those who smoked during pregnancy, were from a more disadvantaged socioeconomic background, and lived in remote areas were more likely to have HBV. There was also a trend suggesting a decrease in the prevalence of HBV over time. Antenatal screening for HBV can provide systematic population estimates of HBV prevalence in migrants and also identify other high prevalence groups. Longer follow-up will be required to confirm the small decrease in HBV prevalence observed in this study. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  12. Jump Start: International High School Students From Other Countries Earning Early U.S. College Credits

    Science.gov (United States)

    Hu, Jiayi; Hagedorn, Linda Serra

    2015-01-01

    This study analyzes data from one of the larger credit-based college transition programs for international students, the U.S. Bound College Credit Program or USBC2 Program (a pseudonym), mainly offered to high school students around the globe who are planning on attending American colleges or universities. Upon successful program completion, these…

  13. Impacts of urbanization on national transport and road energy use: Evidence from low, middle and high income countries

    International Nuclear Information System (INIS)

    Poumanyvong, Phetkeo; Kaneko, Shinji; Dhakal, Shobhakar

    2012-01-01

    Few attempts have been made to investigate quantitatively and systematically the impact of urbanization on transport energy use for countries of different stages of economic development. This paper examines the influence of urbanization on national transport and road energy use for low, middle and high income countries during 1975–2005, using the Stochastic Impacts by Regression on Population, Affluence and Technology (STIRPAT) model. After controlling for population size, income per capita and the share of services in the economy, the main results suggest that urbanization influences national transport and road energy use positively. However, the magnitude of its influence varies among the three income groups. Changes in urbanization appear to have a greater impact on transport and road energy use in the high income group than in the other groups. Surprisingly, the urbanization elasticities of transport and road energy use in the middle income group are smaller than those of the low income group. This study not only sheds further light on the existing literature, but also provides policy makers with insightful information on the link between urbanization and transport energy use at the three different stages of development. - Highlights: ► Overall, urbanization increases national transport and road energy use. ► Urbanization elasticities of transport energy use differ across development stages. ► Urbanization elasticities in high-income group are higher than in other groups.

  14. State of development of high temperature gas-cooled reactors in foreign countries

    International Nuclear Information System (INIS)

    Sudo, Yukio

    1990-01-01

    Emphasis has been placed in the development of high temperature gas-cooled reactors on high thermal efficiency as power reactors and the reactor from which nuclear heat can be utilized. In U.K., as the international project 'Dragon Project', the experimental Dragon reactor for research use with 20 MWt output and exit coolant temperature 750 deg C was constructed, and operated till 1976. Coated fuel particles were developed. In West Germany, the experimental power reactor AVR with 46 MWt and 15 MWe output was operated till 1988. The prototype power reactor THTR-300 with 300 MWe output and 750 deg C exit temperature is in commercial operation. In USA, the experimental power reactor Peach Bottom reactor with 40 MWe output and 728 deg C exit temperature was operated till 1974. The prototype Fort Saint Vrain power reactor with 330 MWe output and 782 deg C exit temperature was operated till 1989. In USSR, the modular VGM with 200 MWh output is at the planning stage. Also in China, high temperature gas-cooled reactors are at the design stage. Switzerland has taken part in various international projects. (K.I.)

  15. Uranium resources

    International Nuclear Information System (INIS)

    1976-01-01

    This is a press release issued by the OECD on 9th March 1976. It is stated that the steep increases in demand for uranium foreseen in and beyond the 1980's, with doubling times of the order of six to seven years, will inevitably create formidable problems for the industry. Further substantial efforts will be needed in prospecting for new uranium reserves. Information is given in tabular or graphical form on the following: reasonably assured resources, country by country; uranium production capacities, country by country; world nuclear power growth; world annual uranium requirements; world annual separative requirements; world annual light water reactor fuel reprocessing requirements; distribution of reactor types (LWR, SGHWR, AGR, HWR, HJR, GG, FBR); and world fuel cycle capital requirements. The information is based on the latest report on Uranium Resources Production and Demand, jointly issued by the OECD's Nuclear Energy Agency (NEA) and the International Atomic Energy Agency. (U.K.)

  16. High performance work practices in small firms : A resource-poverty and strategic decision-making perspective

    NARCIS (Netherlands)

    Kroon, B.; van de Voorde, F.C.; Timmers, J.

    2013-01-01

    High performance work practices (HPWPs) are human resource management practices aimed at stimulating employee and organisational performance. The application of HPWPs is not widespread in small organisations. We examine whether the implementation of coherent bundles of HPWPs (aimed at employee

  17. High performance work practices in small firms: a resource-poverty and strategic decision-making perspective

    NARCIS (Netherlands)

    Kroon, B.; Voorde, F.C. van de; Timmers, J.

    2013-01-01

    High performance work practices (HPWPs) are human resource management practices aimed at stimulating employee and organisational performance. The application of HPWPs is not widespread in small organisations. We examine whether the implementation of coherent bundles of HPWPs (aimed at employee

  18. Performance-Based Regulation In A High Distributed Energy Resources Future

    Energy Technology Data Exchange (ETDEWEB)

    Newton Lowry, Mark [Pacific Economics Group Research LLC, Madison, WI (United States); Woolf, Tim [Synapse Energy Economics, Cambridge, MA (United States); Schwartz, Lisa C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2018-03-07

    Performance-based regulation (PBR) of utilities has emerged as an important ratemaking option in the last 25 years. It has been implemented in numerous jurisdictions across the United States and is common in many other advanced industrialized countries. PBR’s appeal lies chiefly in its ability to strengthen utility performance incentives relative to traditional cost-of-service regulation (COSR). Some forms of PBR can streamline regulation and provide utilities with greater operating flexibility. Ideally, the benefits of better performance are shared by the utility and its customers. The shortcomings of traditional COSR in providing electric utilities with incentives that are aligned with certain regulatory goals are becoming increasingly clear. In particular, COSR can provide strong incentives to increase electricity sales and utility rate base. Further, some parties express concern that traditional COSR does not provide utilities with appropriate financial incentives to address evolving industry challenges such as changing customer demands for electricity services, increased levels of distributed energy resources (DERs), and growing pressure to mitigate carbon dioxide emissions. In addition, attention to potential new regulatory models to support the “utility of the future” has renewed interest in PBR. This report describes key elements of PBR and explains some of the advantages and disadvantages of various PBR options. We present pertinent issues from the perspectives of utilities and customers. In practice, these different perspectives are not diametrically opposed. Nonetheless, this framework is useful for illustrating how various aspects of PBR may be viewed by those key groups. Regulators have a unique perspective, in that they must balance consumer, utility, and other interests with the goal of achieving a result that is in the overall public interest.

  19. Isolation rooms for highly infectious diseases: an inventory of capabilities in European countries

    DEFF Research Database (Denmark)

    Fusco, F M; Puro, V; Baka, A

    2009-01-01

    Isolation of patients with highly infectious diseases (HIDs) in hospital rooms with adequate technical facilities is essential to reduce the risk of spreading disease. The European Network for Infectious Diseases (EUNID), a project co-funded by European Commission and involving 16 European Union...... on prevailing circumstances. Sporadic HID cases can be managed in the available HIRs. HIRs could also have a role in the initial phases of an influenza pandemic. However, large outbreaks due to natural or to bioterrorist events will need management strategies involving healthcare facilities other than HIRs....

  20. Country programme review. Mongolia

    International Nuclear Information System (INIS)

    Dolnicar, J.; Kamel, R.; Perera, O.; Tauchid, M.

    1992-08-01

    This document reviews the current nuclear program in Mongolia, identifying the peaceful uses of nuclear technology in the country and possible future technical co-operation activities. Separate brief sections deal with food and agriculture; mineral resources; nuclear chemistry, nuclear physics and instrumentation; human health; radiation protection; water resources and nuclear energy. 1 tab

  1. Water Resources

    International Nuclear Information System (INIS)

    Abira, M.A.

    1997-01-01

    Water is essential for life and ecological sustenance; its availability is essential component of national welfare and productivity.The country's socio-economic activities are largely dependent on the natural endowment of water resources. Kenya's water resources comprises of surface waters (rivers, lakes and wetlands) and ground water. Surface water forms 86% of total water resources while the rest is ground water Geological, topographical and climatic factors influence the natural availability and distribution of water with the rainfall distribution having the major influence. Water resources in Kenya are continuously under threat of depletion and quality degradation owing to rising population, industrialization, changing land use and settlement activities as well as natural changes. However, the anticipated climate change is likely to exacerbate the situation resulting in increased conflict over water use rights in particular, and, natural resource utilisation in general. The impacts of climate change on the water resources would lead to other impacts on environmental and socio-economic systems

  2. Southward shift of the global wind energy resource under high carbon dioxide emissions

    Science.gov (United States)

    K