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Developed World (developed + world)
Selected AbstractsThe End of the Fertility Transition in the Developed WorldPOPULATION AND DEVELOPMENT REVIEW, Issue 3 2002John Bongaarts By the late 1990s the average period total fertility rate in the developed world had declined to 1.6, a level substantially lower than projected in the 1970s and 1980s. This article examines recent trends and patterns in fertility in the developed world with particular emphasis on the effects and implications of changes in the timing of childbearing. The main objective is to demonstrate that while fertility in these countries is indeed low, women's childbearing levels are not as low as period measures such as the total fertility rate suggest. To obtain a full understanding of the various dimensions of fertility change. several indicators are examined, including period and cohort fertility by birth order and childbearing preferences. An analysis of these indicators demonstrates that period fertility measures in many developed countries are temporarily depressed by a rise in the mean age at childbearing. The distortion of the TFR is as great as 0.4 births per woman in Italy and Spain. These effects have been present in many developed countries since the 1970s and could continue for years into the future. But tempo effects are temporary, and once the postponement of childbearing ends,as it eventually must,the corresponding fertility-depressing effect stops, thus putting upward pressure on period fertility. Countries with very low fertility and substantial tempo effects may well experience rises in fertility in the near future if the timing of childbearing stabilizes. Even if this happens, however, it seems unlikely that fertility will rebound to the replacement level. [source] Practical Assessment of Maternal Cardiovascular Risk in PregnancyCONGENITAL HEART DISEASE, Issue 5 2008Nazanin Moghbeli MD ABSTRACT Cardiovascular disease in pregnancy is the most common cause of maternal mortality in the developed world and an important cause of heart failure, stroke, and arrhythmia. As more children with congenital heart disease survive into adulthood, there is a more pressing need to understand the risks that pregnancy poses for these women. Pregnancy, labor, and delivery increase the hemodynamic stress on the cardiovascular system and place women with heart disease at increased risk of cardiovascular complications, which include heart failure and death. Systematic assessment of pregnancy risk in these women, ideally before conception, is essential in optimizing maternal and fetal outcomes. This article describes the process of assessing risk of pregnancy-associated cardiovascular complications in women with structural heart disease. We review the current literature on pregnancy risk in women with complex congenital lesions, valvular heart disease, cardiomyopathy, and aortopathy, and suggest an approach to risk stratification. Based on a review of the literature, we report features that pose an increased risk of adverse maternal and fetal outcomes, which include poor maternal functional status; prior history of heart failure, arrhythmia, or cerebral vascular events; cyanosis; poor systemic ventricular function; and severe aortic or mitral stenosis. Pulmonary hypertension and Eisenmenger syndrome place women at exceedingly high risk for cardiovascular complications in pregnancy, including maternal and fetal death. [source] Neurodevelopmental outcomes in children with HIV infection under 3 years of ageDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2006C J Foster BA MBBS MRCPCH Following the introduction of combination antiretroviral therapy, children vertically infected with the human immunodeficiency virus (HIV-1) living in the developed world are surviving into adult life. This paper reviews the neurodevelopmental outcomes of 62 consecutively-presenting children with HIV-1 infection diagnosed before 3 years of age (32 males, 30 females; median age at presentation 6mo). Neurological and developmental data are presented with immunological and virological responses to antiretroviral therapy. Fourteen children (22%) had abnormal neurological signs and 25 (40%) demonstrated significant developmental delay on standardized developmental assessments. Children presenting with more severe HIV-1 disease and immune compromise had significantly more abnormal neurological signs and developmental delays than children presenting with milder HIV-1 symptomatology. Immune function, control of HIV-1 viral replication, and growth parameters improved with antiretroviral therapy (median age at last follow-up 7y 3mo); however, abnormal neurological signs and significant gross motor difficulties persisted. [source] Vascular endothelial growth factor and diabetic retinopathy: pathophysiological mechanisms and treatment perspectivesDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 6 2003Ruth B. Caldwell Abstract Retinal neovascularization and macular edema are central features of diabetic retinopathy, the major cause of blindness in the developed world. Current treatments are limited in their efficacy and are associated with significant adverse effects. Characterization of the molecular and cellular processes involved in vascular growth and permeability has led to the recognition that the angiogenic growth factor and vascular permeability factor vascular endothelial growth factor (VEGF) plays a pivotal role in the retinal microvascular complications of diabetes. Therefore, VEGF represents an exciting target for therapeutic intervention in diabetic retinopathy. This review highlights the current understanding of the mechanisms that regulate VEGF gene expression and mediate its biological effects and how these processes may become altered during diabetes. The cellular and molecular alterations that characterize experimental models of diabetes are considered in relation to the influence of high glucose-mediated oxidative stress on VEGF expression and on the mechanisms of VEGF's actions under hyperglycemic induction. Finally, potential therapeutic strategies for preventing VEGF overexpression or blocking its pathological effects in the diabetic retina are considered. Copyright © 2003 John Wiley & Sons, Ltd. [source] Genetics of Type 2 diabetesDIABETIC MEDICINE, Issue 5 2005I. Barroso Abstract Type 2 diabetes (T2D) has become a health-care problem worldwide, with the rise in disease prevalence being all the more worrying as it not only affects the developed world but also developing nations with fewer resources to cope with yet another major disease burden. Furthermore, the problem is no longer restricted to the ageing population, as young adults and children are also being diagnosed with T2D. In recent years, there has been a surge in the number of genetic studies of T2D in attempts to identify some of the underlying risk factors. In this review, I highlight the main genes known to cause uncommon monogenic forms of diabetes (e.g. maturity-onset diabetes of the young,MODY,and insulin resistance syndromes), as well as describe some of the main approaches used to identify genes involved in the more common forms of T2D that result from the interaction between environmental risk factors and predisposing genotypes. Linkage and candidate gene studies have been highly successful in the identification of genes that cause the monogenic variants of diabetes and, although progress in the more common forms of T2D has been slow, a number of genes have now been reproducibly associated with T2D risk in multiple studies. These are discussed, as well as the main implications that the diabetes gene discoveries will have in diabetes treatment and prevention. [source] MEASURING POVERTY , WHAT HAPPENED TO COPENHAGEN?ECONOMIC AFFAIRS, Issue 3 2007Chris Sarlo Absolute poverty can be thought of as a condition of ,insufficiency', i.e. the inability to acquire the basic necessities of life. Relative poverty can be thought of as a condition of ,inequality'. At the World Summit on Social Development in Copenhagen in 1995, all participants made a commitment to produce official measures of both absolute and relative poverty and to strive to eradicate absolute poverty within a reasonable time frame. Despite these commitments, measures of absolute poverty are rare in the developed world. This paper concludes that both kinds of measures are needed for intelligent discussions and good policy-making. [source] European industry: the emerging market competitiveness challengeECONOMIC OUTLOOK, Issue 3 2006Article first published online: 24 AUG 200 As the global economy has become increasingly open to 'free' trade, European industry - and, indeed, industry across the developed world - has found itself faced with growing competition from low cost, emerging market countries. How is it facing up to this stiff challenge? Newspaper headlines may suggest that effort has been focused on raising trade barriers to keep competition at bay. However, such actions are a thin veneer over the very real, structural changes that are rapidly taking place. This article, by Grant Colquhoun, examines the changing structure of the EU15's trading patterns and the differential impact across manufacturing sectors. It then analyses the steps industry is taking to cope with the competitiveness challenge. As well as attempting to squeeze costs, it is clear that industry in Europe is restructuring in order to focus on higher value added activities, where it typically has a competitive advantage over emerging markets. [source] Edible insects: Traditional knowledge or western phobia?ENTOMOLOGICAL RESEARCH, Issue 5 2009Alan L. YEN Abstract With an increasing human population and environmental degradation, the world faces a major problem in providing adequate animal based proteins. Many traditional societies have used or still use insects as a protein source, while westernized societies are reluctant to use insects, despite being the major consumers of animal proteins. We now need to consider insects as a source of food for humans in a manner that acknowledges both the role of entomophagy in indigenous societies and the need for westernized societies to reduce the size of their environmental footprint with regard to food production. The situation on continents such as Africa, Asia, and Central and South America has some parallels to Australia in that there are two forces in operation: the sustainable traditional use of edible insects and the "westernization" of these societies leading to a movement away from entomophagy. However, the potential to reach a compromise is greater in these continents because entomophagy is already accepted. The major challenges will be establishing sustainable production systems that include food safety and security as well as environmental protection. Whether this will happen or not will depend upon: (i) a major change in attitude in westernized societies towards entomophagy; (ii) pressure to conserve remaining habitats in a sustainable manner; (iii) economic impetus to develop food production systems that include insects; and (iv) an acknowledgement that achieving adequate nutrition on a global basis will involve different diets in much of the developed world. [source] Phenobarbital for the Treatment of Epilepsy in the 21st Century: A Critical ReviewEPILEPSIA, Issue 9 2004Patrick Kwan Summary:, Phenobarbital (PB) is the most widely used antiepileptic drug (AED) in the developing world and remains a popular choice in many industrialized countries. Meta-analyses of randomized controlled trials suggest that few differences in efficacy exist between PB and other established AEDs, but its possible deleterious cognitive and behavioral side effects remain a concern in the developed world. In contrast, high degrees of efficacy and tolerability in everyday clinical use have been demonstrated consistently in observational studies in developing countries. We propose that a pragmatic, comprehensive outcomes program be carried out, perhaps under the aegis of the Global Campaign Against Epilepsy, to optimize the conditions of the use of PB, so that more people around the world can benefit from this cost-effective medication and live more fulfilling lives. [source] REVIEW: Behavioral evidence for the significance of serotoninergic (5-HT) receptors in cocaine addictionADDICTION BIOLOGY, Issue 3 2010gorzata Filip ABSTRACT Cocaine addiction has somatic, psychological, psychiatric, socio-economic and legal implications in the developed world. Presently, there is no medication approved for the treatment of cocaine addiction. In recent years, data from the literature (pre-clinical studies and clinical trials) have provided several lines of evidence that serotonin (5-HT) and 5-HT receptors play a modulatory role in the mechanisms of action of cocaine. Here we review the contribution of 5-HT receptor subtypes to cocaine sensitization, discrimination, conditioned place preference, self-administration, reinstatement of seeking behavior and withdrawal symptoms in laboratory animals. Additionally, the consequences of chronic cocaine exposure on particular 5-HT receptor-assigned functions in pre-clinical studies are presented. [source] Financial Exclusion in Rural and Remote New South Wales, Australia: a Geography of Bank Branch Rationalisation, 1981,98GEOGRAPHICAL RESEARCH, Issue 2 2000N.M. Argent The provision of financial services in rural Australia is a significant public policy issue, reflected in the high level of media and political interest in the recent spate of branch closures. There are, however, many aspects of the current debate regarding the delivery of financial services to rural communities that are, at best, less than ideal and, at worst, erroneous. Using telephone directories for New South Wales, non-metropolitan bank branch listings for the period 1981 to 1998 were collated. A recategorisation of these data according to the Rural, Remote and Metropolitan Areas classification reveals, amidst a spatial realignment of financial service provision, that rural and remote New South Wales have been disproportionately affected by a relatively recent and concerted withdrawal of services. The research demonstrates that corporate-level responses to increased competition within the financial system are significantly more important in deciding rural access to banking services than local and regional population trends. Indeed, two-thirds of rural localities that have lost branches had experienced healthy population growth during the study period. In the wake of the post-deregulation reconfiguration of the bank branch network, the socio-economic marginalisation of rural communities is being compounded, a process of ,financial exclusion' recognised in other parts of the developed world. [source] Staunch protections: the ethics of haemophilia gene transfer researchHAEMOPHILIA, Issue 1 2008J. KIMMELMAN Summary., Haemophilia has long been considered an ideal system for validating human gene transfer (GT). However, haemophilia GT trials present a particular ethical challenge because they involve subjects whose medical condition is stabilized by standard therapies. Below, I review the ethics and risks of haemophilia GT clinical research. I propose several conditions and practices that strengthen the ethical basis for such trials. These include consultation with haemophilia advocacy organizations as trials are designed and executed, high standards of supporting evidence before trials are initiated, pretrial publication of this evidence, and the offer of indemnification for participants. I further argue against the conduct of paediatric haemophilia GT studies at this time, and raise questions about the fairness of recruiting economically disadvantaged subjects into studies that are primarily directed towards the health needs of persons in the developed world. [source] Ethnic variation in AMD-associated complement factor H polymorphism p.Tyr402His,HUMAN MUTATION, Issue 9 2006Michael A. Grassi Abstract Age-related macular degeneration (AMD) is the most common cause of irreversible visual loss in the developed world. Previous studies have demonstrated that the c.1204T>C, p.Tyr402His allelic variant in the complement factor H (CFH) gene is associated with an approximately three-fold increased risk for AMD in Caucasians of predominantly European descent. Both the prevalence as well as the phenotypic spectrum of AMD varies widely among persons of different ethnicities. We hypothesized that populations with a lower prevalence of AMD might also have a lower prevalence of the CFH risk allele. In this study we sought to determine the frequency of this sequence variant in control populations of Caucasians, African Americans, Hispanics, Somalis, and Japanese. Normal control populations were assembled for each ethnic group: Caucasian (n=148), Somali (n=128), African American (n=75), Hispanic (n=81), and Japanese (n=82). Individuals were genotyped using a restriction digest assay and the frequency of the C allele at nucleotide position 1204 of the CFH gene was determined. A bioinformatic approach was used to identify SNPs in linkage disequilibrium with rs1061170 (c.1204T>C, p.Tyr402His) from the human haplotype map project database (HapMap) in order to validate the findings. We found widely discordant frequencies of the risk allele between some of the different ethnic groups: Japanese 0.07±0.02, Hispanics 0.17±0.03, African-Americans 0.35±0.04, Caucasians 0.34±0.03, and Somalis 0.34±0.03. Allele frequencies generated by analysis of the HapMap database were consistent with these findings. This study suggests that there are other yet unidentified genetic factors important in the pathogenesis of AMD that may mitigate the effects of c.1204T>C, p.Tyr402His variant. Hum Mutat 27(9), 921,925, 2006. © 2006 Wiley-Liss, Inc. [source] Constraints on union organising in the United KingdomINDUSTRIAL RELATIONS JOURNAL, Issue 1 2008Edmund Heery ABSTRACT Despite increased investment by unions in organising, across much of the developed world there is at best modest evidence of a recovery of union membership. This has led to a research interest in the barriers to successful union organising and it is with this critical issue that the following article is concerned. It uses survey and interview data from trainee organisers in Britain to identify the internal and external constraints they have encountered while working on organising campaigns. The findings point to a broad range of organising constraints both within and beyond trade unions. Experience of constraints varies and is shown partly to be a function of the characteristics of organisers, the nature of the organising task in which they are engaged and the systems in place to manage their work. [source] World Gastroenterology Organization Practice Guidelines for the Diagnosis and Management of IBD in 2010INFLAMMATORY BOWEL DISEASES, Issue 1 2010Dr. Charles N. Bernstein Chairman Abstract Inflammatory bowel disease (IBD) represents a group of idiopathic, chronic, inflammatory intestinal conditions. Its two main disease categories are: Crohn's disease (CD) and ulcerative colitis (UC), which feature both overlapping and distinct clinical and pathological features. While these diseases have, in the past, been most evident in the developed world, their prevalence in the developing world has been gradually increasing in recent decades. This poses unique issues in diagnosis and management which have been scarcely addressed in the literature or in extant guidelines. Depending on the nature of the complaints, investigations to diagnose either form of IBD or to assess disease activity will vary and will also be influenced by geographic variations in other conditions that might mimic IBD. Similarly, therapy varies depending on the phenotype of the disease being treated and available resources. The World Gastroenterology Organization has, accordingly, developed guidelines for diagnosing and treating IBD using a cascade approach to account for variability in resources in countries around the world. Inflamm Bowel Dis 2010 [source] Resource utilisation and costs for the treatment of diabetes in the developed world: an economical burden that needs to be solvedINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 7 2009J. H. Jendle No abstract is available for this article. [source] A systematic review of the use of simulated patients and pharmacy practice researchINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2006Dr. MC Watson MRC fellow Objective The use of simulated patients to assess current practice, or to derive outcome measures for pharmacy practice research, has received much attention in recent years. A simulated patient is an individual who is trained to visit a pharmacy to enact a scenario testing specific behaviour of the pharmacist or pharmacy staff. The aim of this study was to provide a definitive review of the use of simulated patients as a methodological tool for pharmacy practice research. Method A systematic review was undertaken to identify all pharmacy practice studies that had used simulated patient methodology. The electronic databases searched to identify relevant studies were MEDLINE, EMBASE and CINAHL. Articles fulfilling all the following criteria were considered for inclusion in the review: primary reports of trials conducted in community pharmacy and drug store settings which used simulated patients to derive outcome measures. The review was not restricted by language or by country. The review was restricted to publications from 1976 to May 2005. Key findings In total, 56 full publications were retrieved for further examination, of which 46 studies were included in the review, including: nine randomised controlled trials, three controlled trials, 30 cross-sectional, two time-series and two ,other' studies. Ten publications were excluded: seven reviews, one laboratory-based study, one telephone survey and one study presented only as an abstract. Conclusions There has been steady growth in the use of simulated patient methodology over the past 30 years. Although simulated patients have received negative attention in the pharmaceutical media, they can be a rigorous and robust method of measuring practice if used appropriately. This review demonstrates the range of activities for which this method can be used, including the assessment of counselling and advice provision, the treatment of minor and major illness, and the assessment of the public health activities of pharmacy and drug store staff. Simulated patient methodology has been used in developing countries to a similar, if not greater extent, than the developed world, demonstrating its versatility and applicability to pharmacy practice research globally. [source] Europe and the Immigration of Highly Skilled LabourINTERNATIONAL MIGRATION, Issue 5 2001Sami Mahroum The competition for highly skilled labour continues to be fierce and is taking a more institutionalized pattern across most of the developed world. This article sketches the changes in policies, legislations, and procedures across various EU countries and compares these with those of other developed countries. The article shows that EU member states not only compete with non-EU countries and regions but also among themselves in order to attract and maintain sufficient flows of highly skilled labour. [source] Operations Research and public policy for Africa: harnessing the revolution in management science instructionINTERNATIONAL TRANSACTIONS IN OPERATIONAL RESEARCH, Issue 2 2008Jonathan P. Caulkins Abstract Operations Research (OR) has made major contributions in the developed world to public policy domains that are of great relevance to Africa. Inasmuch as OR has failed to live up to its potential for addressing such issues in Africa, a principal barrier may have been distance between OR analysts and decision makers. However, the revolution in management science instruction and potential to train end-user modelers has democratized OR. This makes training for policy makers and managers in the public and non-profit sectors in Africa both feasible and highly beneficial. Existing management science courses for public and non-profit leaders, such as those taught at Carnegie Mellon's Heinz School, could be adapted to fit the needs of educators and policy makers in Africa and disseminated via a "train the trainers" approach. A plan is sketched whereby 800,000 end-user modelers might be trained in Africa (one for every 1000 people) at an annual cost of about $5 million/year. Such budgets are well within the range of investments in human capital formation currently being made in Africa. [source] The Social Affordances of the Internet for Networked IndividualismJOURNAL OF COMPUTER-MEDIATED COMMUNICATION, Issue 3 2003Barry Wellman We review the evidence from a number of surveys in which our NetLab has been involved about the extent to which the Internet is transforming or enhancing community. The studies show that the Internet is used for connectivity locally as well as globally, although the nature of its use varies in different countries. Internet use is adding on to other forms of communication, rather than replacing them. Internet use is reinforcing the pre-existing turn to societies in the developed world that are organized around networked individualism rather than group or local solidarities. The result has important implications for civic involvement. [source] An exploration of values in ethical consumer decision makingJOURNAL OF CONSUMER BEHAVIOUR, Issue 3 2005Deirdre Shaw Abstract Consumer concern for ethical issues has been well documented across much of the developed world. Research on values is also prominent in the literature. Neglected in consumer behaviour is an understanding of the pertinence of particular values in ethical decision making contexts. This paper outlines the results of qualitative research, which explores those values pertinent to ethical consumers in decision making and the nature of their influence in grocery consumption contexts. A questionnaire was used to ascertain the dominance and nature of values influencing consumer decision making in this context. [source] The inflammatory reflex , IntroductionJOURNAL OF INTERNAL MEDICINE, Issue 2 2005J. ANDERSSON Abstract. Sepsis is the third leading cause of death in the developed world. Despite recent advances in intensive care treatment and the discovery of antibiotics, sepsis remains associated with a high mortality rate. The pathogenesis of sepsis is characterized by an overwhelming systemic inflammatory response that is central to the development of lethal multiple organ failure. This volume of the Journal of Internal Medicine contains three reviews addressing novel aspects of a system we are only beginning to understand , the interactions between the immune and the nervous systems, the ,neuro-immune axis'. Tracey (Nature 2002; 420: 853) recently discovered that the nervous system, through the vagus nerve, can modulate circulating TNF- , levels induced by microbial invasion or tissue injury. This cholinergic anti-inflammatory pathway is mediated primarily by nicotinic acetylcholine receptors on tissue macrophages , the pathway leads to decreased production of proinflammatory cytokines. The author reports that treatment with the acetylcholine receptor agonist, nicotine, modulates this system and reduces mortality in ,established' sepsis. Watkins and Maier (J Intern Med 2005; 257: 139) illustrate that pathological pain (induced by inflammation) is not simply a strict neuronal phenomenon, but is a component of the immune response, and is modulated by peripheral immune cells and spinal cord glia cells. This may be of importance for future development of novel drugs for neuropathic pain as well as our understanding of increased risks for infections in anaesthetic skin areas. Blalock (J Immunol 1984; 132: 1067) elucidates the possibility that the immune system actually functions as the sixth sense, sensing microbes and microbial toxins that we cannot see, hear, taste, touch or smell. Activation of the sympathetic nervous system also has predominantly anti-inflammatory effects that are mediated through direct nerve to immune cell interaction or through the adrenal neuro-endocrine axis. [source] Examining the Intersection of Sex and Stress in Modelling Neuropsychiatric DisordersJOURNAL OF NEUROENDOCRINOLOGY, Issue 4 2009N. Goel Sex-biased neuropsychiatric disorders, including major depressive disorder and schizophrenia, are the major cause of disability in the developed world. Elevated stress sensitivity has been proposed as a key underlying factor in disease onset. Sex differences in stress sensitivity are associated with corticotrophin-releasing factor (CRF) and serotonin neurotransmission, which are important central regulators of mood and coping responses. To elucidate the underlying neurobiology of stress-related disease predisposition, it is critical to develop appropriate animal models of stress pathway dysregulation. Furthermore, the inclusion of sex difference comparisons in stress responsive behaviours, physiology and central stress pathway maturation in these models is essential. Recent studies by our laboratory and others have begun to investigate the intersection of stress and sex where the development of mouse models of stress pathway dysregulation via prenatal stress experience or early-life manipulations has provided insight into points of developmental vulnerability. In addition, examination of the maturation of these pathways, including the functional importance of the organisational and activational effects of gonadal hormones on stress responsivity, is essential for determination of when sex differences in stress sensitivity may begin. In such studies, we have detected distinct sex differences in stress coping strategies where activational effects of testosterone produced females that displayed male-like strategies in tests of passive coping, but were similar to females in tests of active coping. In a second model of elevated stress sensitivity, male mice experiencing prenatal stress early in gestation showed feminised physiological and behavioural stress responses, and were highly sensitive to a low dose of selective serotonin reuptake inhibitors. Analyses of expression and epigenetic patterns revealed changes in CRF and glucocorticoid receptor genes in these mice. Mechanistically, stress early in pregnancy produced a significant sex-dependent effect on placental gene expression that was supportive of altered foetal transport of key growth factors and nutrients. These mouse models examining alterations and hormonal effects on development of stress pathways provide necessary insight into how specific stress responses can be reprogrammed early in development resulting in sex differences in stress sensitivity and neuropsychiatric disease vulnerability. [source] Economic evaluation of neonatal screening for phenylketonuria and congenital hypothyroidismJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 11 2005EA Geelhoed Objective: To evaluate the costs and benefits of neonatal screening for phenylketonuria (PKU) and congenital hypothyroidism (CH). Neonatal screening for PKU and CH is common throughout the developed world. It represents a model of preventive care in that the screening procedure is simple and intellectual disability is otherwise irreversible. Changes in treatment and care, and in particular the advent of maternal PKU, require regular evaluation of a programme that also impacts on a large healthy population. Method: Costs of screening were based on the programme provided within Western Australia. Costs averted were derived using patterns of care currently adopted in Western Australia and applied according to historical patterns of intellectual disability for each condition. Results: A net saving of $A2.9 million is attributable to the programme annually. The economic benefits derive from the prevention of intellectual disability which otherwise incurs costs throughout the life of the affected individual. Maternal PKU represented a minor proportion of overall costs. Sensitivity analysis showed that the cost savings were robust, given changes in the levels of intellectual disability, but varied according to the discount rate. The result of a net saving was evident under all assumptions. Conclusion: Neonatal screening for PKU and CH is a cost saving use of resources and the emergence of maternal PKU has not had a significant effect on the economic outcomes. [source] Twenty years of phylogeography: the state of the field and the challenges for the Southern HemisphereMOLECULAR ECOLOGY, Issue 17 2008LUCIANO B. BEHEREGARAY Abstract Phylogeography is a young, vigorous and integrative field of study that uses genetic data to understand the history of populations. This field has recently expanded into many areas of biology and also into several historical disciplines of Earth sciences. In this review, I present a numerical synthesis of the phylogeography literature based on an examination of over 3000 articles published during the first 20 years of the field (i.e. from 1987 to 2006). Information from several topics needed to evaluate the progress, tendencies and deficiencies of the field is summarized for 10 major groups of organisms and at a global scale. The topics include the geography of phylogeographic surveys, comparative nature of studies, temporal scales and major environments investigated, and genetic markers used. I also identify disparities in research productivity between the developing and the developed world, and propose ways to reduce some of the challenges faced by phylogeographers from less affluent countries. Phylogeography has experienced explosive growth in recent years fuelled by developments in DNA technology, theory and statistical analysis. I argue that the intellectual maturation of the field will eventually depend not only on these recent developments, but also on syntheses of comparative information across different regions of the globe. For this to become a reality, many empirical phylogeographic surveys in regions of the Southern Hemisphere (and in developing countries of the Northern Hemisphere) are needed. I expect the information and views presented here will assist in promoting international collaborative work in phylogeography and in guiding research efforts at both regional and global levels. [source] Zygomycosis , a case report and overview of the disease in IndiaMYCOSES, Issue 4 2007Amit Diwakar Summary A case of zygomycosis caused by Rhizopus oryzae in a diabetic patient previously misdiagnosed as invasive pulmonary aspergillosis and an overview of the disease in India are presented. The case was diagnosed by direct microscopy, histopathologic examination and culture. Following surgical resection of pulmonary cavity under cover of amphotericin B administration, the patient recovered completely. Of 461 cases reported to-date, approximately 70% had been diagnosed at the Postgraduate Institute of Medical Education and Research, Chandigarh, in north India. This may be attributed to better awareness, expertise and infrastructural facilities for mycological diagnosis than to any particular regional preponderance of the disease. Rhino-orbito-cerebral manifestations were the most common feature of zygomycosis (269 cases), followed by cutaneous disease (66 cases), which is in conformity with the pattern prevalent worldwide. The etiologic agents encountered were Rhizopus oryzae, Apophysomyces elegans, Saksenaea vasiformis, Cunninghamella bertholletiae, Absidia corymbifera, Basidiobolus ranarum and Conidiobolus coronatus. In contrast to cases from the developed world where transplant recipients and patients with haematological malignancies seem to be most vulnerable to zygomycosis, the most common risk factor in India was uncontrolled diabetes mellitus. Amphotericin B was the mainstay of various treatment modalities employed. The relevance of a strong clinical suspicion and early diagnosis of zygomycosis for favourable prognosis can hardly be over-emphasised. [source] Britain in Europe/the British in Spain: exploring Britain's changing relationship to the other through the attitudes of its emigrantsNATIONS AND NATIONALISM, Issue 2 2002Karen O'Reilly This article explores Britain's changing relationship towards the outside in the context of contemporary British migration to the Costa del Sol. Historically, the British abroad have (apparently) retained a myth of the glorious homeland, to which they will eventually return, but the critique of colonialism both challenged the ethno-centrism of the colonisers and questioned the validity of the descriptions of colonial life. More recently, Britain has been forced to shed some of its ,great nation'/uncontaminated island mentality and to attempt to embrace both Europe and the rest of the developed world. At the same time the ,race relations' approach has been exchanged for a multiculturalist one at home. But the relationship with the outside remains ambivalent: Europe is embraced one day and spurned the next; racism remains a problem in Britain; and the British abroad seem to retain a ,little England' mentality. The British who have migrated to Spain in the last few decades are especially interesting. Their compatriots back home denigrate their behaviour and impute to them a longing for home which they do not have. They, themselves, fail to integrate into Spanish society yet talk of Spain as their home and construct new identities based on symbols of Spanishness. Dangling between two countries and two cultures, the British in Spain are, in many ways, symbolic of Britain's ambivalence to the outside and to its self. [source] The Anticarcinogenic Potential of Soybean Lectin and LunasinNUTRITION REVIEWS, Issue 7 2003Elvira Gonzalez de Mejia PhD Cancer is one of the leading causes of death worldwide, generally exceeded only by cardiovascular disease in the developed world. The number of people diagnosed with cancer within the next few decades is expected to double. There will therefore be increased demand for novel diagnostic and medical therapies that use new non-traditional sources. Soybeans contain a variety of anticarcinogenic phytochemicals. Recently, there has been increased interest in the potential health benefits of bioactive polypeptides and proteins from soybeans, including lunasin and lectins. Lunasin is a polypeptide that arrests cell division and induces apoptosis in malignant cells. Lectins are glycoproteins that selectively bind carbohydrates; lectins are used in medicine in a variety of new applications. Additional research, including clinical trials, should continue to examine and elucidate the therapeutic effects, nutritional benefits, and toxic consequences of commonly ingested soybean lectins and lunasin. [source] Before demand-side management is discarded, let's see what pieces should be keptOPEC ENERGY REVIEW, Issue 1 2000Clark W. Gellings Over the last 15 years, demand-side management (DSM) in developed countries has been transformed from a start-up activity to a full-blown industry, and then down-sized to a modest activity. While DSM remains a part of some utilities' strategies to meet current and future customer needs, its image in developed countries has been tarnished and its future is in doubt. More than ever now, retail energy customers are demanding from the marketplace a broad range of energy products and services that satisfy their most important needs. The electric utility industry has evolved into an energy and energy services industry. Its strategies, of retaining customers, enhancing revenue and controlling costs through various programmes and initiatives, while meeting customer needs, do not necessarily include DSM; but, nor is DSM in conflict with them. It is now, therefore, time to move on from DSM in the developed world. However, in developing countries, where the growth in electric energy production and delivery systems has not kept pace with population, DSM remains a viable option. [source] Children with cerebral palsy: severity and trends over timePAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 6 2009Geraldine Surman Summary Increasingly, more very-low-birthweight infants in the developed world are now expected to survive the neonatal period than was previously the case. There are concerns that there may be a related increase in the number of infants developing severe sensorimotor impairments. Pooled data from five registers contributing to the UK Network of Cerebral Palsy Registers, Surveys and Databases were used to identify patterns of motor impairment in relation to additional impairments and to birthweight, and to assess whether prevalence of cerebral palsy (CP) by birthweight and by severity of motor impairment had changed over time. Low-birthweight infants are at greater risk of developing CP than larger-birthweight babies. The CP rate amongst children with birthweights <2500 g was significantly higher at 16 per 1000 livebirths [95% confidence interval (CI) 14.9, 16.2] than 1.2 per 1000 livebirths [95% CI 11, 1.2] for normal-birthweight children. Despite being at greater risk of developing CP, smaller-birthweight babies are proportionately less likely to develop the most severe forms of motor impairment. Of those born weighing ,2500 g, 23% compared with 15% weighing <1000 g (P < 0.001) were in the most severely motor impaired group. Severe motor impairment is associated with higher levels of additional impairments. CP rates for each motor impairment group in the 1990s were similar to those in the late 1970s. Rates of CP among infants born below normal birthweight are high but have decreased over time. The CP rate for infants weighing 1000,1499 g at birth decreased from around 180 per 1000 livebirths in 1979 to around 50 per 1000 livebirths from the early 1990s onwards. [source] | ||||||||||||||||||||||||||||||||||