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Selected AbstractsRegional tourism and South-South economic cooperationTHE GEOGRAPHICAL JOURNAL, Issue 2 2001Krishna B. Ghimire Regional tourism within developing countries is a growing phenomenon. Yet this aspect has been largely neglected in social science research as well as tourism planning. This paper highlights the general nature, scale and economic significance of regional tourism in three leading regions in Asia, Africa and Latin America. The topic is especially timely as economic self-reliance and cooperation are increasingly reiterated in the context of the emergence of regional groupings. A key question addressed is whether regional tourism development represents any new and viable prospects for regional economic improvement and partnership, especially compared to international tourism centred on attracting visitors from industrialized countries. Based on a critical assessment of the experiences of three regional blocs (ASEAN , the Association of South-East Asian Nations; SADC , the Southern African Development Community; and Mercosur , a common market comprising Argentina, Brazil, Paraguay and Uruguay, with Chile being an associated member), the paper suggests that a basic appreciation of the prospects of regional tourism is not enough to produce perceptible benefits. Regional tourism development is occurring in a haphazard manner, with little attention to managing existing socio-economic inequalities and centre-periphery relations. The paper is based primarily on the review of secondary literature readily available to the author combined with a few documents obtained directly from different regional organizations or through Internet search. A small amount of material, especially concerning emerging tourism trends and outcomes, is drawn from a research project on national mass tourism in developing countries coordinated by the author at the United Nations Research Institute for Social Development, Geneva. [source] Adverse Event Reporting: Lessons Learned from 4 Years of Florida Office DataDERMATOLOGIC SURGERY, Issue 9 2005Brett Coldiron MD, FACP Background Patient safety regulations and medical error reporting systems have been at the forefront of current health care legislature. In 2000, Florida mandated that all physicians report, to a central collecting agency, all adverse events occurring in an office setting. Purpose To analyze the scope and incidence of adverse events and deaths resulting from office surgical procedures in Florida from 2000 to 2004. Methods We reviewed all reported adverse incidents (the death of a patient, serious injury, and subsequent hospital transfer) occurring in an office setting from March 1, 2000, through March 1, 2004, from the Florida Agency for Health Care Administration. We determined physician board certification status, hospital privileges, and office accreditation via telephone follow-up and Internet searches. Results Of 286 reported office adverse events, 77 occurred in association with an office surgical procedure (19 deaths and 58 hospital transfers). There were seven complications and five deaths associated with the use of intravenous sedation or general anesthesia. There were no adverse events associated with the use of dilute local (tumescent) anesthesia. Liposuction and/or abdominoplasty under general anesthesia or intravenous sedation were the most common surgical procedures associated with a death or complication. Fifty-three percent of offices reporting an adverse incident were accredited by the Joint Commission on Accreditation of Healthcare Organizations, American Association for Accreditation of Ambulatory Surgical Facilities, or American Association for Ambulatory Health Care. Ninety-four percent of the involved physicians were board certified, and 97% had hospital privileges. Forty-two percent of the reported deaths were delayed by several hours to weeks after uneventful discharge or after hospital transfer. Conclusions Requiring physician board certification, physician hospital privileges, or office accreditation is not likely to reduce office adverse events. Restrictions on dilute local (tumescent) anesthesia for liposuction would not reduce adverse events and could increase adverse events if patients are shifted to riskier approaches. State and/or national legislation establishing adverse event reporting systems should be supported and should require the reporting of delayed deaths. [source] Diabetic retinopathy screening: a systematic review of the economic evidenceDIABETIC MEDICINE, Issue 3 2010S. Jones Diabet. Med. 27, 249,256 (2010) Abstract This paper systematically reviews the published literature on the economic evidence of diabetic retinopathy screening. Twenty-nine electronic databases were searched for studies published between 1998 and 2008. Internet searches were carried out and reference lists of key studies were hand searched for relevant articles. The key search terms used were ,diabetic retinopathy', ,screening', ,economic' and ,cost'. The search identified 416 papers of which 21 fulfilled the inclusion criteria, comprising nine cost-effectiveness studies, one cost analysis, one cost-minimization analysis, four cost,utility analyses and six reviews. Eleven of the included studies used economic modelling techniques and/or computer simulation to assess screening strategies. To date, the economic evaluation literature on diabetic retinopathy screening has focused on four key questions: the overall cost-effectiveness of ophthalmic care; the cost-effectiveness of systematic vs. opportunistic screening; how screening should be organized and delivered; and how often people should be screened. Systematic screening for diabetic retinopathy is cost-effective in terms of sight years preserved compared with no screening. Digital photography with telemedicine links has the potential to deliver cost-effective, accessible screening to rural, remote and hard-to-reach populations. Variation in compliance rates, age of onset of diabetes, glycaemic control and screening sensitivities influence the cost-effectiveness of screening programmes and are important sources of uncertainty in relation to the issue of optimal screening intervals. There is controversy in relation to the economic evidence on optimal screening intervals. Further research is needed to address the issue of optimal screening interval, the opportunities for targeted screening to reflect relative risk and the effect of different screening intervals on attendance or compliance by patients. [source] Development of Feminizing Genitoplasty for Gender DysphoriaTHE JOURNAL OF SEXUAL MEDICINE, Issue 4i 2007FRCS(Urol), Jonathan Charles Goddard MD ABSTRACT Introduction., Determining the history and development of feminizing genitoplasty is fascinating and instructive but fraught with difficulty. Earliest examples relate to practices carried out in ancient cultures. Gender reassignment surgery (GRS) developed from reconstructive procedures for congenital abnormalities. Some surgery was disguised, techniques were not recorded, and operations were carried out in secret. Aim., The aim of this article is to review the historical development of male-to-female GRS. Methods., Information was gleaned from Medline and general Internet searches. Further evidence was found by reviewing the references of early articles. A fascinating insight was also found in the autobiographies of GRS patients. Results., The first recorded case was by Abrahams in 1931. Techniques evolved from the early vaginal absence work of Beck and Graves. Pioneers of GRS were Sir Harold Gillies in England and Georges Burou of Casablanca. In the 1950s, they both used invagination of the penile skin sheath to form a vagina. Howard Jones, of Johns Hopkins, published the second classic technique using penile and scrotal skin flaps. These two methods form the basis of male-to-female GRS today. The history of GRS reveals a struggle to improve functionality as well as cosmesis. In particular, the neovagina but also a functioning neoclitoris, which has developed from a cosmetic swelling into an innovated organ, derived from the glans penis and harvested penile neurovascular bundle. Conclusions., Improved function and cosmesis continue to be the aim of the gender dysphoria surgeon. However, this review suggests the future management of transwomen should address not only refinements of surgical techniques but also prospective collection of posttreatment quality-of-life issues. Goddard JC, Vickery RM, and Terry TR. Development of feminizing genitoplasty for gender dysphoria. J Sex Med 2007;4:981,989. [source] The Sydney Medically Supervised Injecting Centre: a controversial public health measureAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2002Cate Kelly Background: Injecting drug use remains a major public health concern, particularly because of opiate overdose and transmission of blood-borne viruses. Sydney's Medically Supervised Injecting Centre (MSIC) opened on a trial basis in May 2001 in an effort to reduce the harms of drug use. In this report, we provide a brief overview of the reported public health impact of supervising injecting facilities (SIFs) and review the history and early process evaluations of the Sydney Centre. Methods Medline, Internet searches and perusal of bibliographies of articles were used to identify key English language publications on SIFs. These were supplemented by interview with the Medical Director of Sydney MSIC, Dr Ingrid van Beek. Discussion and conclusions: It is difficult to be certain of the public health impact of SIFs but evidence from overseas and Sydney's early process evaluations provide promise that they may make a positive contribution to health. [source] Prehospital airway management on rescue helicopters in the United KingdomANAESTHESIA, Issue 6 2009M. Schmid Summary Adequate equipment is one prerequisite for advanced, out of hospital, airway management. There are no data on current availability of airway equipment on UK rescue helicopters. An internet search revealed all UK rescue helicopters, and a questionnaire was sent to the bases asking for available airway management items. We identified 27 helicopter bases and 26 (96%) sent the questionnaire back. Twenty-four bases (92%) had at least one supraglottic airway device; 16 (62%) helicopters had material for establishing a surgical airway (e.g. a cricothyroidotomy set); 88% of the helicopters had CO2 detection; 25 (96%) helicopters carried automatic ventilators; among these, four (15%) had sophisticated ventilators and seven (27%) helicopters carried special face masks suitable for non-invasive ventilation. We found a wide variation in the advanced airway management equipment that was carried routinely on air ambulances. Current guidelines for airway management are not met by all UK air ambulances. [source] How does economic empowerment affect women's risk of intimate partner violence in low and middle income countries?JOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 5 2009A systematic review of published evidence Abstract Objectives To identify whether individual and household economic empowerment is associated with lower intimate partner violence in low and middle income country settings. Methods Systematic PubMed and internet searches. Results Published data from 41 sites were reviewed. Household assets and women's higher education were generally protective. Evidence about women's involvement in income generation and experience of past year violence was mixed, with five finding a protective association and six documenting a risk association. Conclusion At an individual and household level, economic development and poverty reduction may have protective impacts on IPV. Context specific factors influence whether financial autonomy is protective or associated with increased risk. Copyright © 2008 John Wiley & Sons, Ltd. This article was published online on 6 October 2008. Errors were subsequently identified. This notice is included in the online and print versions to indicate that both have been corrected [17 April 2009]. [source] | |||||||||||||