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Universal Access (universal + access)
Selected AbstractsUniversal access to water and sanitation: Why the private sector must participateNATURAL RESOURCES FORUM, Issue 4 2003Terence Lee Abstract Against the background of the current state of provision of drinking water and sanitation in the world , with one billion lacking safe water, and 2.2 billion not having adequate sanitation , this article argues that private participation is necessary. The most important issues for the management of water utilities in the 21st century are identified as mobilizing investment for the highly capital intensive operation of water supply and sanitation infrastructure, and achieving efficiency in the delivery of services. The article highlights the issues that need to be raised if private investment is to be seriously considered as an alternative. Case studies, especially from Latin America (Argentina, Chile, Peru, Bolivia), illustrate different modes of private participation, and possible reasons for successes and failures are discussed. The article stresses that regardless of the modality of private sector involvement, on-going government regulatory responsibility in the water sector is crucial. It suggests that regulatory policy must go beyond just setting tariffs, to develop standards for drinking water quality and waste treatment, as well as other standards. In conclusion, the article recognizes that numerous and increasingly difficult challenges face utilities in fulfilling their responsibility to deliver drinking water of adequate quality, in sufficient quantity, and at affordable prices, as well as safe and sustainable disposal of wastewaters for members of urban and rural communities. [source] Education for All: How Much Will It Cost?DEVELOPMENT AND CHANGE, Issue 1 2004Enrique Delamonica In 1990, a target of universal access to basic education by the year 2000 was set by two global conferences. Ten years later, however, it was clear that the target had not been met. Too many countries had made insufficient progress, and although many of the reasons for this inadequate progress were country-specific, one factor stood out in virtually all countries: inadequate public finance for primary education. In 2000, the Millennium Summit set a new target date for achieving ,education for all' of 2015. This article updates the global and regional cost estimates for reaching that target. The estimates are based on the most recent country-by-country data on budgetary expenditure, population and enrolment trends, and unit cost. The annual additional cost of achieving ,education for all' in developing countries by 2015 is estimated at US$ 9.1 billion. Although this is affordable at the global level, individual countries will need considerably more resources than are currently available. However, official development assistance (ODA) has been declining, and the share of ODA allocated to basic education has changed little over the past decade. Therefore, although affordable, the target of universal basic education by 2015 is likely to be missed, just as it was in 2000, without a major change both in ODA and national budgets. [source] Globalization, global health, and access to healthcare,INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 2 2003Téa Collins Abstract It is now commonly realized that the globalization of the world economy is shaping the patterns of global health, and that associated morbidity and mortality is affecting countries' ability to achieve economic growth. The globalization of public health has important implications for access to essential healthcare. The rise of inequalities among and within countries negatively affects access to healthcare. Poor people use healthcare services less frequently when sick than do the rich. The negative impact of globalization on access to healthcare is particularly well demonstrated in countries of transitional economies. No longer protected by a centralized health sector that provided free universal access to services for everyone, large segments of the populations in the transition period found themselves denied even the most basic medical services. Only countries where regulatory institutions are strong, domestic markets are competitive and social safety nets are in place, have a good chance to enjoy the health benefits of globalization. Copyright © 2003 John Wiley & Sons, Ltd. [source] IPv6 networks over DVB-RCS satellite systemsINTERNATIONAL JOURNAL OF SATELLITE COMMUNICATIONS AND NETWORKING, Issue 1 2008Ricardo Castellot Lou Abstract Satellite plays an important role in global information infrastructure (GII) and next generation networks (NGNs). Similarly, satellite communication systems have great advantages to support IPv6 (Internet Protocol version 6) networks as a technology that allows universal access to broadband e-services (audio, video, VPN, etc.). In the context of DVB-S2 (digital video broadcast-satellite) and DVB-RCS (digital video broadcast-return channel via satellite) standards, this paper presents the current SatSix project (satellite-based communications systems within IPv6 networks) within the European 6th Framework Programme, which is implementing innovative concepts and effective solutions (in relation with the economical cost) for broadband satellite systems and services using the technology presented above. This project is promoting the introduction of the IPv6 protocol into satellite-based communication systems. Moreover, through SatSix, the industry is addressing the next generation Internet, IPv6. It also enhances its competitive position in satellite broadband multimedia systems by exploiting the common components defined by the European DVB-S2 and DVB-RCS satellite broadband standards. Copyright © 2007 John Wiley & Sons, Ltd. [source] Population Trends in BMD Testing, Treatment, and Hip and Wrist Fracture Rates: Are the Hip Fracture Projections Wrong?JOURNAL OF BONE AND MINERAL RESEARCH, Issue 6 2005Susan B Jaglal PhD Abstract A worldwide epidemic of hip fractures has been predicted. Time trends in BMD testing, bone-sparing medications and hip and wrist fractures in the province of Ontario, Canada, were examined. From 1996 to 2001, BMD testing and use of bone-sparing medications increased each year, whereas despite the aging of the population, wrist and hip fracture rates decreased. Introduction: If patients with osteoporosis are being diagnosed and effective treatments used with increasing frequency in the population, rates of hip and wrist fractures will remain stable or possibly decrease. We report here time trends in BMD testing, prescriptions for bone-sparing medications, hip and wrist fracture rates, and population projections of fracture rates to 2005 in the province of Ontario, Canada. Materials and Methods: Ontario residents have universal access to Medicare. To examine time trends in BMD testing, all physician claims for DXA from 1992 to 2001 were selected from the Ontario Health Insurance Plan (OHIP) database. Trends in prescribing were examined from 1996 to 2003 using data from the Ontario Drug Benefit plan, which provides coverage to persons ,65 years of age. Actual numbers of hip and wrist fractures were determined for 1992-2000 and population projections for 2001-2005 using time-series analysis. Wrist fractures were identified in the OHIP database and hip fractures through hospital discharge abstracts. Results: From 1992 to 2001, the number of BMD tests increased 10-fold. There has been a steady increase in the number of persons filling prescriptions for antiresorptives (12,298 in 1996 to 225,580 in 2003) and the majority were for etidronate. For women, the rate of decline for wrist fractures is greater than that for hip fractures. The rate of hip fracture was fairly constant around 41 per 10,000 women ,50 years between 1992 and 1996. In 1997, the hip fracture rate began to decrease, and the population projections suggest that this downward trend will continue to a rate of 33.1 per 10,000 in 2005. Conclusions: Our findings suggest that fracture rates may be on the decline, despite the aging of the population, because of increased patterns of diagnosis and treatment for osteoporosis. [source] Health, Social Movements, and Rights-based Litigation in South AfricaJOURNAL OF LAW AND SOCIETY, Issue 3 2008Marius Pieterse This article investigates the impact of rights-based litigation on social struggles in the South African health sector. It considers the manner in which individuals and social movements have utilized rights and the legal process in their efforts to dismantle the ill-health/poverty cycle, in the particular context of the struggle for universal access to treatment for HIV/AIDS. Relying on literature concerning the transformative potential of socio-economic rights litigation and on examples from South African case law, the article critically evaluates the gains that have been made and the obstacles that have been encountered in this context. It argues that rights-based litigation presents a powerful tool in the struggle against poverty, but also elaborates on structural and institutional hurdles that continue to inhibit the effectiveness of rights-based strategies in this regard. [source] ADAM 12 as a first-trimester maternal serum marker in screening for Down syndromePRENATAL DIAGNOSIS, Issue 10 2006Jennie Laigaard Abstract Background A Disintegrin And Metalloprotease 12 (ADAM 12) is a glycoprotein synthesised by placenta and it has been shown to be a potential first-trimester maternal serum marker for Down syndrome (DS) in two small series. Here we analyse further, the potential of ADAM 12 as a marker for DS in a large collection of first-trimester serum samples. Materials and Methods The concentration of ADAM 12 was determined in 10,14-week pregnancy sera from 218 DS pregnancies and 389 gestational age-matched control pregnancies, which had been collected as part of routine prospective first-trimester screening programs (DS = 105) or as part of previous research studies (DS = 113). ADAM 12 was measured using a semi-automated time resolved immunofluorometric assay and median values for normal pregnancies were established by polynomial regression. These medians were then used to determine population distribution parameters for DS and normal pregnancy groups. Correlation with previously established PAPP-A and free ,-hCG multiple of the medians (MoMs) and delta nuchal translucency (NT) were determined and used to model the performance of first-trimester screening with ADAM 12 in combination with other first-trimester markers at various time periods across the first trimester. The benefits of a contingent testing model incorporating early measurement of PAPP-A and ADAM 12 were also explored. Results The maternal serum concentration of ADAM 12 was significantly reduced (p = 0.0049) with an overall median MoM of 0.79 in the DS cases and a log10 MoM SD of 0.3734 in the DS cases and 0.3353 in the controls. There was a significant correlation of ADAM 12 MoM in DS cases with gestational age (r = 0.375) and the median MoM increased from 0.50 at 10,11 weeks to 1.38 at 13 weeks. ADAM 12 was correlated with maternal weight (r(controls) = 0.283), PAPP-A (r(controls) = 0.324, r(DS) = 0.251) but less so with free ,-hCG (r(controls) = 0.062, r(DS) = 0.049) and delta NT (r(controls) = 0.110, r(DS) = 0.151). ADAM 12 was significantly (p = 0.026) lower in smokers (0.87 vs 1.00) and elevated in Afro-Caribbean women compared to Caucasian women (1.34 vs 1.00). Population modelling using parameters from this and an earlier study showed that a combination of ADAM 12 and PAPP-A measured at 8,9 weeks and combined with NT and free ,-hCG measured at 12 weeks could achieve a detection rate of 97% at a 5% false-positive rate or 89% at a 1% false-positive rate. PAPP-A and ADAM 12 alone at 8,9 weeks could identify 91% of cases at a 5% false-positive rate. Using this as part of a contingent-screening model to select an intermediate risk group of women for NT and free ,-hCG at 11,12 weeks would enable the detection of 92% of cases with a 1% false-positive rate at a cost of providing NT and free ,-hCG for 6% of women with 94% of women having completed screening by the 10th week of pregnancy. Conclusion ADAM 12 in early first trimester is a very efficient marker of DS. In combination with existing markers, it offers enhanced screening efficiency in a two-stage sequential first-trimester screening program or in a contingent-screening model, which may have benefits in health economies where universal access to high quality ultrasound is difficult. More data on early first-trimester cases with DS are required to establish more secure population parameters by which to assess further the validity of these models. Copyright © 2006 John Wiley & Sons, Ltd. [source] Socio-economic status and survival from breast cancer for young, Australian, urban womenAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2010Katherine I. Morley Abstract Objective: To estimate the association between measures of socio-economic status (SES) and breast cancer (BC) survival for young, urban Australian women. Methods: We used a population-based sample of 1,029 women followed prospectively for a median of 7.9 years. SES was defined by education and area of residence. Hazard ratios (HRs) associated with SES measures were estimated for (i) distant recurrence (DR) and (ii) all-cause mortality as end-points. Results: HRs for area of residence were not significantly different from unity, with or without adjustment for age at diagnosis and education level. The univariable HR estimate of DR for women with university education compared with women with incomplete high school education was 1.51 (95% CI = 1.08 , 2.13, p = 0.02), which reduced to 1.20 (95% CI = 0.85 , 1.72, p = 0.3) after adjusting for age at diagnosis and area of residence. Adjusting for prognostic factors differentially distributed across SES groups did not substantially alter the association between survival and SES. Conclusions: Among young, urban Australian women there is no association between SES and BC survival. Implications: This lack of estimates of association may be partly attributed to universal access to adequate breast cancer care in urban areas. [source] Extemporaneous (magistral) preparation of oral medicines for children in European hospitalsACTA PAEDIATRICA, Issue 4 2003S Conroy The lack of availability of licensed paediatric medicines forces pharmacists to compound drugs into a form that children can tolerate. There is a lack of information to support much of this practice and standards tend to vary. Suitable licensed alternatives are often available in other countries but importing restrictions complicate obtaining them. Conclusion: Regulatory action is needed to simplify licensing and importation processes to facilitate universal access to suitable paediatric medicines. [source] | ||||||||||