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Selected AbstractsThe Politics of Service Delivery ReformDEVELOPMENT AND CHANGE, Issue 1 2004Richard Batley This article identifies the leaders, the supporters and the resisters of public service reform. It adopts a principal,agent framework, comparing reality with an ,ideal' situation in which citizens are the principals over political policy-makers as their agents, and policy-makers are the principals over public service officials as their agents. Reform in most developing countries is complicated by an additional set of external actors , international financial institutions and donors. In practice, international agencies and core government officials usually act as the ,principals' in the determination of reforms. The analysis identifies the interests involved in reform, indicating how the balance between them is affected by institutional and sectoral factors. Organizational reforms, particularly in the social sectors, present greater difficulties than first generation economic policy reforms. [source] Breaking taboos in the tropics: incest promotes colonization by wood-boring beetlesGLOBAL ECOLOGY, Issue 4 2001Bjarte H. Jordal Abstract 1,Inbreeding and parthenogenesis are especially frequent in colonizing species of plants and animals, and inbreeding in wood-boring species in the weevil families Scolytinae and Platypodidae is especially common on small islands. In order to study the relationship between colonization success, island attributes and mating system in these beetles, we analysed the relative proportions of inbreeders and outbreeders for 45 Pacific and Old World tropical islands plus two adjacent mainland sites, and scored islands for size, distance from nearest source population, and maximum altitude. 2,The numbers of wood-borer species decreased with decreasing island size, as expected; the degree of isolation and maximum island altitude had negligible effects on total species numbers. 3,Numbers of outbreeding species decreased more rapidly with island size than did those of inbreeders. Comparing species with similar ecology (e.g. ambrosia beetles) showed that this difference was best explained by differential success in colonization, rather than by differences in resource utilization or sampling biases. This conclusion was further supported by analyses of data from small islands, which suggested that outbreeding species have a higher degree of endemism and that inbreeding species are generally more widespread. 4,Recently established small populations necessarily go through a period of severe inbreeding, which should affect inbreeding species much less than outbreeding ones. In addition, non-genetic ecological and behavioural (,Allee') effects are also expected to reduce the success of outbreeding colonists much more than that of inbreeders: compared with inbreeders, outbreeders are expected to have slower growth rates, have greater difficulties with mate-location and be vulnerable to random extinction over a longer period. [source] Measuring the shortage of medical practitioners in rural and urban areas in developing countries: a simple framework and simulation exercises with data from IndiaINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 2 2008Homi Katrak Abstract This paper suggests a simple framework to estimate the shortage of medical practitioners in rural and urban areas in developing countries. Shortages are defined with respect to four main considerations. The overall numbers and also the different categories of practitioners in the rural and urban areas, the relatively greater difficulties of access in the rural areas (which reduce the number of accessible practitioners) and the greater health hazards in those areas (which lead to greater need for medical treatment). The quantitative effect of these factors is examined by undertaking simulation exercises with data for the Ujjain district in Madhya Pradesh state, India and also data for that state. The simulations turned up the following results. The un-weighted total number of practitioners, per head of population, is relatively greater in the rural areas; this is because of the relatively large numbers of the unqualified doctors in those areas. On the other hand, a ,quality adjusted' total, with lower weights for the unqualified doctors, found little overall difference between the rural and urban areas. Third, allowance for rural,urban differences in the difficulties of access showed that the number of accessible practitioners is much lower in the rural areas. Fourth, rural,urban differences in the incidence of health hazards and estimates of the need for medical treatment also showed a marked shortage of practitioners in the rural areas. The main implication of the results is that developmental efforts in the rural areas, including improvements in transport facilities and reduction of health hazards, would help to greatly reduce the shortage of practitioners in those areas. Training programmes to improve the quality of practitioners in the rural areas are also required. Copyright © 2007 John Wiley & Sons, Ltd. [source] HOW TO RECTIFY UNFAIR TRADE PRACTICES AND TO ESTABLISH APPROPRIATE SUPPLY CHAINS AND BETTER BUSINESS CULTURE UNDER THE GLOBAL MARKET ECONOMYPACIFIC ECONOMIC REVIEW, Issue 5 2009Tsugio Ide Banning unfair trade practices stands alongside private monopolization and the unjust restraint of trade as a key theme in competition policy. However, it poses much greater difficulties to deal with the matter than either private monopolization or unjust restraint of trade. In recent years, ongoing economic globalization, advances in information communication technology and other factors have wrought major changes in the traditional supply chain: for example, in subcontracting structure. Given the role of small and medium enterprises in underpinning economic growth, lifting the basic quality and performance level of these firms and improving business conditions for them have emerged as key policy themes. New efforts are needed to establish fair trade as a business practice and to create a new business culture in corporation with competition policy, small and medium enterprise policy and business ethics, such as Corporate Social Responsibility (CSR) practices. [source] Alan Greenspan on the Economic Implications of Population AgingPOPULATION AND DEVELOPMENT REVIEW, Issue 4 2004Article first published online: 15 DEC 200 At the 2004 annual symposium of central bank leaders sponsored by the Federal Reserve Bank of Kansas City at Jackson Hole, Wyoming, Alan Greenspan, Chairman of the US Federal Reserve Board, devoted his opening remarks on 27 August to a discussion of the economic implications of population aging. The full text of his remarks is reproduced below. Greenspan's high prestige and great influence on US economic policy lend special interest to his views on this much-discussed subject (see also the next Documents item in this issue). He outlines the coming demographic shift in the United States in language that is characteristically cautious and qualified. (The elderly dependency ratio will "almost certainly" rise as the baby boom generation retires, Greenspan says, although elsewhere he terms the process, more accurately, inexorable.) The main factor responsible for population aging he identifies as the decline of fertility. Immigration is an antidote, but, to be effective, its size would have to be much larger than is envisaged in current projections. Greenspan's assessment of the economic consequences of the changing age structure highlights the prospect of a deteriorating fiscal situation in the United States: chronic deficits in the Social Security program over the long haul, assuming that existing commitments for benefits per retiree are met, and even greater difficulties for the health care system for the elderly,Medicare,in which the effects of increasing numbers in old age are amplified by advances in medical technology and the bias inherent in the current system of subsidized third-party payments. The sober outline of policy choices imposed by population aging,difficult in the United States, but less so, Greenspan notes, than in Europe and Japan,underlies the need for counteracting the declining growth of the population of labor force age through greater labor force participation and later retirement. Beyond that, growth of output per worker can provide the key "that would enable future retirees to maintain their expected standard of living without unduly burdening future workers." This requires continuation of policies that enhance productivity, such as deregulation and globalization, and greater investment. In turn, the latter presupposes greater domestic saving, both personal and by the government, as the United States cannot "continue indefinitely to borrow saving from abroad." Demographic aging requires a new balance between workers and retirees. Curbing benefits once bestowed is difficult: only benefits that can be delivered should be promised. Public programs should be recalibrated, providing incentives for individuals to adjust to the inevitable consequences of an aging society. [source] The Environment of Poverty: Multiple Stressor Exposure, Psychophysiological Stress, and Socioemotional AdjustmentCHILD DEVELOPMENT, Issue 4 2002Gary W. Evans The one in five children growing up in poverty in America have elevated risk for socioemotional difficulties. One contributing factor to their elevated risk may be exposure to multiple physical and psychosocial stressors. This study demonstrated that 8, to 10,year,old, low,income, rural children (N= 287) confront a wider array of multiple physical (substandard housing, noise, crowding) and psychosocial (family turmoil, early childhood separation, community violence) stressors than do their middle,income counterparts. Prior research on self,reported distress among inner,city minority children is replicated and extended among low,income, rural White children with evidence of higher levels of self, and parent,reported psychological distress, greater difficulties in self,regulatory behavior (delayed gratification), and elevated psychophysiological stress (resting blood pressure, overnight neuroendocrine hormones). Preliminary mediational analyses with cross,sectional data suggest that cumulative stressor exposure may partially account for the well,documented, elevated risk of socioemotional difficulties accompanying poverty. [source] The sublethal effects of tebufenozide on the precopulatory and copulatory activities of Choristoneura fumiferana and C. rosaceanaENTOMOLOGIA EXPERIMENTALIS ET APPLICATA, Issue 3 2004Renée Dallaire Abstract The sublethal effects of tebufenozide, an ecdysone agonist, on the reproductive biology of Choristoneura fumiferana (Clem) and of Choristoneura rosaceana (Harris) (Lepidoptera: Tortricidae), treated during the larval stage, were evaluated using two treatment methods: the force-feeding method and the diet method. The percentage of mortality and the developmental time of survivors increased linearly with the concentration of tebufenozide used. This ecdysone analogue proved to be more toxic to C. fumiferana than to C. rosaceana. In C. rosaceana, the weight of males and females decreased proportionally with the dose ingested, but females were affected to a greater extent. This difference might be due to a greater consumption of the treated diet, or to a differential vulnerability to tebufenozide. Tebufenozide did not modify the pre-copulatory activities associated with chemical communication in the females. However, the consumption of tebufenozide delayed ovarian maturation, causing a reduction in the fecundity of females. Treated males had smaller spermatophores and fewer eupyrene sperms in their bursa copulatrix and spermatheca, along with lower mating success. In C. fumiferana, tebufenozide delayed the females' onset time of calling the first night after emergence, but did not affect the mean time spent calling or the production of the main component of the sex pheromone. The males showed significantly greater difficulty in executing oriented flight in a wind tunnel, although their mating success was not affected. We concluded that tebufenozide interferes with various aspects of the reproductive biology of males and females of C. fumiferana and C. rosaceana, including some pre-copulatory behaviors associated with sex pheromone communication. [source] Family and work predictors of parenting role stress among two-earner families of children with disabilitiesINFANT AND CHILD DEVELOPMENT, Issue 2 2005Marji Erickson Warfield Abstract Family resources (i.e. household income and spouse support), parenting challenges (i.e. number of children, difficulty finding reliable child care, and child characteristics), work rewards (i.e. work interest) and work demands (i.e. hours and work overload) were tested as predictors of parenting role stress among mothers and fathers in two-earner families of five-year old children with disabilities. The two-level hierarchical model was adapted to assess mothers and fathers as nested within married couples. Both common and unique predictors of maternal and paternal parenting role stress were found. Having fewer children in the family predicted less stress for both parents. Household income and an interaction between child behaviour problems and work interest were significant predictors of maternal parenting role stress. In contrast, greater difficulty in finding reliable child care predicted higher levels of parenting role stress for fathers but not mothers. The policy and research implications of these findings are discussed. Copyright © 2005 John Wiley & Sons, Ltd. [source] Hearing Impairment Affects Older People's Ability to Drive in the Presence of DistractersJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2010Louise Hickson PhD OBJECTIVES: To investigate the effects of hearing impairment and distractibility on older people's driving ability, assessed under real-world conditions. DESIGN: Experimental cross-sectional study. SETTING: University laboratory setting and an on-road driving test. PARTICIPANTS: One hundred seven community-living adults aged 62 to 88. Fifty-five percent had normal hearing, 26% had a mild hearing impairment, and 19% had a moderate or greater impairment. MEASUREMENTS: Hearing was assessed using objective impairment measures (pure-tone audiometry, speech perception testing) and a self-report measure (Hearing Handicap Inventory for the Elderly). Driving was assessed on a closed road circuit under three conditions: no distracters, auditory distracters, and visual distracters. RESULTS: There was a significant interaction between hearing impairment and distracters, such that people with moderate to severe hearing impairment had significantly poorer driving performance in the presence of distracters than those with normal or mild hearing impairment. CONCLUSION: Older adults with poor hearing have greater difficulty with driving in the presence of distracters than older adults with good hearing. [source] Holocaust Survivors in Old Age: The Jerusalem Longitudinal StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2008Jochanan Stesssman MD OBJECTIVES: To examine the hypothesis that Holocaust exposure during young adulthood negatively affects physical aging, causing greater morbidity, faster deterioration in health parameters, and shorter survival. DESIGN: A longitudinal cohort study of the natural history of an age-homogenous representative sample born in 1920/21 and living in Jerusalem. SETTING: Community-based home assessments. PARTICIPANTS: Four hundred fifty-eight subjects of European origin aged 70 at baseline and 77 at follow-up. MEASUREMENTS: Comprehensive assessment of physical, functional, and psychosocial domains; biographical history of concentration camp internment (Camp), exposure to Nazi occupation during World War II (Exposure), or lack thereof (Controls); and 7-year mortality data from the National Death Registry. RESULTS: Holocaust survivors of the Camp (n=93) and Exposure (n=129) groups were more likely than Controls (n=236) to be male and less educated and have less social support (P=.01), less physical activity (P=.03), greater difficulty in basic activities of daily living (P=.009), poorer self-rated health (P=.04), and greater usage of psychiatric medication (P=.008). No other differences in health parameters or physical illnesses were found. Holocaust survivors had similar rates of deterioration in health and illness parameters over the follow-up period, and 7-year mortality rates were identical. Proportional hazard models showed that being an elderly Holocaust survivor was not predictive of greter 7-year mortality. CONCLUSION: Fifty years after their Holocaust trauma, survivors still displayed significant psychosocial and functional impairment, although no evidence was found to support the hypothesis that the delayed effects of the trauma of the Holocaust negatively influence physical health, health trajectories, or mortality. [source] Clinician attitudes towards prescribing and implications for interventions in a multi-specialty group practiceJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 6 2008Robert J. Fortuna MD Abstract Background, Prescribing decisions are subject to a myriad of external forces, including patient requests for advertised medications. Although numerous factors influence prescribing, resources to support unbiased evidence-based prescribing are not widely available. Methods, To guide future interventions, we surveyed clinicians about influences on prescribing, awareness of pharmaceutical costs and attitudes towards computerized decision support. A 21-item survey was sent to 604 prescribing clinicians in a large multi-specialty group practice that employs a robust electronic medical record. Results, Surveys were returned from 405 clinicians (67%). Most respondents (87%) felt that direct-to-consumer (DTC) advertising prompts patients to request inappropriate medications, and more than one in five clinicians (22%) reported difficulty declining patients' requests for advertised medications. Providers with more clinical sessions per week reported greater difficulty. Although 93% of clinicians felt they have access to the information needed to guide prescribing, only about half (54%) reported they are aware of how much patients pay for prescription medications. Clinicians' awareness of medication costs varied considerably by specialty, with behavioural health clinicians being the most aware. The majority of providers (79%) stated that computerized prescribing alerts are a clinically useful source of information. Conclusions, Although the majority of clinicians reported that DTC advertising leads many patients to request medications that are inappropriate for their condition, a sizable proportion of clinicians reported difficulty declining these requests, and many are unaware of medication costs. Interventions to support prescribing decisions should provide the busiest clinicians with up-to-date, specialty-specific evidence and cost information. [source] Patient evaluation of treatment with fixed implant- supported partial denturesJOURNAL OF ORAL REHABILITATION, Issue 11 2001S.-W. Yi The aim of this study was to analyse the patient evaluation of functional treatment outcome in 40 periodontally compromised patients who received implant-supported prostheses (ISPs) as part of the total treatment. The treatment protocol comprised periodontal treatment, extraction of teeth with poor prognosis, placement of dental titanium implants, and after healing, insertion of fixed ISPs. Five of the patients became edentulous in one jaw after extraction of all teeth and received a complete ISP, whereas 35 patients became partially edentulous after extraction of some teeth, 12 receiving a partial ISP on , 3 implants, and 23 one on two implants. The follow-up period was on average 1,8 years after the connection of the prostheses, which provided the patients a dentition with a mean of 12 occluding dental units. The first author (S.-W. Yi) performed all implant treatment. Patients' opinions on oral functions , mastication, phonetics, oral hygiene, chewing comfort and aesthetics , were evaluated by means of a questionnaire both before implant installation and at the last follow-up. A control group of 30 subjects with a healthy dentition of 14 occluding natural pairs of teeth answered the same questionnaire on one occasion. A great majority of the patients were extremely satisfied with the oral function after treatment and experienced the ISPs as ,natural teeth'. There was no significant difference between the three treatment groups and the control group for mastication, phonetics, chewing comfort and aesthetics. Patients with ISPs reported a small but significantly greater difficulty with oral hygiene procedures than the controls with natural teeth. Most patients said that they would undergo the treatment again, if necessary, and recommend it to others. It was concluded that the rehabilitation of the periodontally compromised patients, including ISPs on osseointegrated dental titanium implants, resulted in subjectively improved and satisfactory oral function. [source] When Grammar Instruction Undermines Cohesion in L2 Spanish Classroom DiscourseMODERN LANGUAGE JOURNAL, Issue 1 2004Paul D. Toth This article compares ordinary conversational topics and targeted second language (L2) forms for their effectiveness in building and maintaining classroom discourse cohesion. In this study, 16 learners participated in 2 lessons, 1 with teacher turns determined by a grammatical object of instruction, and the other with turns determined by conversation topics. Based on research by Sperber and Wilson (1995) and Vuchinich (1977), extended latency gaps and remedy sequences in learner turns were taken as evidence of poor cohesion. Both lessons were videotaped, transcribed, and coded. Of the 16 learners, 5 volunteers viewed the videotapes and offered written explanations for their extended latencies. Longer latencies and more frequent remedy sequences occurred during the grammatically-determined discourse, with volunteers likewise indicating greater difficulty understanding the instructor, than during the conversational lesson. It is argued that for grammar instruction to work effectively, a focus on form must be transparent as the instructional objective, and targeted L2 forms must themselves be properly treated as discourse topics. [source] Cultural Identification and Second Language Pronunciation of Americans in NorwayMODERN LANGUAGE JOURNAL, Issue 2 2002Karen Lybeck Schumann's Acculturation Theory as presented in The Pidginization Process: A Model for Second Language Acquisition (1978) predicts that the degree of a learner's success in second language (L2) acquisition depends upon the learner's degree of acculturation. Attempts to test this theory have not been particularly fruitful due to the lack of an adequate measure of acculturation and the particular linguistic markers selected to measure success in L2 acquisition. This study proposes to measure sojourners' acculturation in terms of their social exchange networks (Milroy & Wei, 1995). It measures L2 success in terms of pronunciation, which in the view of many scholars (Guiora, Beit,Hallahmi, Brannon, Dull, & Scovel, 1972; Labov, 1972; Scovel, 1988) is the strongest linguistic marker of a speaker's cultural identification. Using this framework, the current study provides strong evidence in support of Schumann's Acculturation Theory. The acculturation experiences and L2 pronunciation of 9 American women residing in Norway are described and the relationship examined. It is concluded that learners who developed positive network connections with native speakers of Norwegian evidenced more native,like pronunciation than those who had greater difficulty establishing such relationships. [source] The breast cancer experience of rural women: a literature reviewPSYCHO-ONCOLOGY, Issue 10 2007B. Ann Bettencourt Abstract This report is a review of studies that focus on rural breast cancer survivorship. It includes a total of 14 studies using large databases and 27 other studies using qualitative and quantitative methods. In our review of this literature, we identified four broad themes, including access to treatment and treatment type, medical providers and health information, psychosocial adjustment and coping, and social support and psychological support services. We review the findings of the rural breast cancer survivorship studies within each of these broad themes. A few of the findings of the review include that rural and urban women receive different primary treatments for breast cancer, that rural women may have greater difficulty negotiating their traditional gender roles during and after treatment, that rural women desire greater health-related information about their breast cancer, and that rural women have less access to mental health therapy. The review discusses the implications of these findings as well as the weakness in the literature. Copyright © 2007 John Wiley & Sons, Ltd. [source] Neural control of shortening and lengthening contractions: influence of task constraintsTHE JOURNAL OF PHYSIOLOGY, Issue 24 2008Jacques Duchateau Although the performance capabilities of muscle differ during shortening and lengthening contractions, realization of these differences during functional tasks depends on the characteristics of the activation signal discharged from the spinal cord. Fundamentally, the control strategy must differ during the two anisometric contractions due to the lesser force that each motor unit exerts during a shortening contraction and the greater difficulty associated with decreasing force to match a prescribed trajectory during a lengthening contraction. The activation characteristics of motor units during submaximal contractions depend on the details of the task being performed. Indexes of the strategy encoded in the descending command, such as coactivation of antagonist muscles and motor unit synchronization, indicate differences in cortical output for the two types of anisometric contractions. Furthermore, the augmented feedback from peripheral sensory receptors during lengthening contractions appears to be suppressed by centrally and peripherally mediated presynaptic inhibition of Ia afferents, which may also explain the depression of voluntary activation that occurs during maximal lengthening contractions. Although modulation of the activation during shortening and lengthening contractions involves both supraspinal and spinal mechanisms, the association with differences in performance cannot be determined without more careful attention to the details of the task. [source] Assessment of childhood diabetes-related quality-of-life in West SwedenACTA PAEDIATRICA, Issue 2 2009J E Chaplin Abstract Aim: To investigate health-related quality-of-life (HrQoL) in childhood diabetes and the level of agreement between West Sweden and European reference data for the new multi-cultural European questionnaire , DISABKIDS. Method: Twenty percent of the Swedish paediatric diabetes population was included in the survey. Child-parent pairs completed the DISABKIDS chronic generic (37 questions) and diabetes modules (10 questions) during their routine clinic visit. A one-page results summary, based on positive domains, was used to provide feedback to clinicians. Results: Three hundred and sixty-one child-parent pairs were included in the analysis. In Sweden, diabetes was perceived by the children as having less impact than the European average. Swedish parents rated the HrQoL of their children lower than did the European parents. Swedish girls had a lower HrQoL than boys and greater difficulty accepting their diabetes; adolescents had greater difficulty accepting the diagnosis than younger children. Parents reported greater impact of diabetes on their children than the children themselves but reported no difference between boys and girls. Parents reported better acceptance of treatment in boys. The child's reported quality-of-life (QoL) is related to age and gender. Conclusion: Our results confirm the applicability of DISABKIDS to the Swedish paediatric diabetes population. [source] | |||||||||||||||||||