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Socioeconomic
Terms modified by Socioeconomic Selected AbstractsStrategies for Successful Marine Conservation: Integrating Socioeconomic, Political, and Scientific FactorsCONSERVATION BIOLOGY, Issue 6 2005CAROLYN J. LUNDQUIST áreas marinas protegidas; planificación de conservación; reservas marinas Abstract:,As the process of marine-protected-area design and implementation evolves, the incorporation of new tools will advance our ability to create and maintain effective protected areas. We reviewed characteristics and approaches that contribute to successful global marine conservation efforts. One successful characteristic emphasized in most case studies is the importance of incorporating stakeholders at all phases of the process. Clearly defined goals and objectives at all stages of the design process are important for improved communication and standardized expectations of stakeholder groups. The inclusion of available science to guide the size and design of marine protected areas and to guide clear monitoring strategies that assess success at scientific, social, and economic levels is also an important tool in the process. Common shortcomings in marine conservation planning strategies include government instability and resultant limitations to monitoring and enforcement, particularly in developing nations. Transferring knowledge to local community members has also presented challenges in areas where in situ training, local capacity, and existing infrastructure are sparse. Inaccessible, unavailable, or outdated science is often a limitation to conservation projects in developed and developing nations. To develop and maintain successful marine protected areas, it is necessary to acknowledge that each case is unique, to apply tools and lessons learned from other marine protected areas, and to maintain flexibility to adjust to the individual circumstances of the case at hand. Resumen:,A medida que evoluciona el proceso de diseño e implementación de áreas marinas protegidas, la incorporación de nuevas herramientas mejorará nuestra habilidad para crear y mantener áreas protegidas efectivas. Revisamos las características y enfoques que contribuyen a los esfuerzos exitosos de conservación marina global. La importancia de incorporar a los actores en todas las fases del proceso es una característica exitosa enfatizada en la mayoría de los estudios de caso. Es importante que haya metas y objetivos claramente definidos para todas las etapas del proceso de diseño para mejorar la comunicación y estandarizar las expectativas de los grupos interesados. La inclusión de la ciencia disponible para guiar el tamaño y diseño de áreas marinas protegidas y para guiar las estrategias de monitoreo que evalúa el éxito a nivel científico, social y económico también son herramientas importantes en el proceso. Defectos comunes en las estrategias de planificación de conservación marina incluyen la inestabilidad gubernamental y las resultantes limitaciones para el monitoreo y vigilancia, particularmente en países en desarrollo. La transferencia de conocimiento a miembros de la comunidad local también ha enfrentado retos en áreas donde el entrenamiento in situ, la aptitud local y la infraestructura existente son escasos. La ciencia inaccesible, no disponible u obsoleta a menudo es una limitación para los proyectos de conservación en países desarrollados y en desarrollo. Para desarrollar y mantener áreas marinas protegidas exitosas, es necesario reconocer que cada caso es único, aplicar herramientas y lecciones aprendidas en otras áreas marinas protegidas y mantener la flexibilidad para ajustarse a las circunstancias individuales de cada caso. [source] Bridging the Ethnic Divide: Student and School Characteristics in African American, Asian-Descent, Latino, and White Adolescents' Cross-Ethnic Friend NominationsJOURNAL OF RESEARCH ON ADOLESCENCE, Issue 1 2005Jill V. Hamm Based on the revised social contact theory, correlates of cross-ethnic friend nomination among 580 African American, 948 Asian-descent, 860 Latino, and 3986 White adolescents were examined. Socioeconomic and academic disparities between ethnic groups differentiated cross-ethnic friend nomination between schools for all groups but African Americans. For all groups, cross-ethnic friend nomination was less likely among students who preferred same-ethnic friends. Academic orientations were associated with cross-ethnic friend nomination positively for African American and Latino, but negatively for White participants. Longer family residence in the U.S. and English language facility was associated positively with cross-ethnic friend nomination for Asian-descent and Latino participants. Results point to the need to differentiate hypotheses by ethnic group, and to consider individual-in-context models in cross-ethnic friend nomination. [source] Prevalence of overweight and obesity in Eti-Osa LGA, Lagos, NigeriaOBESITY REVIEWS, Issue 6 2007U. P. Ben-Bassey Summary In many of the urban centres of the developing countries, a change in lifestyle due to increased affluence has been observed. It has been shown that change in lifestyle is an important factor in the global epidemic of overweight and obesity. The aim of this study was to assess the influence of lifestyle and socioeconomic class on the prevalence of overweight and obesity amongst adolescents from rural and urban centres in Lagos, Nigeria. This is a cross-sectional prospective survey carried out on a sample of 1504 randomly selected adolescents, aged between 10 and 19 years, from six public secondary schools located in urban and rural areas of the Eti-Osa local government area of Lagos State, Nigeria. A self-designed completed questionnaire was used to determine the participants' socio-demographic characteristics. Anthropometric measurements were taken to calculate their body mass index (BMI). The overall prevalence rates of overweight and obesity in the urban and rural areas, respectively, were 3.7% and 0.4%, and 3.0% and 0.0%. Socioeconomic class did not significantly affect the BMI values. Overweight is an evolving problem, while obesity is seemingly not a problem yet in adolescent school-aged children in Lagos State, Nigeria. [source] Socioeconomic and lifestyle determinants of body fat distribution in young working males from Cracow, PolandAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2008Agnieszka Suder The aim of the study was to determine the degree of explanation of the central adiposity variation, presented by waist circumference (WC), waist-hip ratio (WHR), and the sum of the three trunk skinfold thicknesses (subscapular, abdominal, suprailiac) (TTS) through the socioeconomic status (SES) and lifestyle. The material included cross-sectional population-based research of 259 healthy working males aged 20,30 from the city of Cracow, Poland. Objective anthropometric measurements, the results of motor fitness tests, and social and lifestyle data from a questionnaire were analyzed. The independent variables were: age, SES (the birthplace, place of residence until the age of 14, social class, educational level, and the type of work done), and lifestyle elements (smoking habits, dietary habits, family obesity resemblance, sport activity in the past, leisure time physical activity (LTPA), and the level of motor fitness). Three separate full models were created using stepwise straightforward regression with WC, WHR, and TTS as dependent variables. The highest autonomous influence on WC was ascribed to age, level of motor fitness, and family obesity resemblance. Variation in WHR was explained by age, level of motor fitness, upper-middle class, LTPA, and village as the birthplace. Level of motor fitness, place of residence until the age of 14 (city), age, smoking fewer than 20 cigarettes a day, and family obesity resemblance had greatest influence on TTS. The findings indicated the importance, besides age, of lifestyle elements connected with motor fitness and LTPA in determining body fat distribution in young working males. Am. J. Hum. Biol., 2008. © 2007 Wiley-Liss, Inc. [source] Driven to Tiers: Socioeconomic and Racial Disparities in the Quality of Nursing Home CareTHE MILBANK QUARTERLY, Issue 2 2004VINCENT MOR Nursing home care is currently a two-tiered system. The lower tier consists of facilities housing mainly Medicaid residents and, as a result, has very limited resources. The nearly 15 percent of U.S. nonhospital-based nursing homes that serve predominantly Medicaid residents have fewer nurses, lower occupancy rates, and more health-related deficiencies. They are more likely to be terminated from the Medicaid/Medicare program, are disproportionately located in the poorest counties, and are more likely to serve African-American residents than are other facilities. The public reporting of quality indicators, intended to improve quality through market mechanisms, may result in driving poor homes out of business and will disproportionately affect nonwhite residents living in poor communities. This article recommends a proactive policy stance to mitigate these consequences of quality competition. [source] Antimalarial treatment may have a time-dependent effect on lupus survival: Data from a multinational Latin American inception cohortARTHRITIS & RHEUMATISM, Issue 3 2010Samuel K. Shinjo Objective To evaluate the beneficial effect of antimalarial treatment on lupus survival in a large, multiethnic, international longitudinal inception cohort. Methods Socioeconomic and demographic characteristics, clinical manifestations, classification criteria, laboratory findings, and treatment variables were examined in patients with systemic lupus erythematosus (SLE) from the Grupo Latino Americano de Estudio del Lupus Eritematoso (GLADEL) cohort. The diagnosis of SLE, according to the American College of Rheumatology criteria, was assessed within 2 years of cohort entry. Cause of death was classified as active disease, infection, cardiovascular complications, thrombosis, malignancy, or other cause. Patients were subdivided by antimalarial use, grouped according to those who had received antimalarial drugs for at least 6 consecutive months (user) and those who had received antimalarial drugs for <6 consecutive months or who had never received antimalarial drugs (nonuser). Results Of the 1,480 patients included in the GLADEL cohort, 1,141 (77%) were considered antimalarial users, with a mean duration of drug exposure of 48.5 months (range 6,98 months). Death occurred in 89 patients (6.0%). A lower mortality rate was observed in antimalarial users compared with nonusers (4.4% versus 11.5%; P< 0.001). Seventy patients (6.1%) had received antimalarial drugs for 6,11 months, 146 (12.8%) for 1,2 years, and 925 (81.1%) for >2 years. Mortality rates among users by duration of antimalarial treatment (per 1,000 person-months of followup) were 3.85 (95% confidence interval [95% CI] 1.41,8.37), 2.7 (95% CI 1.41,4.76), and 0.54 (95% CI 0.37,0.77), respectively, while for nonusers, the mortality rate was 3.07 (95% CI 2.18,4.20) (P for trend < 0.001). After adjustment for potential confounders in a Cox regression model, antimalarial use was associated with a 38% reduction in the mortality rate (hazard ratio 0.62, 95% CI 0.39,0.99). Conclusion Antimalarial drugs were shown to have a protective effect, possibly in a time-dependent manner, on SLE survival. These results suggest that the use of antimalarial treatment should be recommended for patients with lupus. [source] SITEs revisited: Socioeconomic and demographic contours of small island tourist economiesASIA PACIFIC VIEWPOINT, Issue 1 2010Jerome L. McElroy Abstract This study attempts to do three things: (i) provide a review of recent advances in the small island economy literature using the tourism penetration index, (ii) update the impact of tourism across the same global sample of 36 small islands (less than 1 million in population and 5000 km2 in area) introduced in APV 47 (1) 2006, and (iii) employing an abbreviated version of the destination life cycle as a development paradigm, construct three different socioeconomic and demographic profiles based on low, intermediate and high tourism impact. Results using cross-sectional data of 27 indicators reveal three statistically distinct profiles that demonstrate three stages of economic development. Specifically, the findings contrast the low-income, labour-exporting, least tourism-penetrated MIRAB-type (Migrant/Remittances and Aid/Bureaucracy) emerging islands with their more advanced intermediate impact neighbours. In turn, the latter fall at a significant distance from the most successful small island tourist economy (SITE) destinations. Thus, this study further refines the characteristics of SITE islands and confirms the viability of tourism in general and the destination life cycle in particular as an effective engine and model, respectively, of island development. [source] Influence of socioeconomic and cultural factors on rural healthAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2009John R. Beard Abstract Objective:,To provide a framework for investigating the influence of socioeconomic and cultural factors on rural health. Design:,Discussion paper. Results:,Socioeconomic and cultural factors have long been thought to influence an individual's health. We suggest a framework for characterising these factors that comprises individual-level (e.g. individual socioeconomic status, sex, race) and neighbourhood-level dimensions (population composition, social environment, physical environment) operating both independently and through interaction. Recent spatial research suggests that in rural communities, socioeconomic disadvantage and indigenous status are two of the greatest underlying influences on health status. However, rural communities also face additional challenges associated with access to, and utilisation of, health care. The example is given of procedural angiography for individuals with an acute coronary event. Conclusions:,Socioeconomic and cultural factors specific to rural Australia are key influences on the health of residents. These range from individual-level factors, such as rural stoicism, poverty and substance use norms, to neighbourhood-level social characteristics, such as lack of services, migration out of rural areas of younger community members weakening traditionally high levels of social cohesion, and to environmental factors, such as climate change and access to services. [source] A place to play: Socioeconomic and spatial factors in children's physical activityAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 1 2008Jenny Ziviani Background and aims:,Concerns about physical inactivity in children and growing levels of obesity are expressed by politicians, health economists and those involved with the health and well-being of children. As this has the potential to be a major health issue, the aim of this investigation was to explore any contributing socioenvironmental considerations. Methods and results:,Census-matched survey data were analysed from 318 parents of 6- to 7-year-old children, revealing that family socioeconomic status (SES) influenced the places where children engaged in physical activity. Children from low SES backgrounds spent significantly more time playing close to their homes, and their families were less able to afford access to commercial physical-activity facilities, than those from middle and high SES families. Although neighbourhood-based activities are generally associated with more spontaneous free play, such activities may not provide the same opportunities for supervision and physical skill building available through commercial-based activities. Conclusions:,Given that access to ,enriching' physical-activity spaces may be limited by the capacity to pay, these findings have implications for professionals such as occupational therapists who can take on a role in advocating for equity in access and promotion of a more engaging urban design. Dialogue with urban planners is central to this process. [source] The sex of the individual as a factor in allergic contact dermatitisCONTACT DERMATITIS, Issue 2 2004B. S. Modjtahedi Exogenous and endogenous factors have been implicated in allergic contact dermatitis (ACD); this review explores the sex of the individual as a possible endogenous factor. While there is a clinical impression that women are more skin-reactive than men, upon review this hypothesis appears oversimplified. This review explores sex differences in controlled testing of adult ACD, occupational ACD and juvenile ACD. Further, geographical location and socioeconomic and cultural factors in relation to sex differences in allergic contact dermatitis are discussed. We conclude that female sex could be a factor predisposing to allergic contact dermatitis not so much because of possible differences in intrinsic skin characteristics between the sexes, but more because of different exposure patterns. This conclusion has practical consequences regarding product labelling requirements, occupational risk assessment and legislation. [source] Psychological resilience and neurocognitive performance in a traumatized community sample,DEPRESSION AND ANXIETY, Issue 8 2010Aliza P. Wingo M.D. Abstract Background: Whether psychological resilience correlates with neurocognitive performance is largely unknown. Therefore, we assessed association between neurocognitive performance and resilience in individuals with a history of childhood abuse or trauma exposure. Methods: In this cross-sectional study of 226 highly traumatized civilians, we assessed neurocognitive performance, history of childhood abuse and other trauma exposure, and current depressive and PTSD symptoms. Resilience was defined as having ,1 trauma and no current depressive or PTSD symptoms; non-resilience as having ,1 trauma and current moderate/severe depressive or PTSD symptoms. Results: The non-resilient group had a higher percentage of unemployment (P=.006) and previous suicide attempts (P<.0001) than the resilient group. Both groups had comparable education and performance on verbal reasoning, nonverbal reasoning, and verbal memory. However, the resilient group performed better on nonverbal memory (P=.016) with an effect size of .35. Additionally, more severe childhood abuse or other trauma exposure was significantly associated with non-resilience. Better nonverbal memory was significantly associated with resilience even after adjusting for severity of childhood abuse, other trauma exposure, sex, and race using multiple logistic regression (adjusted OR=1.2; P=.017). Conclusions: We examined resilience as absence of psychopathology despite trauma exposure in a highly traumatized, low socioeconomic, urban population. Resilience was significantly associated with better nonverbal memory, a measure of ability to code, store, and visually recognize concrete and abstract pictorial stimuli. Nonverbal memory may be a proxy for emotional learning, which is often dysregulated in stress-related psychopathology, and may contribute to our understanding of resilience. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Serum adiponectin and resistin levels in major depressive disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2010S. M. Lehto Lehto SM, Huotari A, Niskanen L, Tolmunen T, Koivumaa-Honkanen H, Honkalampi K, Ruotsalainen H, Herzig K-H, Viinamäki H, Hintikka J. Serum adiponectin and resistin levels in major depressive disorder. Objective:, To examine the role of the adipose-tissue-derived low-grade inflammation markers adiponectin and resistin in major depressive disorder (MDD) in a population-based sample. Method:, Serum levels of adiponectin and resistin were measured from 70 DSM-IV MDD subjects and 70 healthy controls. Depression severity was assessed with the 29-item Hamilton Depression Rating Scale. Results:, The MDD group had lowered serum adiponectin levels. Regression modelling with adjustments for age, gender, overweight, several socioeconomic and lifestyle factors, coronary heart disease and metabolic syndrome showed that each 5.0 ,g/ml decrease in serum adiponectin increased the likelihood of MDD by approximately 20% (P = 0.01). The resistin levels correlated with atypical (P = 0.02), but not with typical depressive symptoms (P = 0.12). Conclusion:, Our findings suggest that the lowered adiponectin levels in MDD are depression-specific and not explained by conventional low adiponectin-related factors such as such as coronary heart disease and metabolic disorders. [source] From Soviet Modernization to Post,Soviet Transformation: Understanding Marriage and Fertility Dynamics in UzbekistanDEVELOPMENT AND CHANGE, Issue 3 2003Victor Agadjanian In this article we analyse the dynamics of marriage and childbearing in Uzbekistan through the prism of the recent socioeconomic and political history of that country. After becoming an independent nation in 1991, Uzbekistan abandoned the Soviet modernization project and aspired to set out on a radically different course of economic, social, and political development. We argue, however, that not only independence but also the preceding period of perestroika reforms (1985,91) had a dramatic effect on social conditions and practices and, consequently, the demographic behaviour of the country's population. Using data from the 1996 Uzbekistan Demographic and Health Survey we apply event,history analysis to examine changes in the timing of entry into first marriage, first and second births over four periods: two periods of pre,perestroika socialism, the perestroika years, and the period since independence. We investigate the factors that influenced the timing of these events in each of the four periods among Uzbeks, the country's eponymous and largest ethnic group, and among Uzbekistan's urban population. In general, our results point to a dialectic combination of continuity and change in Uzbekistan's recent demographic trends, which reflect the complex and contradictory nature of broader societal transformations in that and other parts of the former Soviet Union. [source] Community Resilience and Volcano Hazard: The Eruption of Tungurahua and Evacuation of the Faldas in EcuadorDISASTERS, Issue 1 2002Graham A. Tobin Official response to explosive volcano hazards usually involves evacuation of local inhabitants to safe shelters. Enforcement is often difficult and problems can be exacerbated when major eruptions do not ensue. Families are deprived of livelihoods and pressure to return to hazardous areas builds. Concomitantly, prevailing socioeconomic and political conditions limit activities and can influence vulnerability. This paper addresses these issues, examining an ongoing volcano hazard (Tungurahua) in Ecuador where contextual realities significantly constrain responses. Fieldwork involved interviewing government officials, selecting focus groups and conducting surveys of evacuees in four locations: a temporary shelter, a permanent resettlement, with returnees and with a control group. Differences in perceptions of risk and health conditions, and in the potential for economic recovery were found among groups with different evacuation experiences. The long-term goal is to develop a model of community resilience in long-term stress environments. [source] Cytogenetic status in newborns and their parents in Madrid: The BioMadrid studyENVIRONMENTAL AND MOLECULAR MUTAGENESIS, Issue 4 2010Virginia Lope Abstract Monitoring cytogenetic damage is frequently used to assess population exposure to environmental mutagens. The cytokinesis-block micronucleus assay is one of the most widely used methods employed in these studies. In the present study we used this assay to assess the baseline frequency of micronuclei in a healthy population of father-pregnant woman-newborn trios drawn from two Madrid areas. We also investigated the association between micronucleus frequency and specific socioeconomic, environmental, and demographic factors collected by questionnaire. Mercury, arsenic, lead, and cadmium blood levels were measured by atomic absorption spectrometry. The association between micronucleated cell frequency and the variables collected by questionnaire, as well as, the risk associated with the presence of elevated levels of metals in blood, was estimated using Poisson models, taking the number of micronucleated cells in 1,000 binucleated cells (MNBCs) as the dependent variable. Separate analyses were conducted for the 110 newborns, 136 pregnant women, and 134 fathers in whom micronuclei could be assessed. The mean number of micronucleated cells per 1,000 binucleated cells was 3.9, 6.5, and 6.1 respectively. Our results show a statistically significant correlation in MNBC frequency between fathers and mothers, and between parents and newborns. Elevated blood mercury levels in fathers were associated with significantly higher MNBC frequency, compared with fathers who had normal mercury levels (RR:1.21; 95%CI:1.02,1.43). This last result suggests the need to implement greater control over populations which, by reason of their occupation or life style, are among those most exposed to this metal. Environ. Mol. Mutagen., 2010. © 2009 Wiley-Liss, Inc. [source] The Epidemiology of Convulsive Status Epilepticus in Children: A Critical ReviewEPILEPSIA, Issue 9 2007Miquel Raspall-Chaure Summary:, There is ongoing debate regarding the most appropriate definition of status epilepticus. This depends upon the research question being asked. Based on the most widely used "30 min definition," the incidence of childhood convulsive status epilepticus (CSE) in developed countries is approximately 20/100,000/year, but will vary depending, among others, on socioeconomic and ethnic characteristics of the population. Age is a main determinant of the epidemiology of CSE and, even within the pediatric population there are substantial differences between older and younger children in terms of incidence, etiology, and frequency of prior neurological abnormalities or prior seizures. Overall, incidence is highest during the first year of life, febrile CSE is the single most common cause, around 40% of children will have previous neurological abnormalities and less than 15% will have a prior history of epilepsy. Outcome is mainly a function of etiology. However, the causative role of CSE itself on mesial temporal sclerosis and subsequent epilepsy or the influence of age, duration, or treatment on outcome of CSE remains largely unknown. Future studies should aim at clarifying these issues and identifying specific ethnic, genetic, or socioeconomic factors associated with CSE to pinpoint potential targets for its primary and secondary prevention. [source] Prevalence of alcohol use disorders and associated factors: a population-based study using AUDIT in southern BrazilADDICTION, Issue 6 2003Raúl A. Mendoza-Sassi ABSTRACT Aims To assess the prevalence of potential alcohol use disorders and associated factors using the Alcohol Use Disorders Identification Test (AUDIT). Design Cross-sectional study. Setting A town in southern Brazil. Participants A representative sample of 1260 people aged 15 and over. Measurements Demographic, socioeconomic, smoking habit and mental health data were collected. Logistic regression was used in the multivariate analysis, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Findings Overall prevalence of alcohol use disorder was 7.9%, with 14.5% prevalence among men and 2.4% among women. The risk of alcohol misuse increased across social class (P linear trend = 0.03) and compared with the highest classes (A and B), groups C through E had ORs of 1.48, 1.51 and 2.36, respectively. Males had an OR of 6.89 (CI 3.61,13.16) compared with women. A linear trend was found (P = 0.001) between smoking categories, and smokers (OR 3.27; CI 1.91,5.58) and ex-smokers (OR 1.30; CI 0.56,2.98) were at higher risk than non-smokers. Those with minor psychiatric disorders had a 2.48 OR (CI 1.35,4.56) of presenting a positive test. Conclusions The AUDIT detected a high prevalence of potential alcohol use disorders in the population sampled. Those identified are potential targets for preventive measures implemented through health policies. [source] A Model of Factors Correlated to Homeownership: The Case of UtahFAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 1 2001Lucy Delgadillo This article examines the relationship between homeownership and socioeconomic, demographic, and market factors in Utah. Units of analyses were census-designated places. The goal was to provide a model that can be replicated by housing specialists and consumer scientists to gain a better understanding of how homeownership (dependent variable) differs from place to place and how this variation relates to socioeconomic index, population density, affordability ratio, and the median value of owner occupied housing units (independent variables). The 1990 data set was analyzed using bivariate and multivariate analyses. Homeownership percentages were regressed on the linear combination of the socioeconomic scale, log of population density, and affordability ratios. Log of population density was the factor that explained most of the variance. The interaction equation slightly improved the explanatory power, accounting for more than 50% of the variance. [source] Loglinear Residual Tests of Moran's I Autocorrelation and their Applications to Kentucky Breast Cancer DataGEOGRAPHICAL ANALYSIS, Issue 3 2007Ge Lin This article bridges the permutation test of Moran's I to the residuals of a loglinear model under the asymptotic normality assumption. It provides the versions of Moran's I based on Pearson residuals (IPR) and deviance residuals (IDR) so that they can be used to test for spatial clustering while at the same time account for potential covariates and heterogeneous population sizes. Our simulations showed that both IPR and IDR are effective to account for heterogeneous population sizes. The tests based on IPR and IDR are applied to a set of log-rate models for early-stage and late-stage breast cancer with socioeconomic and access-to-care data in Kentucky. The results showed that socioeconomic and access-to-care variables can sufficiently explain spatial clustering of early-stage breast carcinomas, but these factors cannot explain that for the late stage. For this reason, we used local spatial association terms and located four late-stage breast cancer clusters that could not be explained. The results also confirmed our expectation that a high screening level would be associated with a high incidence rate of early-stage disease, which in turn would reduce late-stage incidence rates. [source] China's South-to-North Water Transfer Project: Is it Needed?GEOGRAPHY COMPASS (ELECTRONIC), Issue 9 2010Chansheng He China has started the construction of the South-to-North Water Transfer Project (SNWTP; its magnitude is even greater than the Three Gorges Dam Project), to deliver about 45 billion m3 of water from the Yangtze River to the water starving North China Plain. Is the project needed given the multiple socioeconomic, engineering, and environmental challenges and controversies it is facing and the effects of demand management programs China has been implementing in recent years? This article, through the analysis of the water shortage problems in the North China Plain and the Yellow River basin, demonstrates that considering China's current economic base, technological capacity, and income levels, the SNWTP, while facing multiple challenges, is still needed to relieve the water deficit problems in the North China Plain. However, the SNWTP is only a partial solution to North China's chronic water shortage problem. China should continue to actively implement and enforce its demand management programs nationwide to ensure that its limited fresh water resources are used to meet the multiple needs of human societies and ecosystems in a socially responsible, economically viable, and environmentally sustainable way. [source] Transboundary Aquifers: A Global Program to Assess, Evaluate, and Develop PolicyGROUND WATER, Issue 5 2005S. Puri Transboundary aquifers are as important a component of global water resource systems as are transboundary rivers; yet, their recognition in international water policy and legislation is very limited. Existing international conventions and agreements barely address aquifers and their resources. To rectify this deficiency, the International Association of Hydrogeologists and UNESCO's International Hydrological Programme have established the Internationally Shared (transboundary) Aquifer Resource Management (ISARM) Programme. This multiagency cooperative program has launched a number of global and regional initiatives. These are designed to delineate and analyze transboundary aquifer systems and to encourage riparian states to work cooperatively toward mutually beneficial and sustainable aquifer development. The agencies participating in ISARM include international and regional organizations (e.g., Organization of American States, United Nations Environment Programme, United Nations Economic Commission for Europe, Food and Agriculture Organization, and South African Development Community). Using outputs of case studies, the ISARM Programme is building scientific, legal, environmental, socioeconomic, and institutional guidelines and recommendations to aid sharing nations in the management of their transboundary aquifers. Since its start in 2000, the program has completed inventories of transboundary aquifers in the Americas and Africa, and several ISARM case studies have commenced. [source] Do social inequalities exist in terms of the prevention, diagnosis, treatment, control and monitoring of diabetes?HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2010A systematic review Abstract The major increase in the prevalence of diabetes mellitus (DM) has led to the study of social inequalities in health-care. The aim of this study is to establish the possible existence of social inequalities in the prevention, diagnosis, treatment, control and monitoring of diabetes in Organisation for Economic Co-operation and Development (OECD) countries which have universal healthcare systems. We searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews for all relevant articles published up to 15 December 2007. We included observational studies carried out in OECD countries with universal healthcare systems in place that investigate social inequalities in the provision of health-care to diabetes patients. Two independent reviewers carried out the critical assessment using the STROBE tool items considered most adequate for the evaluation of the methodological quality. We selected 41 articles from which we critically assessed 25 (18 cross-sectional, 6 cohorts, 1 case-control). Consistency among the article results was found regarding the existence of ethnic inequalities in treatment, metabolic control and use of healthcare services. Socioeconomic inequalities were also found in the diagnosis and control of the disease, but no evidence of any gender inequalities was found. In general, the methodological quality of the articles was moderate with insufficient information in the majority of cases to rule out bias. This review shows that even in countries with a significant level of economic development and which have universal healthcare systems in place which endeavour to provide medical care to the entire population, socioeconomic and ethnic inequalities can be identified in the provision of health-care to DM sufferers. However, higher quality and follow-up articles are needed to confirm these results. [source] Progressive segmented health insurance: Colombian health reform and access to health servicesHEALTH ECONOMICS, Issue 1 2007Fernando Ruiz Abstract Equal access for poor populations to health services is a comprehensive objective for any health reform. The Colombian health reform addressed this issue through a segmented progressive social health insurance approach. The strategy was to assure universal coverage expanding the population covered through payroll linked insurance, and implementing a subsidized insurance program for the poorest populations, those not affiliated through formal employment. A prospective study was performed to follow-up health service utilization and out-of-pocket expenses using a cohort design. It was representative of four Colombian cities (Cendex Health Services Use and Expenditure Study, 2001). A four part econometric model was applied. The model related medical service utilization and medication with different socioeconomic, geographic, and risk associated variables. Results showed that subsidized health insurance improves health service utilization and reduces the financial burden for the poorest, as compared to those non-insured. Other social health insurance schemes preserved high utilization with variable out-of-pocket expenditures. Family and age conditions have significant effect on medical service utilization. Geographic variables play a significant role in hospital inpatient service utilization. Both, geographic and income variables also have significant impact on out-of-pocket expenses. Projected utilization rates and a simulation favor a dual policy for two-stage income segmented insurance to progress towards the universal insurance goal. Copyright © 2006 John Wiley & Sons, Ltd. [source] Health care reform in BelgiumHEALTH ECONOMICS, Issue S1 2005Erik Schokkaert Abstract Curbing the growth of public sector health expenditures has been the proclaimed government objective in Belgium since the 1980s. However, the respect for freedom of choice for patients and for therapeutic freedom for providers has blocked the introduction of microeconomic incentives and quality control. Therefore , with some exceptions, particularly in the hospital sector , policy has consisted mainly of tariff and supply restrictions and increases in co-payments. These measures have not been successful in curbing the growth of expenditures. Moreover, there remains a large variation in medical practices. While the structure of health financing is relatively progressive from an international perspective, socioeconomic and regional inequalities in health persist. The most important challenge is the restructuring of the basic decision-making processes; i.e. a simplification of the bureaucratic procedures and a re-examination of the role of regional authorities and sickness funds. Copyright © 2002 John Wiley & Sons, Ltd. [source] Cradling in the prevention of excessive crying and colic symptoms in infantsINFANT MENTAL HEALTH JOURNAL, Issue 3 2005Elina Hyödynmaa To evaluate lying in a cradle in the prevention of excessive infant crying or colic symptoms, and to investigate potential protective or risk factors for the phenomenon, 220 newborns were randomized to sleep either in a bed or cot (control group, N = 108) or in a cradle (cradle group, N = 112). During three months, the parents filled in diaries on the sleeping place most used and the amount of crying of their infants. Three infants in the cradle group and one control fulfilled the criteria of colic. The percentages of extremely weepy infants (25.7% vs 24.4 %) and the intensity of crying did not differ between the groups. Medication for colic symptoms was used equally frequently in both groups. A high educational (OR 3.18, 95% CI 1.01; 10.04) and socioeconomic (OR 3.76, 95% CI 1.34; 10.52) level of the family and having a sibling with a history of colic (OR 6.46, 95% CI 1.17; 35.73) were predictors for the infant being weepy. Absence of nursing problems and having no sibling with a history of colic seemed to be related with a low amount of crying. Excessive infant crying was less common in families with unemployed fathers compared to those in which the father had an occupation (p = 0.018). Cradling seems not to prevent excessive crying or colic symptoms in infants. Breast-feeding guidance during rooming-in period and presence of father or another adult supporter at home might be preventive means against excessive crying. [source] Enhancing technology development through integrated environmental analysis: Toward sustainable nonlethal military systemsINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 2 2010Oral S. Saulters Abstract New technologies are not only critical in supporting traditional industrial and military success but also play a pivotal role in advancing sustainability and sustainable development. With the current global economic challenges, resulting in tighter budgets and increased uncertainty, synergistic paradigms and tools that streamline the design and dissemination of key technologies are more important than ever. Accordingly, a proactive and holistic approach can facilitate efficient research, design, testing, evaluation, and fielding for novel and off-the-shelf products, thereby assisting developers, end users, and other diverse stakeholders in better understanding tradeoffs in the defense industry and beyond. By prioritizing mechanisms such as strategic life-cycle environmental assessments (LCEA); programmatic environment, safety, and occupational health evaluations (PESHE); health hazard assessments (HHA); and other innovative platforms and studies early within systems engineering, various nonlethal military technologies have been successfully developed and deployed. These efforts provide a framework for addressing complex environment, safety, and occupational health risks that affect personnel, infrastructure, property, socioeconomic, and natural/cultural resources. Moreover, integrated, comprehensive, multidisciplinary, and iterative analyses involving flexible groups of specialists/subject matter experts can be applied at various spatiotemporal scales in support of collaborations. This paper highlights the Urban Operations Laboratory process utilized for inclusive and transformative environmental analysis, which can translate into advantages and progress toward sustainable systems. Integr Environ Assess Manag 2010;6:281,286. © 2009 SETAC [source] Product attributes, consumer benefits and public approval of genetically modified foodsINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 5 2003Ferdaus Hossain Abstract The use of biotechnology in food production has generated considerable debate involving the benefits and risks associated with its use. Consumer acceptance of genetically modified foods is a critical factor that will affect the future of this technology. Using data from a national survey, this study examines how public acceptance of food biotechnology is related to consumers' socioeconomic and value attributes as well as the benefits associated with the use of this technology. Empirical results suggest that consumer acceptance of food biotechnology increases considerably when the use of this technology brings tangible benefits for the public. Consumers with different socioeconomic and demographic attributes have diverging views of food biotechnology only when its use brings specific benefits to them. When the use of genetic technology confers no additional benefit, public attitudes towards genetically modified foods are driven primarily by their scientific knowledge, views of scientists and corporations associated with biotechnology as well as public trust and confidence in government. [source] Association between pacifier use and breast-feeding, sudden infant death syndrome, infection and dental malocclusionINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 6 2005Ann Callaghan RN RM BNurs(Hons) Executive summary Objective, To critically review all literature related to pacifier use for full-term healthy infants and young children. The specific review questions addressed are: What is the evidence of adverse and/or positive outcomes of pacifier use in infancy and childhood in relation to each of the following subtopics: ,breast-feeding; ,sudden infant death syndrome; ,infection; ,dental malocclusion. Inclusion criteria, Specific criteria were used to determine which studies would be included in the review: (i) the types of participants; (ii) the types of research design; and (iii) the types of outcome measures. To be included a study has to meet all criteria. Types of participants,The participants included in the review were healthy term infants and healthy children up to the age of 16 years. Studies that focused on preterm infants, and infants and young children with serious illness or congenital malformations were excluded. However, some total population studies did include these children. Types of research design, It became evident early in the review process that very few randomised controlled trials had been conducted. A decision was made to include observational epidemiological designs, specifically prospective cohort studies and, in the case of sudden infant death syndrome research, case,control studies. Purely descriptive and cross-sectional studies were excluded, as were qualitative studies and all other forms of evidence. A number of criteria have been proposed to establish causation in the scientific and medical literature. These key criteria were applied in the review process and are described as follows: (i) consistency and unbiasedness of findings; (ii) strength of association; (iii) temporal sequence; (iv) dose,response relationship; (v) specificity; (vi) coherence with biological background and previous knowledge; (vii) biological plausibility; and (viii) experimental evidence. Studies that did not meet the requirement of appropriate temporal sequencing of events and studies that did not present an estimate of the strength of association were not included in the final review. Types of outcome measures,Our specific interest was pacifier use related to: ,breast-feeding; ,sudden infant death syndrome; ,infection; ,dental malocclusion. Studies that examined pacifier use related to procedural pain relief were excluded. Studies that examined the relationship between pacifier use and gastro-oesophageal reflux were also excluded as this information has been recently presented as a systematic review. Search strategy, The review comprised published and unpublished research literature. The search was restricted to reports published in English, Spanish and German. The time period covered research published from January 1960 to October 2003. A protocol developed by New Zealand Health Technology Assessment was used to guide the search process. The search comprised bibliographic databases, citation searching, other evidence-based and guidelines sites, government documents, books and reports, professional websites, national associations, hand search, contacting national/international experts and general internet searching. Assessment of quality, All studies identified during the database search were assessed for relevance to the review based on the information provided in the title, abstract and descriptor/MeSH terms, and a full report was retrieved for all studies that met the inclusion criteria. Studies identified from reference list searches were assessed for relevance based on the study title. Keywords included: dummy, dummies, pacifier(s), soother(s), comforter(s), non-nutritive sucking, infant, child, infant care. Initially, studies were reviewed for inclusion by pairs of principal investigators. Authorship of articles was not concealed from the reviewers. Next, the methodological quality of included articles was assessed independently by groups of three or more principal investigators and clinicians using a checklist. All 20 studies that were accepted met minimum set criteria, but few passed without some methodological concern. Data extraction, To meet the requirements of the Joanna Briggs Institute, reasons for acceptance and non-acceptance at each phase were clearly documented. An assessment protocol and report form was developed for each of the three phases of review. The first form was created to record investigators' evaluations of studies included in the initial review. Those studies that failed to meet strict inclusion criteria were excluded at this point. A second form was designed to facilitate an in-depth critique of epidemiological study methodology. The checklist was pilot tested and adjustments were made before reviewers were trained in its use. When reviewers could not agree on an assessment, it was passed to additional reviewers and discussed until a consensus was reached. At this stage, studies other than cohort, case,control and randomised controlled trials were excluded. Issues of clarification were also addressed at this point. The final phase was that of integration. This phase, undertaken by the principal investigators, was assisted by the production of data extraction tables. Through a process of trial and error, a framework was formulated that adequately summarised the key elements of the studies. This information was tabulated under the following headings: authors/setting, design, exposure/outcome, confounders controlled, analysis and main findings. Results, With regard to the breast-feeding outcome, 10 studies met the inclusion criteria, comprising two randomised controlled trials and eight cohort studies. The research was conducted between 1995 and 2003 in a wide variety of settings involving research participants from diverse socioeconomic and cultural backgrounds. Information regarding exposure and outcome status, and potential confounding factors was obtained from: antenatal and postnatal records; interviews before discharge from obstetric/midwifery care; post-discharge interviews; and post-discharge postal and telephone surveys. Both the level of contact and the frequency of contact with the informant, the child's mother, differed widely. Pacifier use was defined and measured inconsistently, possibly because few studies were initiated expressly to investigate its relationship with breast-feeding. Completeness of follow-up was addressed, but missing data were not uniformly identified and explained. When comparisons were made between participants and non-participants there was some evidence of differential loss and a bias towards families in higher socioeconomic groups. Multivariate analysis was undertaken in the majority of studies, with some including a large number of sociodemographic, obstetric and infant covariates and others including just maternal age and education. As might be expected given the inconsistency of definition and measurement, the relationship between pacifier use and breast-feeding was expressed in many different ways and a meta-analysis was not appropriate. In summary, only one study did not report a negative association between pacifier use and breast-feeding duration or exclusivity. Results indicate an increase in risk for a reduced overall duration of breast-feeding from 20% to almost threefold. The data suggest that very infrequent use may not have any overall negative impact on breast-feeding outcomes. Six sudden infant death syndrome case,control studies met the criteria for inclusion. The research was conducted with information gathered between 1984 and 1999 in Norway, UK, New Zealand, the Netherlands and USA. Exposure information was obtained from a variety of sources including: hospital and antenatal records, death scene investigation, and interview and questionnaire. Information for cases was sought within 2 days after death, within 2,4 weeks after death and in one study between 3 and 11 years after death. Information for controls was sought from as early as 4 days of a nominated sudden infant death syndrome case, to between 1 and 7 weeks from the case date, and again in one study some 3,11 years later. In the majority of the studies case ascertainment was determined by post-mortem. Pacifier use was again defined and measured somewhat inconsistently. All studies controlled for confounding factors by matching and/or using multivariate analysis. Generally, antenatal and postnatal factors, as well as infant care practices, and maternal, family and socioeconomic issues were considered. All five studies reporting multivariate results found significantly fewer sudden infant death syndrome cases used a pacifier compared with controls. That is, pacifier use was associated with a reduced incidence of sudden infant death syndrome. These results indicate that the risk of sudden infant death syndrome for infants who did not use a pacifier in the last or reference sleep was at least twice, and possibly five times, that of infants who did use a pacifier. Three studies reported a moderately sized positive association between pacifier use and a variety of infections. Conversely, one study found no positive association between pacifier use at 15 months of age and a range of infections experienced between the ages of 6 and 18 months. Given the limited number of studies available and the variability of results, no meaningful conclusions could be drawn. Five cohort studies and one case,control study focused on the relationship between pacifier use and dental malocclusion. Not one of these studies reported a measure of association, such as an estimate of relative risk. It was therefore not possible to include these studies in the final review. Implications for practice, It is intended that this review be used as the basis of a ,best practice guideline', to make health professionals aware of the research evidence concerning these health and developmental consequences of pacifier use, because parents need clear information on which they can base child care decisions. With regard to the association between pacifier use and infection and dental malocclusion it was found that, due to the paucity of epidemiological studies, no meaningful conclusion can be drawn. There is clearly a need for more epidemiological research with regard to these two outcomes. The evidence for a relationship between pacifier use and sudden infant death syndrome is consistent, while the exact mechanism of the effect is not well understood. As to breast-feeding, research evidence shows that pacifier use in infancy is associated with a shorter duration and non-exclusivity. It is plausible that pacifier use causes babies to breast-feed less, but a causal relationship has not been irrefutably proven. Because breast-feeding confers an important advantage on all children and the incidence of sudden infant death syndrome is very low, it is recommended that health professionals generally advise parents against pacifier use, while taking into account individual circumstances. [source] Geographic Mobility and Spatial Assimilation among U. S. Latino Immigrants,INTERNATIONAL MIGRATION REVIEW, Issue 3 2005Scott J. South Although the spatial assimilation of immigrants to the United States has important implications for social theory and social policy, few studies have explored the atterns and determinants of interneighborhood geographic mobility that lead to immigrants'residential proximity to the white, non-Hispanic majority. We explore this issue by merging data from three different sources - the Latino National Political Survey, the Panel Study of Income Dynamics, and tract-level census data - to begin unraveling causal relationships among indicators of socioeconomic, social, cultural, segmented, and spatial assimilation. Our longitudinal analysis of 700 Mexican, Puerto Rican, and Cuban immigrants followed from 1990 to 1995 finds broad support for hypotheses derived from the classical account of minority assimilation. High income, English language use, and embeddedness in Anglo social contexts increase Latino immigrants'geographic mobility into Anglo neighborhoods. U. S. citizenship and years spent in the United Stares are ppsidvely associated with geographic mobility into more Anglo neighbor oods, and coethnic contact is inversely associated with this form of mobility, but these associations operate largely through other redictors. Prior experiences of ethnic discrimination increase and residence in public housing decreases the likelihood that Latino immigrants will move from their origin neighborhoods, while residing in metropolitan areas with large Latino populations leads to geographic moves into "less Anglo" census tracts. [source] Social Policymaking and Its Institutional Basis: Transition of The Chinese Social Security SystemINTERNATIONAL SOCIAL SECURITY REVIEW, Issue 2 2006Ka Lin This article discusses Chinese social policy development in response to the growth of the market economy. It provides a general overview of the system's evolution in three stages: (1) the pre-reform period when a system of enterprise welfare was in operation; (2) a period of system transition; (3) the stage when state welfare began to take shape. These developmental trends are interpreted on the basis of three types of institutional relations: the State-enterprise relation, the enterprise- (or employer-) employee relation, and the individual/worker-State relation. Moreover, the discussion deals with policy perceptions at each stage of the developmental process. Based on these analyses, it illustrates the transformation of the Chinese social security system in a broad socioeconomic and political context, where China struggled to establish a modern, market-based enterprise system. The paper thus expounds issues of socialism, market forces and the power of organized labour. [source] | ||||||||||||||||||||||||||||