Environmental policy in economies in transition.
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Considerable improvement in environmental pollution has been achieved, primarily due to targeted environmental policies rather than general economic developments. Some countries in central and eastern Europe have managed to reduce emissions even after the gross domestic product once again began to increase. Everywhere in the region, however, the cost-effectiveness of environmental spending is questionable. Most countries have established systems of earmarked resource and pollution taxes, which provide a sizable share in financing environmental investment. With stationary sources of pollution brought under increasingly effective control, the environmental problems in central and eastern Europe, and eventually in the newly independent states, will start to resemble those of developed market economies. As more activities become affected by environmental protection measures, cost-effectiveness considerations deserve increased attention. (+info)
Information technology and knowledge exchange in health-care organizations.
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Despite the increasing global interest in information technology among health care institutions, little has been discussed about its importance for the effectiveness of knowledge management. In this study, economic theories are used to analyze and describe a theoretical framework for the use of information technology in the exchange of knowledge. The analyses show that health care institutions would benefit from developing global problem-solving collaboration, which allows practitioners to exchange knowledge unrestricted by time and geographical barriers. The use of information technology for vertical integration of health-care institutions would reduce knowledge transaction costs, i.e. decrease costs for negotiating and creating communication channels, and facilitating the determination of what, when, and how to produce knowledge. A global network would allow organizations to increase existing knowledge, and thus total productivity, while also supporting an environment where the generation of new ideas is unrestricted. Using all the intellectual potential of market actors and thereby releasing economic resources can reduce today's global budget conflicts in the public sector, i.e. the necessity to choose between health care services and, for instance, schools and support for the elderly. In conclusion, global collaboration and coordination would reduce the transaction costs inherent in knowledge administration and allow a more effective total use of scarce health-care resources. (+info)
Teaching international animal agriculture.
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Students who major in animal science at U.S. institutions are generally exposed to a curriculum that emphasizes commercial, large-scale production of the few traditional food animals: cattle, poultry, sheep, and swine. Globally, most farmers live in lesser-developed countries under limited-resource conditions of land, feed supplies, equipment, and capital. The promotion of commercial animal production enterprises may not be appropriate for such farms because it can subject farmers to considerable economic risk. Rather, use of limited numbers of large livestock, locally adapted breeds, or smaller livestock (e.g., ducks, goats, guinea pigs, and rabbits) may be more appropriate under subsistence, integrated farming systems. In this global context, a course in international animal agriculture has been taught for 15 yr to undergraduate and graduate students. The course consists of a review of traditional and potential livestock species well suited for impoverished families on small farms and methods to implement sustainable livestock projects, including feasibility, design, implementation, monitoring, and evaluation stages. To enhance student understanding, global food issues and challenges are illustrated with case studies. A term paper is also assigned for which students choose three suitable livestock species or local breeds that would be complementary on a small crop farm (< 5 ha). Daily dietary requirements of protein and energy per family member are calculated. Itemized enterprise budgets and production tables are prepared. Early in the course, the general consensus of students was that people who are malnourished and live in poverty have low personal ambition and motivation, and that their problems should be amenable to solution by application of American technology and expertise. The course modifies such attitudes and enhances a student's critical thinking and problem-solving abilities and communication skills. Course evaluations indicated that students believed that it is important to acquire some international knowledge and understanding when seeking a job, and that certain animal science courses should contain some international content. Students gain an understanding of global animal agriculture and an appreciation of the complexity of food production and hunger issues. (+info)
An international study on the acceptability of a once-a-month pill.
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Totals of 450 women attending family planning clinics in Hong Kong, Shanghai and Edinburgh, and 468 in Cape Town, completed a questionnaire designed to seek their views on a contraceptive pill which would be taken only once each month. At least two-thirds of the women in all centres liked the idea of a once-a-month pill. In Hong Kong, Cape Town and Edinburgh, women preferred a pill which inhibited ovulation to one which inhibited implantation, while in all centres a pill which worked after implantation (early menstrual inducer) was considered unacceptable by over half the women. A pill which was taken after a missed menstrual period was considered preferable in all centres, perhaps because it would not be used every month but rather only if pregnancy had occurred. No demographic characteristics, contraceptive experiences or beliefs were consistently correlated with attitudes towards a once-a-month pill, except that women who would not consider having an abortion were more likely to dislike a method that either prevented, or worked after, implantation. A once-a-month pill is now technically possible, although the major drawback is the need to determine when it should be taken. It is reassuring that many women from a variety of different cultures and with widely different experiences, would find this an attractive approach to contraception. (+info)
ESHRE Preimplantation Genetic Diagnosis (PGD) Consortium: preliminary assessment of data from January 1997 to September 1998. ESHRE PGD Consortium Steering Committee.
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The first clinical application of preimplantation genetic diagnosis (PGD) was reported almost a decade ago. Since then, the range of genetic defects that can be detected at single cell level has increased dramatically. At the 13th Annual Meeting of ESHRE in Edinburgh in 1997, a PGD Consortium was formed to undertake the first systematic and long-term study of the efficacy and clinical outcome of PGD. We report here the first data collection covering the period of January 1997 to September 1998. Referral data on 323 couples have been collected for a variety of monogenic and chromosomal disorders, providing information about which patients, at risk for which genetic diseases, are interested in PGD. Data were collected on 392 PGD cycles, resulting in 302 embryo transfers and 66 clinical pregnancies. Because of the importance of follow-up of the children born after PGD, participating centres were asked to contribute data on the pregnancies achieved and the children born after PGD since the start of their PGD programme. Data on 82 pregnancies and 110 fetal sacs were collected, and information was available on 79 children. Finally, biopsy, fluorescence in-situ hybridization and polymerase chain reaction protocols were collected, clearly showing that no consensus exists on technical aspects such as which culture medium to use, and emphasizing the role the PGD Consortium could play in setting up guidelines for good laboratory practice. In conclusion, it is clear that the effort of gathering data on PGD cycles is worthwhile and will be continued in the future, preferably using electronic data collection. (+info)
Health sector development: from aid coordination to resource management.
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Aid coordination has assumed a prominent place on health policy agendas. This paper synthesizes the findings of research undertaken to explore the changing practices of aid coordination across a number of countries. It begins by reviewing the key issues giving rise to increased attention to aid coordination in the health sector. The second section describes, assesses and compares the strengths and weaknesses of the dominant mechanisms or instruments which were found to be employed to coordinate health sector aid in the case studies. From this analysis, four factors become clear. First, in many countries, coordination mechanisms have been introduced as a part of an incremental process of trying out different approaches--there is no one model that stands out at any one time. Secondly, some instruments function largely for consultation, predominantly coordinating inputs, while others are more directive and operational, and are used to manage inputs, processes and outputs. Third, many of the mechanisms have not excelled, although, fourth, it is difficult to judge the effectiveness or impact of aid coordination. It is therefore argued that concern with the effectiveness of aid coordination arrangements must give way to a broader analysis of the processes, outputs and outcomes governing the use of both external and domestic resources, focusing on institutional characteristics, the distribution and nature of influence among the actors, and the interests which they pursue through the aid regime. These factors varied considerably across the countries indicating that aid management is context dependent and subject to continuing changes. Finally, the paper looks at the findings in the light of the introduction of sector-wide approaches. (+info)
Rehabilitating health services in Cambodia: the challenge of coordination in chronic political emergencies.
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The end of the Cold War brought with it opportunities to resolve a number of conflicts around the world, including those in Angola, Cambodia, El Salvador and Mozambique. International political efforts to negotiate peace in these countries were accompanied by significant aid programmes ostensibly designed to redress the worst effects of conflict and to contribute to the consolidation of peace. Such periods of political transition, and associated aid inflows, constitute an opportunity to improve health services in countries whose health indicators have been among the worst in the world and where access to basic health services is significantly diminished by war. This paper analyzes the particular constraints to effective coordination of health sector aid in situations of 'post'-conflict transition. These include: the uncertain legitimacy and competence of state structures; donor choice of implementing channels; and actions by national and international political actors which served to undermine coordination mechanisms in order to further their respective agendas. These obstacles hindered efforts by health professionals to establish an effective coordination regime, for example, through NGO mapping and the establishment of aid coordinating committees at national and provincial levels. These technical measures were unable to address the basic constitutional question of who had the authority to determine the distribution of scarce resources during a period of transition in political authority. The peculiar difficulties of establishing effective coordination mechanisms are important to address if the long-term effectiveness of rehabilitation aid is to be enhanced. (+info)
International cigarette labelling practices.
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DESIGN: Cross-sectional study. PARTICIPANTS: Members of GLOBALink (), an Internet listserve for tobacco activists with members in 56 countries, who were asked to provide specific information on cigarette warning requirements in their countries. MAIN OUTCOME MEASURES: Presence of specific warning labels, overall content score (based on a 0-10 scale with a point for each specific warning mentioned), size of warning label, location of warning label. RESULTS: Forty-five countries (80%) responded; 40 had mandatory labelling requirements, three had voluntary agreements with the industry and two had no requirements. In general, American companies did no more in foreign countries than required by local law. The average developing country content score was 1.6, compared with 5.0 in developed countries (p = 0.0003). Forty-two per cent of countries either had no warning requirement or had only a very general health warning. The most common warning was for heart disease (49% of countries) and the least common was for addiction (14%). All warnings were more common in developed than developing countries. Warnings in developed country were on average 27% larger than those in developing countries (p = 0.325). Seventy-three per cent of labels in developing countries appeared only on the side of the pack, whereas 78% of labels in developed countries appeared on the front and back (p = 0.003). CONCLUSIONS: In almost every respect measured, residents in developing countries are receiving inferior information about the hazards of smoking than residents of developed countries. Laws should be promulgated in importing and exporting countries to ensure that, where their labelling laws differ, companies would be required to provide the more comprehensive labelling. (+info)