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PubMed1997

Development in vitro of Marsupials: a comparative review of species and a timetable of cleavage and early blastocyst stages of development in Monodelphis domestica.

The development of marsupial oocytes and embryos in vitro is reviewed. Most stages of development have been cultured successfully, usually in a complex medium with added fetal calf serum. Simpler media without added serum have been developed for fertilization and cleavage in vitro. Culture systems have been established for oocyte maturation and fertilization in the grey short-tailed opossum and for cleavage from the zygote to the early expanding unilaminar blastocyst in a number of other marsupials. Survival in vitro of the unilaminar and early bilaminar blastocyst stages is limited in all species examined. In contrast, late bilaminar, trilaminar, embryonic and fetal stages develop at rates approximating those in vivo. More stages have been cultured successfully in Sminthopsis macroura than in any other species. It has been cultured from the late bilaminar blastocyst to within 18 h of birth. Stages of cleavage and unilaminar blastocyst formation of Monodelphis domestica timed by videotaping mating animals, proceeded at similar rates in vivo and in vitro. As in other marsupials, cleavage in this opossum is characterized by a polarized conceptus. This polarity is expressed in the distribution of organelles in the zygote and the localization of secretion of the extracellular matrix material into the cleavage cavity and of the initial cell-zona attachment. Because cell-cell adhesion follows cell-zona adhesion, a unilaminar blastocyst forms without the development of an intervening morula stage.

Animals↗

PubMed2006

Needs assessment of neurosurgery trainees: a survey study of two large training programs in the developing and developed worlds.

BACKGROUND: There are challenges facing surgical education in both the developing and the developed worlds. Few studies have examined trainee perceptions of their educational needs in a systematic way. We undertook a study to examine this issue, focusing on two large training programs, one in the developed world and one in the developing world. METHODS: Neurosurgical trainees at the University of Toronto, Toronto, Canada, and at Hasan Sadikin Hospital in Bandung, Indonesia, were surveyed with a comprehensive questionnaire assessing both the content and the methods of their training. The questionnaire had 37 quantitative questions requesting responses on a 7-point Likert scale and three open-ended questions to give more qualitative data. RESULTS: Sixty-four percent of all trainees responded. A number of interesting findings about the strengths and weaknesses of training emerged. For example, Bandung trainees felt they had excellent training in trauma but not in specialty areas, especially spine and vascular, with ample opportunity to operate as the primary surgeon. Toronto trainees felt that the volume and the variety of cases were excellent but they did not have enough ambulatory experience, and that they had suboptimal experience as the primary surgeon. Trainees in both centers agree that they will feel competent to practice neurosurgery upon completion of their training. CONCLUSION: This study defined different educational needs for neurosurgical trainees in two centers that reflect both their individual training environments and the local culture of medicine. As such, trainees' perceptions of these needs represent an important adjunct to program evaluation.

Attitude of Health Personnel↗

PubMed2000

A comparison of an international experience for nursing students in developed and developing countries.

Theoretical perspectives and approaches to transcultural nursing have been developed and there are different options for teaching transcultural care. The opportunity for nursing students to gain healthcare experience in another country is one option. This article reports a study undertaken in Northern Ireland to evaluate outcomes of a 3-month international experience for undergraduate nursing students (n=74) and to assess differences between the experiences in developed and developing countries. Data were collected by questionnaire. The findings indicate a high impact on students' international perspective and career development. Students' understanding of cultural and political issues within Northern Ireland was enhanced.

Adult↗

PubMed2003

Influenza vaccination in 2000: recommendations and vaccine use in 50 developed and rapidly developing countries.

Influenza vaccination is becoming an increasingly important aspect of public health programs in developed and rapidly developing countries. In 2000, most of these countries had national recommendations to vaccinate elderly people and those with high-risk conditions. Levels of vaccine use, however, varied widely and several rapidly developing countries had higher levels than those seen in many developed countries. More than one-third of all influenza vaccinations occurred in countries outside North America, western Europe and Australia and New Zealand. With increasing vaccine use, all countries will be better prepared for the next pandemic. Nonetheless, those countries that use but do not produce influenza vaccine will find it difficult to obtain supplies of pandemic vaccine.

Developed Countries↗

PubMed2000

Population ageing in developed and developing regions: implications for health policy.

Population ageing is now recognised as a global issue of increasing importance, and has many implications for health care and other areas of social policy. However, these issues remain relatively under-researched, particularly in poorer countries, and there is a dearth of specific policy initiatives at the international level. For example, the 1994 International Conference on Population and Development agreed to 15 key principles for future policy, but none of these even make indirect mention of the aged (International Conference on Population and Development, 1995, Documents. Programme of action of the 1994 International Conference on Population and Development. Population and Development Review, 21(2), 437-461). This paper seeks to highlight some of the key issues arising from population ageing. It begins with a brief overview of international trends in demographic ageing, and considers the health needs of different groups of older people. It sketches out some implications for policy, paying particular attention to the financing and organisation of health services. The final part of the paper contains a discussion about how older people have been affected by, and have adapted to, processes of social, economic and political change. Given the wide scope of these concerns, it is not possible to discuss any issue in detail, and the paper does not claim to give the subject matter a comprehensive or global treatment. It must be stressed that patterns of ageing and their implications for policy are highly complex and variable, and, as such, great care should be taken in generalising between the experiences of different groups of older people, and between different settings.

Aged↗

PubMed2003

Global burden of disease: huge inequities in the health status in developing and developed countries.

This paper outlines the Global Burden of Disease study which was conducted for the 1993 World Bank Development Report. The study revealed huge differences in premature death and disability in the world regions examined; sub-Saharan Africa and India had the highest burden of disease. This paper also examines how the large differences in burden of disease between developed and developing countries can be explained by economic factors, highlighting research findings that suggest egalitarian societies are likely to have better health status than countries with capitalistic, market-based economies. This study then examines the efforts of the Global Forum for Health Research to create an integrated approach to global health policy formulation, using global burden of disease data, and concludes with the assertion that adopting such an approach nationally would also assist developed countries like Canada in better dealing with future health challenges.

Chronic Disease↗

PubMed1989

Life expectancy in less developed countries: socioeconomic development or public health?

Various studies have enquired into the influence of socioeconomic development or public health measures on life expectancies in less developed countries. Analysis of the effect of these two groups of factors upon life expectancy, using data for 95 less developed countries, indicates that mortality is primarily influenced by such socioeconomic development measures as urbanization, industrialization, and education, and secondarily by such public health measures as access to safe water, physicians, and adequate nutrition.

Africa↗

PubMed2000

Revisiting the developed versus developing country distinction in course and outcome in schizophrenia: results from ISoS, the WHO collaborative followup project. International Study of Schizophrenia.

This article examines the long-standing and provocative finding of a differential advantage in course and outcome for persons with schizophrenia living in "developing" countries, using results from the newly completed World Health Organization (WHO) collaborative project, the International Study of Schizophrenia (ISoS). The article addresses two questions: Has the differential survived the 13 years since it was last reported? If so, are the results demonstrably not attributable to artifactual confounding? The analysis focuses on the 809 subjects who make up the combined incidence cohort of ISoS. These include members of the original treated incidence cohorts of two earlier WHO studies (the Determinants of Outcome of Severe Mental Disorders and the Reduction of Disability Studies) as well as subjects drawn from two additional samples (Hong Kong and Madras/Chennai). We first review the consistency of the finding of a "developed versus developing" differential in course and outcome and then examine a variety of course and outcome measures for the ISoS incidence cohorts. Evidence of differences in illness trajectory in favor of the developing centers was consistently found. Six potential sources of bias are then examined: differences in followup, arbitrary grouping of centers, diagnostic ambiguities, selective outcome measures, gender, and age. None of these potential confounds explains away the differential in course and outcome. We conclude with suggestions for further research, with particular attention to the need for close documentation of everyday practices in the local moral worlds that "culture" refers to.

Bias↗

PubMed2003

Dying from cancer in developed and developing countries: lessons from two qualitative interview studies of patients and their carers.

OBJECTIVE: To describe the experiences of illness and needs and use of services in two groups of patients with incurable cancer, one in a developed country and the other in a developing country. DESIGN: Scotland: longitudinal study with qualitative interviews. Kenya: cross sectional study with qualitative interviews. SETTINGS: Lothian region, Scotland, and Meru District, Kenya. PARTICIPANTS: Scotland: 20 patients with inoperable lung cancer and their carers. Kenya: 24 patients with common advanced cancers and their main informal carers. MAIN OUTCOME MEASURES: Descriptions of experiences, needs, and available services. RESULTS: 67 interviews were conducted in Scotland and 46 in Kenya. The emotional pain of facing death was the prime concern of Scottish patients and their carers, while physical pain and financial worries dominated the lives of Kenyan patients and their carers. In Scotland, free health and social services (including financial assistance) were available, but sometimes underused. In Kenya, analgesia, essential equipment, suitable food, and assistance in care were often inaccessible and unaffordable, resulting in considerable unmet physical needs. Kenyan patients thought that their psychological, social, and spiritual needs were met by their families, local community, and religious groups. Some Scottish patients thought that such non-physical needs went unmet. CONCLUSIONS: In patients living in developed and developing countries there are differences not only in resources available for patients dying from cancer but also in their lived experience of illness. The expression of needs and how they are met in different cultural contexts can inform local assessment of needs and provide insights for initiatives in holistic cancer care.

Adaptation, Psychological↗

PubMed1998

Rises in schoolchildren's anthropometry: what do they signify in developed and developing populations?

Recent reports indicate continuing rises in the height and weight of schoolchildren in both developed and developing populations. Also indicated are increases in the body mass index of children, and of adults, despite all public health warnings to the contrary, as well as personal desires of huge proportions of children, and of adults, to be slim. A little researched question concerns which level of schoolchildren's growth is consistent in later life with least occurrence of degenerative diseases. In developing populations, lack of knowledge prevails regarding the current and future health of the large proportions, and huge numbers, of schoolchildren who, judging from Western anthropometric standards, are categorized as suffering from mild to moderate malnutrition. It is questioned whether greater growth is essentially better. As to the future, in Western and in urban developing populations, attempts to control greater attainment of weight for height in schoolchildren, as well as adults, are unlikely to be rewarding, due to unpopularity of a 'prudent' diet on the one hand, and the still diminishing physical activity on the other. Notwithstanding, educational and other efforts to improve the composition of diets and encourage greater physical activity must be energetically pursued.

Adolescent↗

PubMed2005

Adapting developing country epidemiological assessment techniques to improve the quality of health needs assessments in developed countries.

BACKGROUND: We were commissioned to carry out three health assessments in urban areas of Dublin in Ireland. We required an epidemiologically robust method that could collect data rapidly and inexpensively. We were dealing with inadequate health information systems, weak planning data and a history of inadequate recipient involvement in health service planning. These problems had also been identified by researchers carrying out health assessments in developing countries. This paper reports our experience of adapting a cluster survey model originally developed by international organisations to assess community health needs and service coverage in developing countries and applying our adapted model to three urban areas in Dublin, Ireland METHODS: We adapted the model to control for socio-economic heterogeneity, to take account of the inadequate population list, to ensure a representative sample and to account for a higher prevalence of degenerative and chronic diseases. We employed formal as well as informal communication methods and adjusted data collection times to maximise participation. RESULTS: The model we adapted had the capacity to ascertain both health needs and health care delivery needs. The community participated throughout the process and members were trained and employed as data collectors. The assessments have been used by local health boards and non-governmental agencies to plan and deliver better or additional services. CONCLUSION: We were able to carry out high quality health needs assessments in urban areas by adapting and applying a developing country health assessment method. Issues arose relating to health needs assessment as part of the planning cycle and the role of participants in the process.

Censuses↗

PubMedDate not supplied

Development of a positive youth development program in Hong Kong: overview of the proposed curriculum for the junior secondary school years.

The development of a positive youth development program for Secondary 1 to 3 students in Hong Kong is outlined here. The Full Program consists of 40 units per grade, 20 of which belong to the Core Program. Each unit takes 30 minutes of class time to complete. The major features of the program are as follows: (i) strong theoretical underpinnings, (ii) comprehensive and holistic coverage of youth development, (iii) an expected effective developmental outcome of the participating students, (iv) a happy and stimulating developmental process of the students, (v) flexible teaching schedules and combinations of program units, (vi) professional training for participating teachers and social workers, and (vii) rigorous quality assurance of the program product. The whole project will contribute significantly to the fields of youth development, whole-person education, and life and moral education.

Adolescent↗

PubMed1998

A comparison of international learning experiences for baccalaureate nursing students: developed and developing countries.

As faculty seek creative learning opportunities for students in a changing social, political, and health care environment, knowledge about international learning experiences can provide critical information for decision making. This study sought the answer to two questions: What are the learning outcomes of an international experience for baccalaureate nursing students and what are the similarities and differences in what students learn in developed and developing countries? Using grounded theory methodology, 14 students who had participated in international learning experiences were interviewed. Three major categories emerged from the data analysis: personal and professional growth, empirical knowledge, and the learning experience. More similarities than differences were identified among the students who had traveled to developing versus developed countries. The findings suggest that international experiences need to include the opportunity to provide direct nursing care. A proposed model for such experiences is presented.

Adult↗

PubMed1997

Health and rural-to-urban migration in Thailand. The Population and Community Development Association's experience in rural development.

The Population and Community Development Association (PDA), a non-governmental organisation, has designed and implemented a new model of rural economic development in which health is considered to be the cornerstone of all development strategies. By attacking migration as the root cause of current threats to the population's health, PDA's Thai Business Initiative in Rural Development program provides economic opportunities to villagers in the poorest areas of the country. This structural approach to health enhancement includes specific components to address primary health care, family planning, and HIV/AIDS prevention, education and care.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Spirituality as a positive youth development construct: conceptual bases and implications for curriculum development.

This paper outlines the conceptual bases of 'spirituality' as a positive youth development construct and the implications for curriculum development in junior secondary schools. In essence, spirituality embraces (i) connectedness with others that includes other people and a higher being, (ii) establishing personal beliefs and values, and (iii) the search of answers to the meaning of life. By considering adolescents' cognitive development and other developmental needs, gender and cultural issues, ten units of positive youth development programmes are designed to foster spirituality in Secondary 1 to 3 students in Hong Kong. These programme units constitute part of the P.A.T.H.S. Project supported by the Hong Kong Jockey Club Charities Trust. In the Secondary 1 curriculum, the goal of the units is to facilitate students to connect with other people and a higher being. In the Secondary 2 curriculum, the goals of the units are to help students reflect on their possessions in life and reevaluate the meaning of their life from people who experience great agony. In the Secondary 3 curriculum, the goals are to help students search for the meaning of life.

Adolescent↗

PubMed1988

The importance of regressive changes in the development of the nervous system: towards a neurobiological theory of child development.

In this paper we propose that theories of early personality development be revised to consider knowledge of neurodevelopment. Research findings are reviewed that have established the presence of regressive changes in the normal development of the brain. These regressive changes, consisting of neuronal death and process and synapse elimination, are theoretically linked to three precursors of personality: sex differences, temperamental traits and perceptual-motor coordination. Evidence supporting these hypotheses is provided from studies examining how the effects of genetic, environmental, and experiential factors on brain development may determine the development of these personality features.

Animals↗

PubMed1993

Measles control in developing and developed countries: the case for a two-dose policy.

Despite major reductions in the incidence of measles and its complications, measles control with a single dose of the currently used. Schwarz strain vaccine has failed to eradicate the disease in the developed countries. In developing countries an enormous toll of measles deaths and disability continues, despite considerable efforts and increasing immunization coverage. Empirical evidence from a number of countries suggests that a two-dose measles vaccination programme, by improving individual protection and heard immunity can make a major contribution to measles control and elimination of local circulation of the disease. Cost-benefit analysis also supports the two-dose schedule in terms of savings in health costs, and total costs to society. A two-dose measles vaccination programme is therefore an essential component of preventive health care in developing, as well as developed countries for the 1990s.

Cost-Benefit Analysis↗

PubMed2005

Health in the developing world: achieving the Millennium Development Goals.

The Millennium Development Goals depend critically on scaling up public health investments in developing countries. As a matter of urgency, developing-country governments must present detailed investment plans that are sufficiently ambitious to meet the goals, and the plans must be inserted into existing donor processes. Donor countries must keep the promises they have often reiterated of increased assistance, which they can easily afford, to help improve health in the developing countries and ensure stability for the whole world.

Advisory Committees↗