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PubMedDate not supplied

PVO / NGO initiatives, Asia. Karmajibi Kallyan (KKS), Bangladesh and Save the Children Fund Australia (SCFA).

Karmajibi Kallyan (KKS) and Save the Children Fund Australia (SCFA) are implementing a program that integrates HIV/AIDS prevention and income generation activities aimed at the pre-adolescent girl servants of commercial sex workers in the Rajbari district of Bangladesh. The initial objectives of the program were to identify and establish alternative income generating activities for 150 girl servants; provide literacy education to these girls based on such topics as primary health care (HIV/AIDS prevention), credit, and small business management; and promote HIV/AIDS awareness in the wider community. Since implementation, the program has adjusted its objectives in order to meet the needs of the community. Many of the girls are much younger than the project originally planned for--most are only 7 or 8 years old--therefore, KKS and SCFA have begun identifying income generation possibilities for their mothers and encouraging the girls to focus on their education. They are also hoping to expand their literacy programs to other children in the community. For more information, please contact HIDNA (HIV/AIDS and International Development Network of Australia), ACFOA, Private Bag 3, Deakin ACT 2600, Australia; tel: +61 6 285 1816; fax: +61 6 285 1720; e-mail: acfoa@peg.apc.org. (ECHIDNA, Bulletin No. 5, September 1995)

Acquired Immunodeficiency Syndrome↗
PubMed1993

General thoracic surgery in the year 2010.

Education and clinical practice in general thoracic surgery will be considerably different in the year 2010. The individual surgeon will most likely see a decline in patient volume and net income. Teaching hospitals with declining profit margins will place monetary constraints on patient programs that do not generate income, and capital budgets will be curtailed. To remain competitive, the general thoracic surgeon will have to keep pace with technologic advances and maintain a current knowledge in the field of thoracic oncology. General thoracic surgical training will profit by a core curriculum with a defined general thoracic surgical faculty dedicated to education in this field.

Economic Competition↗
PubMed2002

Socioeconomic profile and nutritional status of children in rubber smallholdings.

This paper will present the socioeconomic profile and nutritional status of children aged 1-6 years in the rubber smallholdings of Peninsula Malaysia. A total of 323 households were involved in this study. The sociodemographic data were obtained through interviews with heads of households using a set of questionnaires. Anthropometric measurements were taken from 506 children aged 1-6 years from these households. The weight and height of the children were compared with the reference values of the National Center for Health Statistics (NCHS) and the nutritional status was classified based on the recommendations of WHO. The average age of the fathers was 39.9+/-8.6 years and 34.4+/-7.0 years for the mothers. The mean household size was 6.67+/-2.27. The majority (49.7%) of the heads of households received 4-6 years of formal education and 7.9% received no formal education. Based on the monthly per capita income, 24.0% were found to be in the hardcore poor category, 38.3% fall into the poor category and 37.7% in the above poverty income group. The prevalence of stunting and underweight among children between the ages of 1-6 years were highest among children from the hardcore poor, followed by the poor category and above the poverty line income group. Wasting was present in all income groups, with a prevalence of 4.2% found among the hardcore poor, 9.4% among the poor group and 8.4% in the above poverty income group. The Pearson Product Moment Correlation showed significant relationships between household total income and height-for-age (r = 0.131, P = 0.05) and weight-for-age (r = 0.127, P = 0.05). There were also significant correlations between monthly per capita income with height-for-age (r = 0.16, P < 0.01) and weight-for-age (r = 0.13, P < 0.05). The acreage of land utilised was correlated with height-for-age (r = 0.11, P < 0.05), weight-for-age (r = 0.17, P < 0.05) and weight-for-height (r = 0.16, P < 0.05). However, stepwise multiple regression analysis indicated that the predictor of height-for-age was monthly per capita income (R2 = 0.03, P < 0.01) and acreage of land utilised was a predictor for weight-for-age (R2 = 0.03, P < 0.01) and weight-for-height (R2 = 0.01, P < 0.01). Because income and acreage of land utilised have been shown to be associated with nutritional status, it is recommended that intervention programs that focus on generation of income and diversification of land utilisation should be undertaken. A multidiscipline approach involving the family, community and government agencies should be applied to any type of intervention program.

Agriculture↗
PubMed1998

A note on intergenerational risk sharing and the design of pay-as-you-go pension programs.

"Different versions of pay-as-you-go public pension programs may have entirely different effects on the intergenerational distribution of income risk. If the pension benefit is a fixed proportion of previous labor income, a pay-as-you-go program increases the net income risk of all generations. On the other hand, a pay-as-you-go program characterized by a fixed labor income tax rate and uncertain pension benefits provides intergenerational risk sharing."

Americas↗
PubMedDate not supplied

Technical assistance offered to community health programs through a resource model.

A multidisciplinary unit in the Department of Community Medicine, Mount Sinai School of Medicine, consists of a core group of specialists who plan, develop, and evaluate community health care programs. The primary tools used by the staff of the Services Coordination Unit, epidemiology and behavioral and management sciences, result in improved organization and coordination of health services and community resources. The small unit of specialists functions as a resource group, helping community groups address the complex problems of planning, organization, delivery, and financing of health services. By offering technical assistance rather than day-to-day health care services, the unit has established an education and training program in New York's East Harlem, which surrounds the medical school. Over the last 10 years, that approach has enhanced the administrative and financial viability of existing health programs in East Harlem. Since the unit's establishment, it has collaborated with a broad variety of community groups. More than 20 programs have resulted. The income generated by the unit completely covers the expenses and has done so since 1976; "seed money" was used for startup and the first 3 years of operation. The unit is paid for long-term services and for most consultations.

Community Health Services↗
PubMed1989

Financing graduate medical education in family medicine.

Family practice residency programs differ fiscally from residency programs in most other specialties because they have limited income-generating potential. The present review demonstrates that the typical family practice residency program has been fiscally solvent as a result of receiving approximately one-third of its income from state and federal appropriations. The level of such support plateaued in the 1980s and programs have not continued to expand despite an ongoing shortage of family physicians. Today, declining Medicare payments to hospitals threaten hospitals' contributions to family practice residency programs. The ability of family practice residency programs to meet the continuing need for family physicians will depend upon the development of specific state and federal policies that provide fiscal incentives to maintain and expand family practice residencies.

Cost-Benefit Analysis↗
PubMed1995

Use of performance ratios to calculate the economic impact of thin cows in a beef cattle herd.

OBJECTIVE: To determine gross income lost that was attributable to thin cows in a beef cattle herd, to estimate the cost of added nutrition necessary to prevent thin cows in the herd, and to determine the financial outcome of the improved nutritional practices. DESIGN: Prospective, observational study. ANIMALS: Four hundred and twenty-two Santa Gertrudis cows and their calves. PROCEDURE: At pregnancy examination in the fall of 1992, cows were assigned a body condition score (BCS), using a scale of 1 (emaciated) to 9 (obese), and the ratio of the productivity of BCS-3 and BCS-4 cow groups (thin cows), compared with the mean productivity of BCS-5 and BCS-6 cows (cows in good condition), was determined. Measures of productivity evaluated included pregnancy rates, weaning weights, and prices per hundredweight of calves. The performance ratios of BCS-3 and BCS-4 cows were multiplied by the mean gross income of BCS-5 and BCS-6 cows to calculate their gross income. This was then subtracted from the mean income of BCS-5 and BCS-6 cows to estimate the amount of lost gross income per thin cow. The cost of a nutritional program that would prevent thin cows in the herd was subtracted from the lost gross income of the thin cows to yield the amount of increased net income that could be generated from a nutritional program that would maintain cows in the herd at a BCS of 5 or 6. RESULTS: Cows with a BCS of 3 were 0.48 as productive, and cows with a BCS of 4 were 0.74 as productive as the average of the BCS-5 and BCS-6 cows combined. Each BCS-3 cow generated $215.06 less, and each BCS-4 cow generated $107.53 less gross income than the average gross income of BCS-5 and BCS-6 cows. The added cost of nutrition that would have reconditioned BCS-3 and BCS-4 cows to a BCS of 5.5 was $91.48/BCS-3 cow and $43.67/BCS-4 cow. Implementation of the reconditioning nutrition program the previous fall would have resulted in an extra net income of $123.58/BCS-3 cow and $63.86/BCS-4 cow, received over a 2-year period. The 262 thin cows in the herd accounted for a total net income loss of $19,897. CLINICAL IMPLICATIONS: The time of pregnancy examination is a strategic intervention point to estimate the past negative economic impact of thin cows and to implement a plan to prevent these losses in the future. Pregnancy examinations should be performed at least 100 days before the beginning of the calving season, and thin pregnant cows should be sorted into a special group and fed a reconditioning diet that will improve their body condition to an average BCS of 5.5 by the onset of the calving season.

Animal Husbandry↗
PubMed2002

Effects of managed care on teaching, research, and clinical practice in academic plastic surgery.

The aim of this study was to determine: 1) if there have been changes in teaching, research, and clinical practice in academic plastic surgery in recent years; and 2) if there have been, are they associated with changes in the managed care environment? Gaining a clearer perspective on how managed care affects academic plastic surgery will enable academicians to define better the problems and opportunities they face mutually and to respond effectively to these issues. This study used a cross-sectional study design. Reference time periods were the premanaged care era (1990-1991) versus the current time (1997-1998). Data were collected by questionnaires sent to 94 academic program directors in plastic surgery. The main independent variable of managed care was measured as the difference in the percent of income from health maintenance organizations generated by each program in 1990 to 1991 versus 1997 to 1998. The dependent variables of teaching, research, and clinical practice were measured by the percentage of time spent in each category, the number of work hours per week, the number of staff personnel, the location of teaching, the number of grants and publications, and the percentage of reconstructive and cosmetic cases in 1990 to 1991 versus 1997 to 1998. Univariate analysis, paired Student's t-test, Fisher's exact test, Pearson's correlation, Spearman's correlation, and linear regression were used to establish significance (alpha = 0.05) of the effects of managed care on dependent variables. Sixty-six questionnaires were completed and returned (70% response rate). There were significant changes in the managed care environment, clinical practice (operating room and clinics), and research in academic plastic surgery from 1990 to 1997. The percentage of income generated from managed care increased from 9.8% (of total revenue) in 1990 to 23.6% in 1997 (an increase of 13.8%; p < 0.0001). Academic plastic surgeons were found to spend significantly more time in clinical practice (3% more of total time spent; 5.3 hours more per week in 1997; p < 0.016). This change correlated significantly with the increase in managed care (p < 0.015). In addition, the percentage of cosmetic cases increased from 18.0% in 1990 to 28.3% in 1997 (p < 0.001), and that of reconstructive surgery was reduced proportionately (p < 0.001). Also, a significant decrease in the time spent for research was observed (mean reduction, 2.8 hours less per week; p < 0.001). Although the trend was to a lower number, there were no significant changes in the amount of time spent in teaching (p > 0.08) and in administrative duty (p > 0.06), or in the number of personnel employed in the teaching programs (p > 0.05). In summary, these findings suggest that: 1) a greater percentage of revenue was generated from managed care in 1997 than in 1990, indicating a growing fiscal influence by managed care on academic plastic surgery; 2) furthermore, this change is associated with academic plastic surgeons devoting more time to clinical practice and less time to research endeavors; and 3) although managed care policies do affect teaching adversely, this effect has not yet reached significance for the period examined during this study.

Academic Medical Centers↗
PubMed1989

The effect of government policy on family practice programs.

Government, both federal and state, has long recognized that the American public does not have ready access to primary care physicians. Federal and state legislation has been passed to establish and fund family practice programs to alleviate the shortage of primary care physicians. In addition to federal and state funds, family practice programs receive financial support from hospitals and generate patient fee income. In the current era of cost containment, family practice programs are more dependent on patient fee income and hospital support.

Comprehensive Health Care↗
PubMed1991

Crack: new directions in drug research. Part 2. Factors determining the current functioning of the crack economy--a program for ethnographic research.

Factors which hypothetically influence rates, volumes, and methods of income generation in crack distribution, use, and misuse are indicated, and a research program to investigate them is suggested. This research will contribute significantly to the development of a theoretical framework which adequately relates substance using/abusing and trafficking populations to the wider community and will explain why crack use and distribution have had such different outcomes than marijuana. Factors to be researched include: polyethnicity, crack-related deculturation, gender differentiation in crack use and effects, neighborhood effects, vertically organized crack-distributing organizations, crack-related violence and crime, and replacement of previous drug markets by crack.

Crack Cocaine↗