PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Developed Countries”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,729 records · Page 96Linked to original sources
PubMed1984

IUD-associated hospitalization in less developed countries.

Data on 11,977 insertions of an intrauterine device (IUD) from 25 collaborating centers in 16 less developed countries (LDCs) were investigated for IUD-associated hospitalizations. These centers maintained regular follow-up and reported at least one hospitalization among their IUD cases. The Lippes Loop, Copper T, Delta Loop, and Delta T were the most commonly used devices, and three-fourths of all devices were inserted in postpartum women. Fifty-five of the 128 reported subsequent hospitalizations were associated with IUD use. Main indications for IUD-associated hospitalizations were pelvic infection, bleeding/pain, and method failure. Statistically significant differences were not detected in the three-month gross cumulative rates for hospitalizations due to IUD complications by age (less than 30 vs 30+), parity (0-1 vs 2+), or device type (Lippes Loop and Copper T vs Delta devices vs others). Three types of IUD-associated hospitalization rates were calculated, each involving a margin of error: 1) a Pearl rate of 8.0 per 1,000 woman-years of IUD use; 2) a one-year life table rate of 6.3 per 1,000 insertions; and 3) crude rates ranging from 3.2 to 4.6 per 1,000 cases.

Adult↗
PubMed1994

Cognitive and attitudinal impact of the Advanced Trauma Life Support program in a developing country.

Improvement in trauma patient outcome has been reported after Advanced Training Life Support training (ATLS) in the developing country of Trinidad and Tobago (T & T). The cognitive impact of ATLS training was assessed from pre-ATLS and post-ATLS performance of T & T physicians in multiple choice question tests and comparison with post-ATLS test performance among Nebraska physicians. Overall, improvement between the pre-test and post-test among the T & T physicians was 22.0% +/- 2.0%. All physicians including failures (199 out of 212 passed) improved in their post-test scores. Individual item analysis of the post-test, including the KR-20 determination, varied but the overall performance was similar for both physician groups with the T & T physicians performing slightly better in test 2 (6 of 16 vs. 25 of 100 failures, p < 0.05). Attitudinal impact was assessed through 87 questionnaires from 50 physicians (92% response) and 37 nurses (89% response). Physicians (97.8% compared with 69.7%) were more aware of the ATLS training, and both groups (physicians, 77.3%; nurses, 69.6%) differentiated ATLS-trained physicians based on better resuscitation, more timely and appropriate consultation, greater confidence in trauma management, and improvement in trauma mortality and morbidity; all respondents recommended ATLS training for all emergency room physicians. The demonstrated positive cognitive and attitudinal effects very likely contributed to the improved post-ATLS trauma patient outcome.

Attitude of Health Personnel↗
PubMed2006

Acute renal failure in pregnancy in a developing country: twenty years of experience.

UNLABELLED: Acute renal failure (ARF) has become a rare complication of pregnancy in developed countries. The aim of this study was to describe changing trends in pregnancy-related acute renal failure (PR-ARF) in two successive periods; 1982-1991 and 1992-2002. From July 1982 to December 2002, 190 cases of PR-ARF were observed in Eastern India (11.6% of total number of ARF needing dialysis). Obstetrical complications were causative factors for ARF in 15% (65/426) and 10% (125/1201) of patients in the two periods, respectively. The incidence of PR-ARF fell from 15% in 1982-1991 to 10% in 1992-2002, with respect to the total number of acute renal failure cases. Post-abortal ARF showed a declining trend, 9% in the 1980s to 7% in the 2000s, of the total number of ARF cases. Preeclampsia-eclampsia was the cause of obstetrical ARF in 23% (1982-1991) and 14.4% (1992-2002) of cases in these two periods. The percentage of total ARF due to eclampsia declined from 3.5% during the period 1982-1991 to 1.4% in 1992-2002. Puerperal sepsis contributed to 0.8% of total ARF in recent years, compared to 2.4% in the earlier period. The incidence of cortical necrosis decreased significantly (p < 0.001) from 17% in 1982-1991 to 2.4% in the 2000s. The maternal mortality reduced to 6.4% in 1992-2002 from initial high mortality of 20% in the period of 1982-1991. CONCLUSION: PR-ARF which remained high in the initial period has decreased in recent years. This is associated with a declining trend in

Abortion, Induced↗
PubMed1995

Tetanus immunization and prenatal care in developing countries.

OBJECTIVE: We sought to estimate the proportion of women immunized against tetanus while attending prenatal care in the developing countries. METHOD: We computed the ratio of the percentage of births to women immunized against tetanus to the percentage of births to women with prenatal care (TP ratio). A TP ratio is lower than 100% if not every woman attending prenatal care is immunized. We used 1986-1992 Demographic and Health Surveys data from 38 countries. RESULTS: The mean TP ratios were 86% in Africa (n = 23), 79% in Asia (n = 6) and 60% in Latin American and the Caribbean (n = 9). The TP ratio was lower than 75% in 15 countries. Of these, four had a TP ratio lower than 50%. CONCLUSION: In many countries the number of pregnant women immunized against tetanus is lower than the number of women attending prenatal care, suggesting that prenatal services are missing opportunities to immunize attending women.

Developing Countries↗
PubMed2000

The evolution of child health programmes in developing countries: from targeting diseases to targeting people.

Mortality rates among children and the absolute number of children dying annually in developing countries have declined considerably over the past few decades. However, the gains made have not been distributed evenly: childhood mortality remains higher among poorer people and the gap between rich and poor has grown. Several poor countries, and some poorer regions within countries, have experienced a levelling off of or even an increase in childhood mortality over the past few years. Until now, two types of programmes--short-term, disease-specific initiatives and more general programmes of primary health care--have contributed to the decline in mortality. Both types of programme can contribute substantially to the strengthening of health systems and in enabling households and communities to improve their health care. In order for them to do so, and in order to complete the unfinished agenda of improving child health globally, new strategies are needed. On the one hand, greater emphasis should be placed on promoting those household behaviours that are not dependent on the performance of health systems. On the other hand, more attention should be paid to interventions that affect health at other stages of the life cycle while efforts that have been made to develop interventions that can be used during childhood continue.

Case Management↗
PubMed2002

Laparoscopy-assisted live donor nephrectomy: a modified cost-effective approach for developing countries.

BACKGROUND AND PURPOSE: Because of the prohibitive cost of laparoscopic disposable instruments such as the PneumoSleeve, Endocatch, and vascular staples, laparoscopic live-donor nephrectomy has not gained wide acceptance in many developing countries. To circumvent this problem, we have developed a cost-saving approach, which is described herein and compared with the open method. PATIENTS AND METHODS: Forty-nine patients underwent laparoscopic live-donor nephrectomy at our institute, of which two were performed by the hand-assisted technique, five by the technique described by Fabrizio et al and forty-two by our modified cost-saving laparoscopy-assisted technique (LD). The latter patients were compared with 50 patients who had a standard open donor nephrectomy (OD) through a rib-resecting (12th rib) flank incision. Our technique is similar to the procedure described by Fabrizio et al except for a 6- to 8-cm incision placed in the subcostal region to retrieve the kidney after the renal vessels are cut and ligated as in the open procedure. The costs of the various techniques at our institute were compared. RESULTS: The LD and OD groups were similar in terms of age, weight, side of nephrectomy, and number of renal vessels. The operative time was longer in the LD group than in the OD group (180.7 +/- 18 minutes v 101.5 +/- 10.4 minutes), whereas the mean intraoperative blood loss was less (85.5 +/- 21.35 v 220 +/- 22.5 mL; P < 0.001). Warm ischemia time and recipient outcomes were comparable in the two groups. Patients in the LD group had lower postoperative narcotic (tramadol hydrochloride) requirement (155.3 +/- 53.3 mg v 251.8 +/- 63.1 mg; P < 0.001) and earlier discharge from the hospital (3.14 v 5.7 days; P < 0.001). The mean expense incurred was US$175 v US$160 in the LD and OD groups, respectively. The cost of the hand-assisted and standard laparoscopic techniques was significantly higher than that of our modified technique. CONCLUSIONS: Our modified technique of laparoscopy-assisted live-donor nephrectomy avoids the use of costly disposables yet offers the advantages of lesser morbidity and small incision of LD. It is cost effective and is an alternative to open nephrectomy in the developing world.

Adult↗
PubMedDate not supplied

[Economics of health systems in developing countries: what is the contribution of work published in french?].

Health economics is poorly developed in the francophone community. There is little published work addressing developing francophone countries, and it is largely limited to the sub-Saharan Africa. Few specialist research workers from developing countries contribute. Universities only propose global analyses, and other groups involved (expert consultants) only conduct narrow studies, targeted at immediate action or decision making. The article analyses some of the reasons from this underdevelopment, and overviews what has been produced over the last 15 years. Three areas appear to be preferred: the analysis of costs and financing of vertical programs (vaccination programs in particular), the issue of supply and the price of essential drugs, and the effects and consequences of attempts to recover costs. Research work is mainly conducted by experts and consultants working for the financing bodies or international organizations. Their ideas, methods and conclusions often reflect the interests and working methods of those sponsoring the study. In many cases, pragmatism and short-termism dominate over intellectual and ethical rigor. A major issue is that of the roles of the State and the marker in the organization and financing of health systems and policies. Francophone economist differ from others on this issue, although, since the 1993 World Bank report entitled "Investing in Health" the opposition is less direct, and the "specificities" in the health sector, including those concerning economics, are now universally recognized.

Africa↗
PubMed2002

Potential benefit and limitations of a broad access to potent antiretroviral therapy in developing countries.

In industrialised countries, highly active antiretroviral therapy (HAART) has drastically reduced HIV mortality. Only few developing countries have introduced HAART on a large scale, leaving millions of HIV-infected individuals without life-saving therapy. Although HAART appears to be economically viable for middle income countries, it remains unaffordable for many of the poorest and worst affected nations. In response, significant discounts for antiretrovirals and debt relief have been granted. Apart from economic problems, other important issues need to be addressed before antiretroviral therapy can be optimally utilised, including the logistics of drug supply, HIV education for hospital staff and patients, and laboratory facilities that allow clinicians to assess the efficacy of HAART.

Antiretroviral Therapy, Highly Active↗
PubMed2002

Ethical oversight of public health research: can rules and IRBs make a difference in developing countries?

Controversies in the conduct of international research continue to pose challenges for the system of ethical review, particularly for developing countries. Although the concept of vulnerability is key to addressing these challenges, ethical review has typically ignored the agency of vulnerable participants and groups in determining what kind of review process is needed. Concurrent with developments shaping the new public health that seek to operationalize empowerment of communities by placing them as initiators and organizers of their own health, ethical review of public health research must find ways to recognize the agency of vulnerable individuals, groups, and communities in the review process if it is to address effectively the ethical dilemmas currently evident in collaborative international research.

Coercion↗
PubMed1988

Transfer of regulatory toxicology from developed to developing countries.

Over the past two decades, industrialized nations have addressed and attempted to solve the problems of chemical risk through the development of laws, government and private organizations, and specialized manpower. Developing nations are now recognizing that the presence of toxicants in the environment, foods, consumer products, and the workplace can seriously affect human health, the ecology, international relations, and economic activities such as trade and tourism. The design and implementation of regulatory programs in developing countries is hampered by lack of government and public concern, pressure of more urgent needs, vested interests of industry, and lack of adequately trained professionals. These factors have allowed developed nations to sell abroad drugs, pesticides, and other chemicals considered too hazardous for use in their own countries. Conversely, products from developing nations must comply with rigorous standards for acceptance by developed nations. Some of these problems would be lessened by agreement on international chemical control guidelines. Multilateral availability of complete information about chemicals is essential. The coordination of this effort should be in the hands of international organizations and reinforced by bilateral agreements between countries. Appropriate public education and economic incentives at the national level would help in enforcing regulatory toxicology.

Developing Countries↗
PubMedDate not supplied

Breast-conserving therapy in low-literacy patients in a developing country.

The purpose of this study was to determine the frequency with which low-literacy patients in a developing country chose their treatment plan. In this study, data for 312 patients admitted to different hospitals in Egypt were reviewed regarding their disease stage, optimal management plan, and treatment. It was found that the majority of patients were primarily concerned with keeping their breasts, regardless of the disease stage.

Adult↗
PubMed1991

Microcomputer applications for primary health care in developing countries.

This article explores some ways in which computer technology can be harnessed to strengthen primary health care planning and management, make more efficient use of scare health resources, and maximize the beneficial impact on health of local, district, and national health systems in both developing and developed countries.

Cost-Benefit Analysis↗
PubMed2003

Palliative care education in the developing countries.

Individuals who have experience in palliative care in wealthier countries with well-structured health systems see the palliative care needs of developing countries as forbiddingly huge. They are aware of an increasing incidence of cancer, but health delivery systems are often patchy and deficient, medications for pain management are not widely available, and cultural considerations limit opportunities to face advanced illness and focus on symptom control in terminal illness. An increasing prevalence of HIV infection compounds palliative care needs. Medical practice focuses on interventions that promise cure and earn a good reward, while nursing standards are variable and often unsatisfactory. There is a need for demonstrations of good care and effective symptom control, even if these reach only a small fraction of the needy population. On such demonstrations can be built education programs that take account of local realities, and promote attitudes, knowledge and skills capable of gradually introducing a greater professional concern and a better prospect of effective care for the dying.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Adolescent childbearing in developing countries: a global review.

This article discusses the current levels and recent trends in the rate of adolescent childbearing, the timing of the first birth, and births to unmarried women for 43 developing countries. Differences in rates of adolescent childbearing by residence and level of education are also examined. The analysis is based on nationally representative fertility surveys. Substantial declines in adolescent fertility have occurred in North Africa and Asia, but levels are still high in some countries. Declines are beginning to occur in sub-Saharan Africa, but current levels are still high in most countries of this region, and the proportion of births to unmarried adolescents is increasing in some countries. In Latin America, where the level of teenage childbearing is moderate, declines are less prevalent and some small increases have occurred. Higher education is associated with lower rates of adolescent childbearing, but other socioeconomic changes cancel or reduce this effect in several countries.

Adolescent↗
PubMed1982

Lens implant surgery in a developing country.

Unilateral, mostly traumatic cataract in children and adults is considered a good indication for lens implant surgery in developing countries. In Suriname fourteen patients with unilateral, non-senile cataract underwent pseudophakos surgery from 1975 to 1980. No major complications occurred. In ten of the fourteen patients good binocular vision was achieved. Two patients had good visual acuity with poor focus. One patient had persistent deprivation amblyopia. Six patients were ultimately lost to follow-up.

Adolescent↗
PubMed2007

Impact of telemedicine on pediatric neuro-oncology in a developing country: the Jordanian-Canadian experience.

BACKGROUND: Telemedicine is widely used in industrialized countries for educational purposes. Twinning experiences using telemedicine between institutions in industrialized and developing countries (DC) have been limited. Pediatric neuro-oncology is a complex multidisciplinary discipline that is underserved in most of DC and provides a model to test the feasibility of such tool for twinning purposes. METHODS: A computer, an EMLO visual presenter HV-7600SX document camera, and a TANDBERG 6000 model videoconference unit were used to present data. For connectivity, we used a six-channel ISDN telephone line. Each channel is 64 megabytes/sec. RESULTS: Between December 2004 and May 2006, 20 sessions of videoconference were held between King Hussein Cancer Center and the Hospital for Sick Children to discuss 72 cases of 64 patients with various brain tumors (5 patients were discussed twice and 1 patient four times). In 23 patients (36%), major changes from original plan were recommended on different aspects of the care. In 21 patients (91%), those recommendations were followed, with potentially significant positive impact on patients' care. CONCLUSIONS: Videoconferencing is a feasible and practical twinning tool in pediatric neuro-oncology with a potentially major impact on patient care.

Brain Neoplasms↗
PubMed2000

Factors associated with trends in infant and child mortality in developing countries during the 1990s.

The 1990s have seen a remarkable decrease in mortality among infants and children in most developing countries. In some countries, particularly in sub-Saharan Africa, these declines in mortality among children have slowed and are now increasing again. Internationally comparable data derived from survey programmes, such as the Demographic and Health Survey (DHS) programme, are available both to document the changes that have occurred in mortality and to provide insight into some of the factors that may explain these trends in mortality. The factors found in repeated DHS programmes that explain these trends fall into five categories: fertility behaviour; nutritional status, breastfeeding, and infant feeding; the use of health services by mothers and for children; environmental health conditions; and socioeconomic status. Both simple analyses and multivariate analyses of changes in these factors between surveys indicate that all factors affected the mortality trends. However, to explain trends in mortality, the variables themselves had to have changed over time. During the 1990s fertility behaviour, breastfeeding, and infant feeding have changed less than other factors and so would seem to have played a smaller role in mortality trends. This study confirms that trends in mortality during the 1990s were related to more than just a handful of variables. It would, therefore, be a mistake to concentrate policy actions on one or a few of these while forsaking others. Countries with the largest decreases in mortality have had substantial improvements in most of the factors that might be used to explain these changes. In some countries mortality has risen. In part these increases can be explained by the factors included in this study, such as deterioration in seeking medical care for children with fever. Other factors that were not measured, such as the increasing resistance of malaria to drug treatment and the increased prevalence of parental HIV/AIDS, may be contributing to the increase noted.

Child Welfare↗