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Determinants of temporal and areal variation in infant mortality in Germany, 1871-1933.

This article investigates how sociodemographic, economic, medical, and public health factors influence infant mortality by using data about German administrative areas from 1871 to 1933. Marital fertility has the largest impact on infant mortality, followed by illegitimacy, medical care, urbanization, and infant welfare centers. The variables considered here account for most of the variation in infant mortality. Some of the unexplained variance is due to factors associated with regions, such as breastfeeding patterns, and with time periods, such as national health insurance. The analyses found no evidence that advances in medical technology affected infant mortality or that the influence of economic development changed over time.

Child Health Services↗

[Migration and the business cycle in the Federal Republic of Germany since the 1960s].

The relationship between migration and economic development in the Federal Republic of Germany is explored. Questions considered include: "How does the economic development change the intensity of migration flows in short and long distance migrations? What kinds of migrations are especially sensitive to economic changes? How do these changes come about?" Migration patterns between West Germany and other European countries are analyzed in comparison with a time series of economic parameters, such as the labor market. Migrations between three West German cities and their surrounding regions are also analyzed in comparison with a different series of parameters, including new housing construction. (SUMMARY IN ENG)

Demography↗

The world economic crisis. Part 1: Repercussions on health.

The widespread economic crisis has resulted in a fall in living standards in the western hemisphere of over 9% (1981-83) and in Sub-Saharan Africa they have fallen to the level of 1970. Food production in the African countries most seriously affected by drought dropped by 15% between 1981 and 1983. Living standards also fell in some countries in Europe and in some of the poorest countries of Asia. The high cost of fuel, the heavy burden of interest payments and unfavourable terms of trade in Africa and Latin America led to serious unemployment, devaluation of national currencies and formidable austerity policies. While some countries have succeeded in protecting their health services from cuts in public expenditure, in many others cuts in health budgets have been substantial. The effects of the crisis in some countries have amounted to the virtual disintegration of rural health services. There are limited data available to show what has been happening to levels of expenditure on health, but those presented here demonstrate that levels of health expenditure per head have fallen in many countries. The cumulative effects on health of increased poverty, unemployment, underemployment and famine, and the reduced capacity of health services to respond to health problems can be documented with facts for a number of countries in Latin America and Africa. Malnutrition has increased and improvements in infant mortality have been checked or reversed. The economic crisis has placed at risk the health of the most vulnerable.

Africa↗

The change of family size and structure in China.

With the socioeconomic development and change of people's values, there is some significant change in family size and structure in China. According to the 10% sample data from the 4th Census, 1 family has 3.97 persons on an average, less than the 3rd Census by 0.44 persons; among all types of families, 1-generation families account for 13.5%, 3 generation families for 18.5%, and 2-generation families account for 68%. Instead of large families consisting of several generations and many members, small families has now become a principal family type in China. According to the analysis of the sample data from the 4th Census, the family size is mainly decided by the fertility level in particular regions, and it also depends on the economic development. So family size is usually smaller in more developed regions, such as in Beijing, Tianjin, Zhejiang, Liaoning as well as in Shanghai of which family size is only 3.08 persons; and family size is generally larger in less developed regions such as in Qinghai, Guangxi, Gansu, Xinjiang, and in Tibet of which family size is as large as 5.13 persons. Specialists regard the increase of the number of families as 1 of the major consequences of the economic development, change of living style, and improvement of living standard, Young people now are more inclined to live separately from their parents. However, the increase of the number of families will undoubtedly place more pressure on housing and require more furniture and other durable consumer goods from the market. Therefore, the government and other social sectors related should make corresponding plans and policies to cope with the increase of families and minifying of family size so as to promote family planning and socioeconomic development, and to create better social circumstances for small families.

Asia↗

Are the economics of pharmaceutical research and development changing?: productivity, patents and political pressures.

Pharmaceutical research and development (R&D) competition in the 1980s and 1990 s was characterised by rising R&D expenditures, favourable returns to innovators and the introduction of many new classes of drugs with high social benefits. However, in the past 3 years, the number of new drug introductions has been well below the historical trend, while the cost per new drug continues to increase. In addition to lagging R&D productivity, the industry has been characterised by other economic and policy uncertainties. These include a wave of early patent challenges and growing political pressure to contain pharmaceutical expenditures. This paper examines the consequences of these developments.

Drug Approval↗

The future of nursing education.

Market-driven economic policy, dramatic technology developments, changing demographics, and the knowledge explosion are rapidly changing health care and educational institutions as well as creating a climate of continuous rapid change. Nursings' contract with society requires the profession to be responsive to these changes. Four views of changes in nursing practice and therefore nursing education are presented. Changes in the role of faculty and in the nature of the curriculum are described. Twelve strategies for facilitating change are listed.

Clinical Competence↗

The historiography of hunger: changing views on the world food problem, 1945-1980.

The author discusses changing views on the world food problem since 1945. "The extent of the problem has been a matter of debate as hunger cannot be directly measured; estimated minimum requirements for energy have been reduced since 1945 and the causes of malnutrition reappraised. World food production has kept up with population growth since 1945, as it has in all major regions except Africa. But when individual countries are considered, food output per head has been declining since 1961-5 in many countries in Africa and Asia. Food output has been increased in the developing countries by expanding the area under cultivation and by increasing yields." In addition the author concludes that "the Green Revolution has however not achieved early expectations and has had some adverse economic and social consequences. Because world food output per caput has risen considerably since 1945, some have argued that the world food problem is one of distribution, not production. Data on food output per caput suggest this is not always so."

Agriculture↗

Neuroscience nursing practice in a new millennium.

Neuroscience nursing practice in the 21st century is considered from two perspectives: 1) scope of care and roles within a collaborative interdisciplinary model of care; and 2) patient-focused care within the challenging health care system. The implications of illness trends for neuroscience nursing practice are discussed, as are the developing changes in the health care delivery system driven by economics. The article focuses on the futuristic role of disease management in shaping practice and the models for practice which will prevail in this new health care environment.

Acute Disease↗

Agricultural policy and sustainable livestock development.

Future agricultural and rural development is, to a large extent, influenced by the projected food needs of 2.5 billion people expected to swell the world population by 2020. This increase will require more food in general and, in view of recent experience in East Asia, more animal products. To achieve this increase will require judicious use of resources, and trade, especially in those countries where natural resources are insufficient to support food production. Achieving food sufficiency in a sustainable manner is a major challenge for farmers, agro-industries, researchers and governments. The latter play an important role as many of the farmers' choices are, to a large extent, directed by government or supra-government, often through macro- and micro-economic policy. In many countries the economic, environmental, trade and agricultural policies have not been conducive to an agricultural development that is risk-free with respect to the environment, animal welfare or public health. The recent decline of government support in agriculture forced farmers in Western countries to think about more risk adverse agricultural practices and more efficient production systems. On the other hand, many countries in Eastern Europe and the former Soviet Union, as well as other developing countries, are still going through a painful process of adjustment to new market conditions. International banks and development agencies have a mandate to help developing countries, but are somewhat restricted both by needing to work directly with governments and by their perceived dogmatic approach to development. Changing policies do, now and in the future, also affect the development of animal disease control programmes, including the control of parasitic diseases. On the one hand there is an increasing interest in risk-free control practices, and on the other hand a demand for greater regulatory control over the production process. As parasitic diseases of animals are closely linked to the environment (i.e. grazing and waste management) and public health (i.e. parasitic zoonoses), the new interest in sustainable agriculture provides a challenge for those concerned with the control and prevention of animal parasitism.

Agriculture↗

[[Regional and monthly variations in mortality]].

"Regional and monthly variations in Korean mortality during the period of 1975-1988 were investigated using vital registration data....A clear regional variation in death rates was found, with lower rates in the large cities of Seoul and Pusan and [in] two provinces...." Differences in provincial rates are associated with socioeconomic variables and differences in levels of public health development. Changes in seasonal variations in mortality over time are noted due to the changing pattern of causes of death from the predominance of infectious diseases in the 1970s to chronic and degenerative diseases in the 1980s. (SUMMARY IN ENG)

Asia↗