Geographic co-distribution of influenza virus subtypes H7N9 and H5N1 in humans, China

Human infection with a novel low pathogenicity influenza A(H7N9) virus in eastern China has recently raised global public health concerns (1). The geographic sources of infection have yet to be fully clarified, and confirmed human cases from 1 province have not been linked to those from other provinces. While some studies have identified epidemiologic characteristics of subtype H7N9 cases and clinical differences between these cases and cases of highly pathogenic influenza A(H5N1), another avian influenza affecting parts of China (2–4), the spatial epidemiology of human infection with influenza subtypes H7N9 and H5N1 in China has yet to be elucidated. To test the hypothesis of co-distribution of high-risk clusters of both types of infection, we used all available data on human cases in mainland China and investigated the geospatial epidemiologic features...

The lag effects and vulnerabilities of temperature effects on cardiovascular disease mortality in a subtropical climate zone in China

This research quantifies the lag effects and vulnerabilities of temperature effects on cardiovascular disease in Changsha—a subtropical climate zone of China. A Poisson regression model within a distributed lag nonlinear models framework was used to examine the lag effects of cold- and heat-related CVD mortality. The lag effect for heat-related CVD mortality was just 0–3 days. In contrast, we observed a statistically significant association with 10–25 lag days for cold-related CVD mortality. Low temperatures with 0–2 lag days increased the mortality risk for those ≥65 years and females. For all ages, the cumulative effects of cold-related CVD mortality was 6.6% (95% CI: 5.2%–8.2%) for 30 lag days while that of heat-related CVD mortality was 4.9% (95% CI: 2.0%–7.9%) for 3 lag days. We found that in Changsha city, the lag effect of hot temperatures is short while the lag effect of cold temperatures is long. Females and older people were more sensitive to extreme hot and cold temperatures than males and younger people.

India's vocational education capacity to support the anticipated economic growth

The buoyancy that the Indian economy experienced between 2000 and 2010, in spite of the global downturn of 2008, is no longer a reality. Growth projections for 2012-13 have been reassessed to 6.5 per cent. This is still higher than most other developed economies of the world (see Figure 1.1), however the growth rate is slowing. The World Bank in its recent forecasts1 expects India’s growth rates not to extend beyond 7.2 % and 7.4 % in the years 2013-14 and 2014-15, respectively. Similarly, the Planning Commission has scaled down the growth target for the 12th Five Year Plan (2012-17) from 9% to 8%. Different reports note different rates, but the consistent message is that the projection of India’s economy is on a downward trend...

Invisible connections : investigating older people's emotions and social relations around objects

The advent of the Internet of Things creates an interest in how people might interrelate through and with networks of internet enabled objects. With an emphasis on fostering social connection and physical activity among older people, this preliminary study investigated objects that people over the age of 65 years viewed as significant to them. We conducted contextual interviews in people's homes about their significant objects in order to understand the role of the objects in their lives, the extent to which they fostered emotional and social connections and physical activity, and how they might be augmented through internet connection. Discussion of significant objects generated considerable emotion in the participants. We identified objects of comfort and routine, objects that exhibited status, those that fostered independence and connection, and those that symbolized relationships with loved ones. These findings lead us to consider implications for the design of interconnected objects.

Pragmatic two-way communication : a practitioner perspective on dialogue in public relations

Public relations has traditionally claimed a close association with dialogue, but this research demonstrates that formal notions of dialogue have little relevance to the real world of public relations practice. Instead, practitioners undertake pragmatic forms of two-way communication, because the constraints within which they work mean dialogue is difficult if not impossible to carry out. This qualitative research project shows that although the label of 'dialogue' has been co-opted in both the theory and practice of public relations, this claimed connection is not supported by empirical evidence.

Happy talk? Toward understanding the significance of dialogue to the practice of public relations

The significance of dialogue to public relations is a persistent and widespread theme in both industry and the academy (International Communication Association, 2013). Dialogue is integral to a number of theoretical perspectives in public relations, from the instrumentalist/functionalist through to the rise of the influence of the two-way symmetric model (Grunig & Hunt, 1984). The emergence of the relational perspective – with its emphasis on dialogue as a means of achieving mutually-beneficial relationships between organisations and stakeholders – brought attention to dialogue as a discrete concept (see, for example, Ledingham, 2003; and 2006). Dialogue continues to be an implicit element in the development of new perspectives on public relations, such as Holtzhausen and Voto’s (2002) postmodern approach...

Disaster resilience in tertiary hospitals : a cross-sectional survey in Shandong Province, China

Background: Hospital disaster resilience can be defined as a hospital’s ability to resist, absorb, and respond to the shock of disasters while maintaining critical functions, and then to recover to its original state or adapt to a new one. This study aims to explore the status of resilience among tertiary hospitals in Shandong Province, China. Methods: A stratified random sample (n = 50) was derived from tertiary A, tertiary B, and tertiary C hospitals in Shandong Province, and was surveyed by questionnaire. Data on hospital characteristics and 8 key domains of hospital resilience were collected and analysed. Variables were binary, and analysed using descriptive statistics such as frequencies. Results: A response rate of 82% (n = 41) was attained. Factor analysis identified four key factors from eight domains which appear to reflect the overall level of disaster resilience. These were hospital safety, disaster management mechanisms, disaster resources and disaster medical care capability. The survey demonstrated that in regard to hospital safety, 93% had syndromic surveillance systems for infectious diseases and 68% had evaluated their safety standards. In regard to disaster management mechanisms, all had general plans, while only 20% had specific plans for individual hazards. 49% had a public communication protocol and 43.9% attended the local coordination meetings. In regard to disaster resources, 75.6% and 87.5% stockpiled emergency drugs and materials respectively, while less than a third (30%) had a signed Memorandum of Understanding with other hospitals to share these resources. Finally in regard to medical care, 66% could dispatch an on-site medical rescue team, but only 5% had a ‘portable hospital’ function and 36.6% and 12% of the hospitals could surge their beds and staff capacity respectively. The average beds surge capacity within 1 day was 13%. Conclusions: This study validated the broad utility of a framework for understanding and measuring the level of hospital resilience. The survey demonstrated considerable variability in disaster resilience arrangements of tertiary hospitals in Shandong province, and the difference between tertiary A hospitals and tertiary B hospitals was also identified in essential areas.

The Healthy Trends of International Relations Research

As the end of the Cold War approached in 1989, Caroline Thomas argued: “It is important that the discipline [International Relations, IR] should address the issue of disease and more broadly, health, not simply to facilitate containment of disease transmission across international borders but also because central notions of justice, equity, efficiency and order are involved” (1989:273).1 Ten years later, Craig Murphy echoed these sentiments. Murphy (2001: 352) proposed that IR had yet to grapple with the political consequences of growing inequality between the world’s rich and poor, and areas such as health—where these inequalities were most stark—should become the field’s core business. How IR’s theories and methods would approach these issues was less clear. Bettcher and Yach (1998) cautioned that IR would be unable to develop progressive research projects that explored global health diplomacy as a global public good without adopting new perspectives and methods. Others warned that the expansion of security studies into areas such as global health would weaken the intellectual coherency of the field (Walt 1991:213). Taking its cue from the recent Ng and Prah Ruger (2011) study, this paper returns to these concerns to briefly explore key trends and potential future concerns of research in IR on health...

Duty in the time of epidemics : what China and Zimbabwe teach us

In November 2002, a man with ‘atypical pneumonia’ treated in Foshan hospital, Guangdong Province, in the People's Republic of China, was the first known case of Severe Acute Respiratory Syndrome (SARS). However, it was not until April 2003 that the Chinese government admitted to the full scale of ‘atypical pneumonia’ cases infected with SARS, two months after the disease had rapidly spread across the world with initial infections in Hong Kong and Vietnam sourced to Guangdong. In 2008, Zimbabwe experienced one of the biggest outbreaks of cholera ever recorded. By February 2009, the disease had spread across all of Zimbabwe's 10 provinces and to neighbouring countries—Botswana, South Africa, Zambia and Mozambique—causing thousands of infections amongst their populations. This article seeks to examine what duties the Chinese and Zimbabwe states had to protect their citizens and the international community from these outbreaks. The article refers to the findings of the International Law Commission's study into the role of states and international organisations in protecting persons in the event of a disaster to consider whether there is an international duty to protect persons from epidemics. The article concludes that both cases reveal a growing concept of protection that entails an international duty to assist individuals when an affected state proves unwilling or unable to assist its own population in the event of a disease outbreak.

Twentieth Anniversary Special Issue – International relations: an Oceanic perspective

In his sweeping survey of the Australian study of international relations, Martin Indyk1 claimed that ‘a common set of assumptions tends to underpin the work of almost all Australian scholars in the discipline’. If that assertion could have been plausibly extended to the whole region one generation ago, it certainly cannot now. The International Relations scholarship emanating from the Oceanic region regales in a diversity of theoretical, methodological and ethical assumptions. This diversity certainly emerged before the first Oceanic Conference on International Studies (OCIS) was convened in Canberra in 2004, however, subsequent conferences in Melbourne (2006) and Brisbane (2008) have galvanised and enriched that diversity. The state of the discipline in the region is as strong and healthy now as it has ever been, as is its integration into the global discipline, something we believe is reflected in the contributions collected in this Special Issue of Global Change, Peace and Security....

What contribution can International Relations make to the evolving global health agenda?

This article presents two approaches that have dominated International Relations in their approach to the international politics of health. The statist approach, which is primarily security-focused, seeks to link health initiatives to a foreign or defence policy remit. The globalist approach, in contrast, seeks to advance health not because of its intrinsic security value but because it advances the well-being and rights of individuals. This article charts the evolution of these approaches and demonstrates why both have the potential to shape our understanding of the evolving global health agenda. It examines how the statist and globalist perspectives have helped shape contemporary initiatives in global health governance and suggests that there is evidence of an emerging convergence between the two perspectives. This convergence is particularly clear in the articulation of a number of UN initiatives in this area—especially the One World, One Health Strategic Framework and the Oslo Ministerial Declaration (2007) which inspired the first UN General Assembly resolution on global health and foreign policy in 2009 and the UN Secretary-General's note ‘Global health and foreign policy: strategic opportunities and challenges'. What remains to be seen is whether this convergence will deliver on securing states’ interest long enough to promote the interests of the individuals who require global efforts to deliver local health improvements.

OCIS and Beyond: International Relations in Australia: Introduction

The Oceanic Conference for International Studies (OCIS) has grown from a small, mostly Australian and New Zealand, affair to an international biennial gathering of scholars from North America, Europe, Asia and the Pacific. Established by a small organising committee drawn from universities across Australia and New Zealand, the principal aim of OCIS was to bring together the Oceanic International Relations (IR) community in an organic and inclusive fashion. There would be no secretariat, minimal bureaucracy, costs would be kept as low as possible, and assistance provided to graduate students. The first OCIS, held at the Australian National University in 2004, proved more successful than the organisers had envisaged. The conference continued to grow at its subsequent meetings at the University of Melbourne (2006) and the University of Queensland (2008). With each conference, a new organising committee was established to take carriage of OCIS. At the 2008 meeting, the question of creating a permanent organising meeting and beginning the transition towards a professional association was discussed in detail. If the transition happens at all, it will be gradual, organic, inclusive, and will prioritise the maintenance of the sense of community OCIS has helped establish. Whilst OCIS itself has flourished, associated initiatives such as OCIS working groups and the OCIS newsletter and listserv have withered on the vine, confirming the original organising committee’s view that endeavours such as this will only prosper to the extent that they are derived and driven from the community as a whole. In 2010, OCIS will hold its first conference in New Zealand, hosted by the University of Auckland...

An examination of microfinance self-help groups and the poorest of the poor women in Tamil Nadu, India

This study examined the formation and operation of women's microfinance self-help groups in southern India and investigated whether or not the poorest of the poor women were accepted as members of those groups. The study found that caste was used as a selection criterion. Many eligible women excluded themselves from joining the self-help group due to their own lack of education, age, poor health, poverty and lack of trust in the system. The research revealed that self-help groups enhanced women's income and education, improved village infrastructure, and reduced household conflict. Factors that might prevent inclusion of the poorest of the poor in future microfinance programs were identified.

Root caries patterns and risk factors of middle-aged and elderly people in China

The objectives of this study were to describe root caries patterns of Chinese adults and to analyze the effect of selected demographic and socioeconomic factors on these patterns. A total sample of 1080 residents aged 35-44-years-old and 1080 residents aged 65-74-years-old from three urban and three rural survey sites in Hubei Province participated in both an oral health interview and a clinical oral health examination. Root surface caries prevalence rates were 13.1% in the middle-aged group and 43.9% in the elderly group. The mean number of teeth affected by caries in the middle-aged group was reported at 0.21 and 1.0 in the elderly group. Mean Root Caries Index (RCI) scores of the middle-aged were reported at 6.29 and elderly subjects were reported at 11.95. Elderly people living in rural areas reported a higher RCI score (13.24) than those living in urban areas (10.70). A significantly higher frequency of root surface caries was observed in elderly participants (P < 0.001, OR = 3.80) and ethnic minorities (P < 0.001, OR = 1.93). In addition, smokers, nontea drinkers, and those with an annual household income of 10,000 yuan or less tended to have higher caries prevalence. RCI figures for the different tooth types ranged from 1% to 16%, indicating a wide variation in attack rates. In conclusion, our study suggests that root surface caries occurrence is high among the Chinese adult population, especially older adults. With an increasing number of retained teeth in both middle-aged and elderly people, root caries is a growing disease in the People's Republic of China which deserves more attention in future research.