903 resultados para human resources for health in low and middle income countries.


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OBJECTIVE - To assess the effect of age on glucose metabolism by examining 1) glucose metabolism in young and middle-aged subjects when total or regional adiposity is taken into account and 2) in vitro glucose transport in adipose tissue explants from young and middle-aged women paired for total and abdominal adiposity. RESEARCH DESIGN AND METHODS - Study 1: body composition, subcutaneous abdominal and visceral adipose tissue areas, and fasting and oral glucose-stimulated glucose and insulin were measured in 84 young and 81 middle-aged men and in 110 young and 91 middle-aged women. Study 2: glucose uptake in subcutaneous abdominal and visceral adipose tissue explants were measured in eight young and eight middle-aged women. RESULTS - Study 1: young and middle-aged men showed similar subcutaneous abdominal tissue area, whereas fat mass and visceral adipose tissue were greater in middle-aged than in young men (P < 0.01). Fat mass and subcutaneous and visceral adipose tissue areas were greater in middle-aged as compared with young women (P < 0.01). Fasting plasma glucose and the glucose response to an oral glucose tolerance test were significantly higher in middle-aged than in young men and women (P < 0.001). Statistical control for visceral adipose tissue area eliminated the difference seen in glucose response in men and women. Study 2: glucose transport in subcutaneous and omental adipose tissue did not differ between young and middle-aged women. CONCLUSIONS - 1) Visceral obesity, more than age per se, correlates with glucose intolerance in middle-aged subjects; 2) aging does not influence in vitro adipose tissue glucose uptake.

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OBJECTIVE: To determine health care costs and economic burden of epidemiological changes in diseases related to tobacco consumption. METHODS: A time-series analysis in Mexico (1994-2005) was carried out on seven health interventions: chronic obstructive pulmonary diseases, lung cancer with and without surgical intervention, asthma in smokers and non-smokers, full treatment course with nicotine gum, and full treatment course with nicotine patch. According with Box-Jenkins methodology, probabilistic models were developed to forecast the expected changes in the epidemiologic profile and the expected changes in health care services required for selected interventions. Health care costs were estimated following the instrumentation methods and validated with consensus technique. RESULTS: A comparison of the economic impact in 2006 vs. 2008 showed 20-90% increase in expected cases depending on the disease (p<0.05), and 25-93% increase in financial requirements (p<0.01). The study data suggest that changes in the demand for health services for patients with respiratory diseases related to tobacco consumption will continue showing an increasing trend. CONCLUSIONS: In economic terms, the growing number of cases expected during the study period indicates a process of internal competition and adds an element of intrinsic competition in the management of preventive and curative interventions. The study results support the assumption that if preventive programs remain unchanged, the increasing demands for curative health care may cause great financial and management challenges to the health care system of middle-income countries like Mexico.

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This paper explores the possibility of using data from social bookmarking services to measure the use of information by academic researchers. Social bookmarking data can be used to augment participative methods (e.g. interviews and surveys) and other, non-participative methods (e.g. citation analysis and transaction logs) to measure the use of scholarly information. We use BibSonomy, a free resource-sharing system, as a case study. Results show that published journal articles are by far the most popular type of source bookmarked, followed by conference proceedings and books. Commercial journal publisher platforms are the most popular type of information resource bookmarked, followed by websites, records in databases and digital repositories. Usage of open access information resources is low in comparison with toll access journals. In the case of open access repositories, there is a marked preference for the use of subject-based repositories over institutional repositories. The results are consistent with those observed in related studies based on surveys and citation analysis, confirming the possible use of bookmarking data in studies of information behaviour in academic settings. The main advantages of using social bookmarking data are that is an unobtrusive approach, it captures the reading habits of researchers who are not necessarily authors, and data are readily available. The main limitation is that a significant amount of human resources is required in cleaning and standardizing the data.

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This research focuses on the career experiences of women managers in the IT industry in China and Finland, two countries with different cultures, policies, size of population, and social and economic structures regarding work-life support and equal opportunities. The object of this research is to present a cross-cultural comparison of women’s career experiences and how women themselves understand and account for their careers. The study explores how the macro and the micro levels of cultural and social processes become manifested in the lives of individual women. The main argument in this thesis is that culture plays a crucial role in making sense of women’s career experiences, although its role should be understood through its interrelationship with other social processes, e.g., institutional relations, social policies, industrial structures and organizations, as well as globalization. The interrelationship of a series of cultural and social processes affects individuals’ attitudes to, and arrangement and organization of, their work and family lives. This thesis consists of two parts. The first part introduces the research topic and discusses the overall results. The second part comprises five research papers. The main research question of the study is: How do cultural and social processes affect the experiences of women managers? Quantitative and qualitative research methods, which include in-depth interviews, Q-methodology, interpretive analysis, and questionnaires, are used in the study. The main theoretical background is culturally sensitive career theory and the theory of individual differences. The results of this study are viewed through a feminist lens. The research methodology applied allows new explorations on how demographic factors, work experiences, lifestyle issues, and organizational cultures can jointly affect women’s managerial careers. The sample group used in the research is 42 women managers working in IT companies in China (21) and Finland (21). The results of the study illustrate the impact of history, tradition, culture, institutional relations, social politics, industry and organizations, and globalization on the careers of women managers. It is claimed that the role of culture – cultural norms within nations and organizations – is of great importance in the relationship of gender and work. Women’s managerial careers are affected by multiple factors (personal, social and cultural) reflecting national and inter-individual differences. The results of the study contribute to research on careers, adding particularly to the literature on gender, work and culture, and offering a complex and holistic perspective for a richer understanding of pluralism and global diversity. The results of the study indicate how old and new career perspectives are evidenced in women managers in the IT industry. The research further contributes to an understanding of women’s managerial careers from a cross-culture perspective. In addition, the study contributes to the literature on culture and extends understanding of Hofstede’s work. Further, most traditional career theories do not perceive the importance of culture in determining an individual’s career experience and this study richens understanding of women managers’ careers and has considerable implications for international human resource management. The results of this study emphasize the need, when discussing women managers’ careers, to understand the ways by which gendering is produced rather than merely examining gender differences. It is argued that the meaning of self-knowledge is critical. Further, the environment where the careers under study develop differs greatly; China and Finland are very different – culturally, historically and socially. The findings of this study should, therefore, be understood as a holistic, specific, and contextually-bound.

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This paper describes the effect of dipyridamole (DIP) on the cytotoxicity of cisplatin in HEp-2 human larynx cancer cells in vitro and the nature of the interaction between cisplatin and dipyridamole. Cytotoxic assays were performed to obtain the IC50 for cisplatin. The cells were treated with 0, 20, 40, 80, 120 or 200 µM cisplatin, with or without a single concentration of DIP and incubated for 60 min at 37ºC and 5% CO2 for 3 days and then counted with a hemocytometer. The accumulation of cisplatin in the cells was measured by atomic absorption and fluorescence was used to determine the membrane binding constant of DIP. In the presence of 10, 20 and 30 µM DIP, the IC50 of cisplatin was reduced by 25, 60 and 82% in HEp-2 cells. Combination index analysis revealed that cisplatin and DIP interact synergistically. In larynx cancer cells, the accumulation of cisplatin increased by 13, 27 and 65% as the DIP concentration was increased from 10 to 20 and 30 µM, respectively. The binding constant of DIP to the cell membrane was estimated to be (0.36 ± 0.12 mg/ml)-1 (N = 2) by fluorescence and cisplatin did not suppress DIP fluorescence. These results suggest that DIP significantly enhances cisplatin cytotoxicity in HEp-2 cells by increasing cisplatin accumulation, probably by altering the cell membrane as suggested by its binding constant. The results obtained reinforce the importance of combination therapy to reduce the doses of chemotherapeutic drugs and therefore the side effects of chemotherapy.

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La captación de glucosa y su conversión en lactato juega un papel fundamental en el metabolismo tumoral, independientemente de la concentración de oxígeno presente en el tejido (efecto Warburg). Sin embrago, dicha captación varía de un tipo tumoral a otro, y dentro del mismo tumor, situación que podría depender de las características microambientales tumorales (fluctuaciones de oxígeno, presencia de otros tipos celulares) y de factores estresores asociados a los tratamientos. Se estudió el efecto de la hipoxia-reoxigenación (HR) y las radiaciones ionizantes (RI) sobre la captación de glucosa, en cultivos de líneas tumorales MCF-7 y HT-29, cultivadas de forma aislada o en cocultivo con la línea celular EAhy296. Se encontró que la captación de glucosa en HR es diferente para lo descrito en condiciones de hipoxia permanente y que es modificada en el cocultivo. Se identificaron poblaciones celulares dentro de la misma línea celular, de alta y baja captación de glucosa, lo que implicaría una simbiosis metabólica de la célula como respuesta adaptativa a las condiciones tumorales. Se evaluó la expresión de NRF2 y la translocación nuclear de NRF2 y HIF1a, como vías de respuesta a estrés celular e hipoxia. La translocación nuclear de las proteínas evaluadas explicaría el comportamiento metabólico de las células tumorales de seno, pero no de colon, por lo cual deben existir otras vías metabólicas implicadas. Las diferencias en el comportamiento de las células tumorales en HR en relación con hipoxia permitirá realizar planeaciones dosimétricas más dinámicas, que reevalúen las condiciones de oxigenación tumoral constantemente.

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El comportamiento biológico de las células cancerosas es influenciado por el microambiente en el que se desarrollan y en este, factores como la angiogénesis o el estímulo de agentes estresores como la hipoxia, se han considerado críticos para su evolución y manejo terapéutico. Uno de los mecanismos moleculares implicados en la respuesta celular frente a estímulos estresores es la activación de vías de señalización intracelulares; en este estudio, se evaluó el estado de la vía JAK/STAT y en ella la expresión/activación de la proteína STAT3 en la línea tumoral (HeLa) y endotelial (EA.hy926), sometidas a hipoxia física y química con mesilato de deferoxamina durante 2, 6 y 24 horas. Adicionalmente, al considerar la importancia de la hipoxia como un agente modificador de la respuesta en el manejo del cáncer utilizando radiaciones ionizantes, se construyeron curvas de supervivencia celular que permitieron evaluar el comportamiento celular frente a estos estímulos. El presente estudio resalta la importancia de la hipoxia como un estímulo que modifica la activación de la proteína STAT3 y la supervivencia de células irradiadas en las dos líneas estudiadas.

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This paper distinguishes three types of countries (rich, middle-income, and pre-industrial) and focus on the latter, which, in contrast to the other two, didn’t complete their industrial and capitalist revolutions. Can pre-industrial countries be governed well and embody the principles of consolidated democracies? Today these countries are under pressure from the imperial West to eschew institutions and developmental strategies that, in the past, allowed rich and middle-income countries to industrialize. At the same time, they are pressured by these same Western parties (and by its own people) to be democratic, even though their societies are not mature enough to fulfill that. In fact, no country completed its industrial and capitalist revolution within the framework of even a minimal democracy, suggesting that such demands are unfair. Added to this, pre-industrial countries are extremely difficult to govern because they usually don’t have a strong nation and capable states. This double pressure to renounce development strategies that have worked for the West while being required to become a democracy represents a major obstacle to their development.

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BACKGROUND AND PURPOSE:Conventional platinum coils cause imaging artifacts that reduce imaging quality and therefore impair imaging interpretation on intraprocedural or noninvasive follow-up imaging. The purpose of this study was to evaluate imaging characteristics and artifact production of polymeric coils compared with standard platinum coils in vitro and in vivo.MATERIALS AND METHODS:Polymeric coils and standard platinum coils were evaluated in vitro with the use of 2 identical silicon aneurysm models coiled with a packing attenuation of 20% each. DSA, flat panel CT, CT, and MR imaging were performed. In vivo evaluation of imaging characteristics of polymeric coils was performed in experimentally created rabbit carotid bifurcation aneurysms. DSA, CT/CTA, and MR imaging were performed after endovascular treatment of the aneurysms. Images were evaluated regarding visibility of individual coils, coil mass, artifact production, and visibility of residual flow within the aneurysm.RESULTS:Overall, in vitro and in vivo imaging showed relevantly reduced artifact production of polymeric coils in all imaging modalities compared with standard platinum coils. Image quality of CT and MR imaging was improved with the use of polymeric coils, which permitted enhanced depiction of individual coil loops and residual aneurysm lumen as well as the peri-aneurysmal area. Remarkably, CT images demonstrated considerably improved image quality with only minor artifacts compared with standard coils. On DSA, polymeric coils showed transparency and allowed visualization of superimposed vessel structures.CONCLUSIONS:This initial experimental study showed improved imaging quality with the use of polymeric coils compared with standard platinum coils in all imaging modalities. This might be advantageous for improved intraprocedural imaging for the detection of complications and posttreatment noninvasive follow-up imaging.

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This chapter discusses the relationship between labour market regulation and regional trade agreements from both a legal and an economic angle. We examine empirically whether regional trade liberalisation is associated with deterioration (“race to the bottom”) of domestic labour standards beyond those reflected in the 1998 ILO Declaration on the Fundamental Principles and Rights at Work. Using a panel of 90 developed and developing countries, covering the years from 1980 to 2005, we find that after the entry into force of a regional trade agreement (RTA), labour standards applying to employment protection and unemployment benefits are significantly weakened. We show that such a lowering of protection levels tends to occur in high income countries and that this effect mainly stems from RTAs among such countries rather than with low or middle income countries. Concern about competitive pressure to weaken domestic labour regulation is reflected in a variety of undertakings in RTAs not to administer labour laws with a view to improving one’s competitive position in trade or foreign direct investment (FDI). The above-mentioned empirical findings indicate that such provisions could potentially become relevant, and that this is more likely to be the case for high income members of RTAs. Our analysis, from a legal point of view, of relevant institutional and procedural mechanisms indicates however that enforceability of the relevant provisions is weak for most of the existing legal texts.

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Research consistently shows that personality development is a lifelong phenomenon, with mean-level and rank-order changes occurring in all life phases. What happens during specific life phases that can explain these developmental patterns? In the present paper, we review literature linking personality development in different phases of adulthood to developmental tasks associated with these phases. Building on previous work, we describe several categories of developmental tasks that are present in all phases of adulthood. However, the specific tasks within these categories change across adulthood from establishing new social roles in early adulthood to maintaining them in middle adulthood and preventing losses in old age. This trajectory is reflected in mean-level changes in personality, which indicates development towards greater maturity (increases in social dominance, conscientiousness, and emotional stability) in early and middle adulthood, but less so at the end of life. Importantly, developmental tasks are not only associated with mean-level changes, but the way in which people deal with these tasks is also related to rank-order changes in personality. We provide an outlook for future research on how the influence of historical time on the normativeness of developmental tasks might be reflected in personality development.

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During Ocean Drilling Program Leg 120, an almost complete Paleogene sediment section on the Kerguelen Plateau in the southern Indian Ocean was recovered. The biostratigraphy of radiolarians from these sediments at Sites 748 and 749 is studied. A biostratigraphic framework established in low and middle latitudes is not applicable because of the absence of most zonal marker species. Biogenic opal is present only in middle Eocene to Oligocene sediments, and three new zones-Lychnocanoma conica, Axoprunum (?) irregularis, and Eucyrtidium spinosum zones-are proposed. The Paleogene antarctic radiolarian fauna is different from that in low and middle latitudes. Three new species, Axoprunum (?) irregularis, Eucyrtidium cheni, and Eucyrtidium spinosum, are described.

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In low and middle latitudes, the Cretaceous/Tertiary boundary is marked by a sudden and pronounced decrease in d13C values of near-surface-water carbonates and a reduction in the surface-to-bottom d13C gradient. These isotopic data have been interpreted as evidence of a decline in surface-water productivity that was responsible for the extinction of many planktic foraminiferal species and other marine organisms at or near the K/T boundary. We present planktic and benthic foraminiferal isotopic data from two almost biostratigraphically complete sections at Ocean Drilling Program Site 738 in the antarctic Indian Ocean and at Nye Kløv in Denmark. These data suggest that planktic carbonate d13C values in high latitudes may not have decreased dramatically at the K/T boundary; thus, surface-water productivity may not have been reduced as much as in low and middle latitudes. Comparison of the records of Site 738 with those of ODP Sites 690 and 750 indicates a pronounced decline in d13C values of planktic and benthic foraminifera and fine-fraction/bulk carbonate ~200 000 yr after the K/T boundary. This reflects a regional shift in the carbon isotopic composition of oceanic total dissolved carbon (TDC) and correlates with a similar change in benthic foraminiferal d13C values at mid- and low-latitude Deep Sea Drilling Project Sites 527 and 577. This oceanographic event was followed by the ecosystem's global recovery ~500 000 yr after the K/T boundary. These data suggest that the environmental effects of the K/T boundary may have been less severe in the high-latitude oceans than in tropical and subtropical regions.

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Strong climatic and temperature fluctuations mark the Late Campanian and Maastrichtian as indicated by stable isotope records from the equatorial Pacific (Site 463) and middle and high latitude South Atlantic (Sites 525, 689 and 690). The first major global cooling decreased intermediate water temperatures (IWT) by 5-6°C between 73-70 Ma. At the same time, sea surface temperature (SST) decreased by 4-5°C in middle and high latitudes. Intermediate waters (IW) temporarily warmed by 2°C in low and middle latitudes between 70-68.5 Ma. Global cooling resumed between 68.5-65.5 Ma when IWT decreased by 3-4°C and SST by 5°C in middle latitudes. About 450 ka before the Cretaceous-Tertiary boundary rapid global warming increased IWT and SST by 3-4°C, though SST in the tropics changed little. During the last 200 ka of the Maastrichtian, climate cooled rapidly with IWT and SST decreasing by 2-3°C. During the global cooling at 71-70 Ma and possibly at 67-65.5 Ma, the sources of cold intermediate waters in the equatorial Pacific, Indo-Pacific and South Atlantic were derived from the high latitude North Pacific. In contrast, during the global climate warming between 65.2-65.4 Ma, the middle latitude South Atlantic was closest to the source of IW production and implies that the low latitude Tethys played a major role in global climate change. Climate changes, sea-level fluctuations and associated restricted seaways appear to be the most likely mechanisms for the alternating sources of IW production.