The impact of medical education and networking on the outcome of leukemia treatment in developing countries. The experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL)

Objectives: Several clinical trials conducted in Europe and US reported favorable outcomes of patients with APL treated with the combination of all trans retinoic acid (ATRA) and anthracyclines. Nevertheless, the results observed in developing countries with the same regimen was poorer, mainly due to high early mortality mainly due bleeding. The International Consortium on Acute Promyelocytic Leukemia (IC-APL) is an initiative of the International Members Committee of the ASH and the project aims to reduce this gap through the establishment of international network, which was launched in Brazil, Mexico and Uruguay. Methods: The IC-APL treatment protocol is similar to the PETHEMA 2005, but changing idarubicin to daunorubicin. All patients with a suspected diagnosis of APL were immediately started on ATRA, while bone marrow samples were shipped to a national central lab where genetic verification of the diagnosis was performed. The immunofluorescence using an anti-PML antibody allowed a rapid confirmation of the diagnosis and, the importance of supportive measures was reinforced. Results: The interim analysis of 97 patients enrolled in the IC-APL protocol showed that complete remission (CR) rate was 83% and the 2-year overall survival and disease-free survival were 80% and 90%, respectively. Of note, the early mortality rate was reduced to 7.5%. Discussion: The results of IC-APL demonstrate the impact of educational programs and networking on the improvement of the leukemia treatment outcome in developing countries.

US medical students' knowledge of obstetric fistula in developing countries

Obstetric fistula is a devastating child birth injury affecting millions of women worldwide. This paper explores the knowledge and understanding of medical students at the University of Texas Health Science Center at San Antonio regarding this global public health issue. Obstetric fistula has been eradicated in most industrialized nations, and has therefore faded from view of many modern medical organizations. The United Nations Population Fund has launched a “Campaign to End Fistula” in an attempt to bring global awareness to this preventable and treatable condition. Based on a survey administered to medical students at UTHSCSA, a baseline understanding of this disorder based on current curriculum is reviewed, with the objective of improving future physicians’ awareness of obstetric fistula. Despite a low survey response rate, there was a significant association between greater knowledge about causes, treatment, and complications of obstetric fistula and advanced years in medical school. However, the fourth year medical students averaged only a 70.5 percent of correct responses on the survey, indicating room for improvement in addressing this topic during medical school. ^

The evidence for groundwater as a source of enteric illness in developing countries: A systematic review of the literature

Groundwater constitutes approximately 30% of freshwater globally and serves as a source of drinking water in many regions. Groundwater sources are subject to contamination with human pathogens (viruses, bacteria and protozoa) from a variety of sources that can cause diarrhea and contribute to the devastating global burden of this disease. To attempt to describe the extent of this public health concern in developing countries, a systematic review of the evidence for groundwater microbially-contaminated at its source as risk factor for enteric illness under endemic (non-outbreak) conditions in these countries was conducted. Epidemiologic studies published in English language journals between January 2000 and January 2011, and meeting certain other criteria, were selected, resulting in eleven studies reviewed. Data were extracted on microbes detected (and their concentrations if reported) and on associations measured between microbial quality of, or consumption of, groundwater and enteric illness; other relevant findings are also reported. In groundwater samples, several studies found bacterial indicators of fecal contamination (total coliforms, fecal coliforms, fecal streptococci, enterococci and E. coli), all in a wide range of concentrations. Rotavirus and a number of enteropathogenic bacteria and parasites were found in stool samples from study subjects who had consumed groundwater, but no concentrations were reported. Consumption of groundwater was associated with increased risk of diarrhea, with odds ratios ranging from 1.9 to 6.1. However, limitations of the selected studies, especially potential confounding factors, limited the conclusions that could be drawn from them. These results support the contention that microbial contamination of groundwater reservoirs—including with human enteropathogens and from a variety of sources—is a reality in developing countries. While microbially-contaminated groundwaters pose risk for diarrhea, other factors are also important, including water treatment, water storage practices, consumption of other water sources, water quantity and access to it, sanitation and hygiene, housing conditions, and socio-economic status. Further understanding of the interrelationships between, and the relative contributions to disease risk of, the various sources of microbial contamination of groundwater can guide the allocation of resources to interventions with the greatest public health benefit. Several recommendations for future research, and for practitioners and policymakers, are presented.^

Symposium on the Reduction of Structural Unemployment in Developing Countries, February 1972, Washington, D. C.

Conducted by the International Manpower Institute under sponsorship of Agency for International Development and U. S. Dept. of Labor.

The Politico-Economics of Electricity Planning in Developing Countries : A Case Study of Ghana

The first author would like to thank the University of Aberdeen and the Henderson Economics Research Fund for funding his PhD studies in the period 2011-2014 which formed the basis for the research presented in this paper.

Exploring Financial Inclusion for Smallholders: Promoting the Sustainable Development of Smallholder Aquaculture in Developing Countries

Thesis (Master's)--University of Washington, 2016-08

O papel das subsidiárias e a internacionalização das atividades tecnológicas pelas Empresas Transnacionais (ETNs)

Este estudo se propõe a analisar os mandatos das subsidiárias de empresas transnacionais (ETNs) no estrangeiro por intermédio dos mecanismos de alocação das atividades de pesquisa e desenvolvimento (P&D) entre os centros descentralizados de pesquisa. Iniciamos o trabalho com a apresentação de uma síntese das diferentes perspectivas encontradas na literatura econômica sobre a subordinação (ou condicionamentos) da autonomia administrativa e tecnológica das filiais. Tal síntese permite estabelecer uma hierarquia entre as subsidiárias e uma tipologia para evolução (retrocesso) de mandatos construída, principalmente, para as ETNs estruturadas em forma de rede corporativa. A seguir, a partir de pesquisas realizadas sobre as atividades dos laboratórios de P&D da indústria de equipamentos de telecomunicações no Brasil, procuramos mostrar que: a) a descentralização das atividades tecnológicas é um fato que não está restrito apenas aos países centrais; b) as tecnologias de informação permitiram que as subsidiárias no país se integrassem aos laboratórios centrais das ETNs, dando-lhes condições de desenvolver e participar de outras atividades tecnológicas, além das tradicionais funções de adaptação de processo e de produtos.

Government procurement policy in developing countries: the case of Petrobras

The aim of this article is to discuss whether public procurement policy can promote innovation by firms located in developing countries. The literature on technological learning is used to create a typology for assessing the impact of public procurement in developing countries from the standpoint of innovation. Petrobras, a Brazilian state-owned enterprise, was chosen as a case study. Petrobras is a global leader in the field of deepwater oil production technology and so offers an interesting opportunity to investigate whether government procurement in developing countries is used to promote the capability of domestic firms to develop innovations. The article presents the findings of a field survey on P-51, a platform that was ordered by the Brazilian state-owned enterprise and began producing in 2009. The case study is based on information collected from interviews with managers of Petrobras, EPC contractors and some of the firms subcontracted to work on P-51.

Understanding successful use of technology in organisations in developing countries : a structurational perspective

Information Technology and its relationship to organisational performance has been a subject of continued interest to researchers and other stakeholders in developing countries. While there is concurrence that IT does contribute to performance, and we are efficiently expanding our knowledge on what factors cause better leveraging of IT resources in organisations, we have done little to understand how these factors interact with technology that results in improved performance. This paper suggests looking that the interaction between organisational resources and technology within the structurational lens, which recognises the recursive interaction between technology and people in the presence of social practices, and the norms that inform their ongoing practices. An ethnographic approach to understanding this interaction between technology and resources, as suggested by the structuration perspective, is suggested, aiming to provide richer insights on the nature of the environment that promotes better use of IT resources in developing countries. Such insights could provide the IT users in developing countries with at least an initial conception of the “IT usage platform” that they could promote in their organisations to leverage the most from their IT resources.

Effects of two-wheelers on saturation flow at signalized intersections in developing countries

Two-wheelers (TW) constitute a major proportion of urban traffic in developing countries and therefore their effect on the saturation flow at signalized intersections could be substantial. This paper attempts to study and analyze the effect of two-wheelers on the saturation flow of signalized intersections by collecting data at a few signalized intersections in Bangalore, India. A strong correlation is observed between the measured saturation flow and the proportion of two-wheeler traffic, which suggest that two-wheelers have significant impact and should be considered in the capacity analysis of signalized intersections. In this paper, the effect of two-wheelers on saturation flow rate is incorporated in a previous model by calibrating and introducing a new adjustment factor for two-wheelers. Results show that saturation flow measured using the modified HCM equation is closer to observed saturation flow values.