Rural smokers : a prevention opportunity

Background: Smoking is the largest single cause of preventable death and disease in Australia. This study describes smoking prevalence and the characteristics of rural smokers to guide general practitioners in targeting particular groups.

Methods: Cross sectional surveys in the Greater Green Triangle region of southeast Australia using a random population sample (n=1563, participation rate 48.7%) aged 25–74 years. Smoking information was assessed by a self administered questionnaire.

Results: Complete smoking data were available for 1494 participants. Overall age adjusted current smoking prevalence was 14.9% (95% CI: 13.1–16.7). In both genders, current smoking prevalence decreased with age. Those aged 25–44 years were more likely to want to stop smoking and to have attempted cessation, but less likely to have received cessation advice than older smokers.

Discussion: This study provides baseline smoking data for rural health monitoring and identifies intervention opportunities. General practice is suited to implement interventions for smoking prevention and cessation at every patient encounter, particularly in younger individuals.

Regional differences in business start-up rates in Australia : implications for future research and public policy

The Global Entrepreneurship Monitor (GEM) project in Australia provided both data and theoretical framework for this investigation of regional differences in entrepreneurial activity within Australia and the factors that might underlie such differences.

This study found that entrepreneurial activity as measured by participation in business start-ups varied significantly between 11 defined regions of Australia. Factors found to be associated with high start-up activity were personal acquaintance with someone who had recently started a business (strong and statistically significant) and the perception of good opportunities for starting a business locally (indicative only). Participation rate by age range across region varied widely. Sample size precluded more in-depth analysis.

The study indicates a need for a research program designed to produce data and analysis that might be constructively shared by those who wish to foster entrepreneurship in Australia.

Significant challenges remain to achieve risk reduction targets for cardiovascular secondary prevention and diabetes

Objective: To examine population-level evidence treatment gaps for cardiovascular risk among rural patients with existing cardiovascular disease or diabetes.

Methods: Three population surveys were undertaken in the Greater Green Triangle region of southeastern Australia 2004-2006. Adults aged 25-84 yrs were randomly selected using age/sex stratified electoral role samples. A representative 1690 participants were recruited (48% participation rate). Anthropometric, clinical and self-administered questionnaire chronic disease risk data were collected in accordance with the WHO MONICA protocol. Detailed investigation of cardiovascular and diabetes history, key cardiovascular risk factors, medication use and health behaviours were included.

Results: After adjusting for age and sex, an estimated 12% (sample n=272) of the population had one or more of coronary heart disease, stroke, or diabetes. Blood pressure was at target (<130/80 mmHg) for 26% of these individuals, and 61% were treated with antihypertensive medications. Lipid targets were achieved by 17% for total cholesterol (<4 mmol/L), 18% for LDL cholesterol (<2 mmol/L), 77% for HDL cholesterol (>1.0 mmol/L) and 44% for triglycerides (<1.5 mmol/L); overall 6% achieved all four lipid targets and 60% reported use of lipid-lowering therapy, including 51% overall using statins. Ten percent were current smokers, and four in every five patients (82%) had suboptimal BMI (outside the range 18.5 - 25.0).

Conclusions: All participants with uncontrolled blood pressure and most with uncontrolled lipids should be taking medications. The magnitude of evidence treatment gaps suggests existing models of care need fundamental reform and renewed focus on prevention.

Potential of pharmacists to help reduce the burden of poorly managed cardiovascular risk

Introduction: Rural areas require better use of existing health professionals to ensure capacity to deliver improved cardiovascular outcomes. Community pharmacists (CPs) are accessible to most communities and can potentially undertake expanded roles in prevention of cardiovascular disease (CVD).

Objective: This study aims to establish frequency of contact with general practitioners (GPs) and CPs by patients at high risk of CVD or with inadequately controlled CVD risk factors.

Design, setting and participants: Population survey using randomly selected individuals from the Wimmera region electoral roll and incorporating a physical health check and self-administered health questionnaire. Overall, 1500 were invited to participate.

Results: The participation rate was 51% when ineligible individuals were excluded. Nine out of 10 participants visited one or both types of practitioner in the previous 12 months. Substantially more participants visited GPs compared with CPs (88.5% versus 66.8%). With the exception of excess alcohol intake, the median number of opportunities to intervene for every inadequately controlled CVD risk factor and among high risk patient groups at least doubled for the professions combined when compared with GP visits alone.

Conclusion: Opportunities exist to intervene more frequently with target groups by engaging CPs more effectively but would require a significant attitude shift towards CPs. Mechanisms for greater pharmacist integration into primary care teams should be investigated.

Evaluating OSHA's ethylene oxide standard: employer exposure-monitoring activities in Massachusetts hospitals from 1985 through 1993

This study characterized exposure-monitoring activities and findings under the Occupational Safety and Health Administration's (OSHA's) 1984 ethylene oxide (EtO) standard. In-depth mail and telephone surveys were followed by on-site interviews at all EtO-using hospitals in Massachusetts (n = 92, 96% participation rate). By 1993, most hospitals had performed personal exposure monitoring for OSHA's 8-hour action level (95%) and the excursion limit (87%), although most did not meet the 1985 implementation deadline. In 1993, 66% of hospitals reported the installation of EtO alarms to fulfill the standard's "alert" requirement. Alarm installation also lagged behind the 1985 deadline and peaked following a series of EtO citations by OSHA. From 1990 through 1992, 23% of hospitals reported having exceeded the action level once or more; 24% reported having exceeded the excursion limit; and 33% reported that workers were accidentally exposed to EtO in the absence of personal monitoring. Almost a decade after passage of the EtO standard, exposure-monitoring requirements were widely, but not completely, implemented. Work-shift exposures had markedly decreased since the mid-1980s, but overexposures continued to occur widely. OSHA enforcement appears to have stimulated implementation.

The German SCREEN project - design and evaluation of the communication strategy

Background: Skin cancer is the most common cancer in light-skinned populations worldwide. Primary and secondary preventive activities such as skin cancer screening are intended to reduce skin cancer burden. In 2003, a population-based skin cancer screening project [SCREEN (Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany)] was conducted in Northern Germany with more than 360 000 people screened. SCREEN was supported by a communication intervention that was aimed at informing the population about skin cancer, its risk factors and the screening intervention as well as preparing the health professionals for the project. Within SCREEN both physicians and practice nurses were educated in counselling. The aim of the present article is to describe and evaluate the communication strategy accompanying SCREEN. Methods: Two computer-assisted telephone interview surveys were performed in April/May 2003 and May 2004. Participants had to be members of the statutory health insurance and be aged ≥20 years. They were asked about knowledge of skin cancer, perception of physicians' performance and skin cancer screening in general. Data are mainly presented in a descriptive manner. For statistical analyses, Mann-Whitney U test and Pearson's chi-square test were used. Results: Knowledge about sunburn in childhood and high ultraviolet exposure as skin cancer risk factors increased during SCREEN. Simultaneously, the awareness for early detection of skin cancer increased significantly from 41.3 to 74.0% (P < 0.001). A total of 21.5% of the interviewees participated in the skin cancer screening project, similar to the population-based participation rate reached. Conclusion: A comprehensive communication strategy accompanying a screening intervention improves the knowledge of potential screenees and may additionally increase the participation rate.

Linkages between growth, poverty and the labour market

From a methodological point of view, this paper makes two contributions to the literature. One contribution is the proposal of a new measure of pro-poor growth. This new measure provides the linkage between growth rates in mean income and in income inequality. In this context, growth is defined as pro-poor (or anti-poor) if there is a gain (or loss) in the growth rate due to a decrease (or increase) in inequality. The other contribution is a decomposition methodology that explores linkages growth patterns, and labour market performances. Through the decomposition analysis, growth in per capita income is explained in terms of four labour market components: the employment rate, hours of work, the labour force participation rate, and productivity. The proposed methodology are then applied to the Brazilian National Household Survey (PNAD) covering the period 1995-2004. The paper analyzes the evolution of Brazilian social indicators based on per capita income exploring links with adverse labour market performance.

Desenvolvimento econômico e mercado de trabalho urbano no nordeste brasileiro

A história recente do Nordeste caracteriza-se por uma primeira fase de isolamento e outra de articulação. Nessa segunda fase, o dinamismo que se instala a partir da década de sessenta provocou profundas transformações na economia da região. Essas transformações implicaram em elevadas taxas de expansão do produto regional, alterações na estrutura produtiva através da adoção de novos processos de trabalho que implicou de um lado, na redução da demanda por trabalho e de outro, na sua expansão. Registrou-se, também, mudanças bastante significativas nos gêneros industriais reduzindo a participação na produção das indústrias de bens de consumo não-duráveis e aumentando de modo importante a participação das indústrias de bens intermediários voltadas para o mercado nacional e internacional, o que contribui para aumentar a dependência do Nordeste em relação as regiões mais ricas. As mudanças iniciadas no setor industrial se propagam para os setores primários, secundários e terciários. No setor agrícola, as transformações dificultaram a sobrevivência do trabalhador, ampliaram as relações capitalistas no setor manifestas na maior proletarização da mão-de-obra rural; estimularam as emigrações para. as cidades e elevaram consideravelmente a participação da população ocupada em atividades predominantemente urbanas. No setor terciário, as mudanças provocaram o incremento do subemprego, grande diferenciação nos 11 níveis de produtividade e rendimentos, gerando um quadro de aprofundamento da heterogeneidadeda estrutura produtiva e do mercado de trabalho. Adicionalmente, houve uma excessiva urbanização, aumento da concentração da renda, incremento do grau de informalidade, crescimento do número de empregados clandestinos e maior participação dos menores e adultos no mercado de trabalho. Tudo isso, ocorreu,associado ao quadro de dinamismo das atividades produtivas, sem paralelo na história recente das regiões atrasadas do pais. A análise dos dados também mostrou que o nível do desemprego aberto, é relativamente baixo tanto para os homens como para as mulheres. Isto ocorre porque na expansão ou na retração econômica as flutuações no nível de ocupação são acampanhadas por modificações da taxa de participação da PIA no mercado de trabalho. Portanto, a recente infonnalidade, fonnalidade e submersão da mão-de-obra no Nordeste estão associadas a um contexto de crescimento da economia e, por conseguinte, resultam do estilo ou padrão de acumulação de capital que, mesmo se realizando com altas taxas de expansão, não repercute positivamente no mercado de trabalho, nos tennos requeridos pela oferta de mão-de-obra. Assim, o aparecimento de um excedente relativo de população é resultado do padrão de acumulação da capital da economia regional, que está associado ao modo como o Nordeste se inseriu no contexto nacional e, nesse sentido, é o padrão de industrialização o principal fator responsável por parte importante do insucesso da economia local em absorver produtivamente a população que se apresenta no mercado de trabalho urbano

Linkages between pro-poor growth, social programmes and labour market : the recent Brazilian experience

From a methodological point of view, this paper makes two contlibutions to the literature. One contribution is the proposal of a new measure of pro-poor growth. This new measure provides the linkage between growth rates in mean income and in income inequality. In this context, growth is defined as pro-poor (or anti-poor) if there is a gain (or loss) in the growth rate due to a decrease (or increase) in inequality. The other contribution is a decomposition methodology that explores linkages between three dimensions: growth pattems, labour market performances. and social policies. Through the decomposition analysis, growth in per capita income is explained in terms of four labour market components: the employment rate. hours of work, the labour force participation rate. and productivity. We also assess the contribution of different nonlabour income sources to growth patterns. The proposed methodologies are then applied to the Brazilian National Household Survey (PNAD) covering the period 1995-2004. The paper analyzes the evolution of Brazilian social indicators based on per capita income exploring links with adverse labour market performance and social policy change, with particular emphasis on the expansion of targeted cash transfers and devising more propoor social security benefits.

Três ensaios sobre o mercado de trabalho no Brasil

Esta tese é composta por três artigos e uma nota, sendo um em cada capítulo. Todos os capítulos enquadram-se na área de Microeconomia Aplicada e Economia do Trabalho. O primeiro artigo estende o modelo tradicional de decomposição das flutuações na taxa de desemprego de Shimer (2012), separando o emprego formal do informal. Com essa modificação, os principais resultados da metodologia se alteram e conclui-se que os principais fatores para a queda do desemprego na última década foram (i) a queda na taxa de participação, principalmente pela menor entrada na força de trabalho; (ii) o aumento da formalização, atingido tanto pelo aumento da probabilidade de encontrar um trabalho formal quanto pela probabilidade de deixar a condição de empregado formal. O segundo capítulo apresenta estimativas para o retorno à educação no Brasil, utilizando uma nova metodologia que não necessita de variáveis de exclusão. A vantagem do método em relação a abordagens que utilizam variáveis instrumentais é a de permitir avaliar o retorno médio para todos os trabalhadores (e não somente os afetados pelos instrumentos) e em qualquer instante do tempo. Face aos resultados, concluímos as estimativas via MQO subestimam o retorno médio. Discute-se possíveis explicações para esse fenômeno. O terceiro artigo trata da terceirização da mão de obra no Brasil. Mais especificamente, mede-se o diferencial de salários entre os trabalhadores terceirizados e os contratados diretamente. Os resultados de uma comparação não condicional indicam que os terceirizados têm salário médio 17% menor no período 2007 a 2012. Porém, com estimativas que levam em conta o efeito fixo de cada trabalhador, esse diferencial cai para 3,0%. Além disso, o diferencial é bastante heterogêneo entre os tipos de serviços: aqueles que utilizam trabalhadores de baixa qualificação apresentam salário menores, enquanto nas ocupações de maior qualificação os terceirizados têm salários iguais ou maiores do que os diretamente contratados. Mais ainda, as evidencias apontam para a diminuição do diferencial ao longo do tempo no período analisado. Finalmente, a nota que encerra a tese documenta dois aspectos relevantes e pouco conhecidos da Pesquisa Mensal de Emprego do IBGE que podem levar a resultados imprecisos nas pesquisas que utilizam esse painel se não forem tratados adequadamente.

Preliminary Overview of the Economies of Latin America and the Caribbean 2008

Includes bibliography

The employment situation in Latin America and the Caribbean: Crisis in the labour markets and countercyclical responses

As predicted in the first bulletin, produced jointly by the Economic Commission for Latin America and the Caribbean (ECLAC) and the International Labour Organization (ILO), the impact of the economic crisis continued to be felt in Latin America and the Caribbean during the second quarter of 2009. Regional exports of goods and services contracted in response to sluggish demand on international markets, while remittances and foreign direct investment flows continued to fall, credit lost its buoyancy and the total wage bill diminished, owing mainly to job losses. As a result, the growth forecasts of many countries had to be adjusted downwards. Since the end of 2008, the countries of the region had started to implement countercyclical policies —albeit with significant differences— in an effort to use public spending to counter flagging investment and consumer-spending levels and boost aggregate demand. In this second bulletin, ECLAC and ILO show how the impact of the crisis has deepened in labour markets in the region in the first half of the year and examine existing options and the outcome of public-infrastructure and emergency employment programmes designed to mitigate the impact of the crisis on the labour market. The unemployment rate has risen in practically all countries compared with the previous year and this situation worsened further in the second quarter, when urban unemployment exceeded the rate of the corresponding period in 2008 by 1 percentage point (to stand at 8.5%, up from 7.5%), while in the first quarter, the variation was 0.6 of a percentage point. Labour indicators also point to an increase in informality, a decline in employment with social protection and a decrease in full-time employment. Labour-market trends observed in the first half-year, together with the forecast for a 1.9% decline in regional GDP in 2009, suggest that the average annual rate of urban unemployment in the region will be close to 8.5%. This forecast is slightly less pessimistic than the estimate given in the first bulletin; this is attributable to the fall in the participation rate in the first half-year to levels that are expected to remain low for the rest of the year. Without this reduction in the labour supply, due largely to the “discouragement effect”, the annual average urban unemployment rate would stand at between 8.8% and 8.9%. Thus, the open urban unemployment figure would increase by 2.5 million and if the “discouraged job-seekers” are included, then the number of additional persons not finding a niche in the urban labour market would climb to 3.2 million. In the region, as in the rest of the world, there are signs that the crisis may have reached bottom in the middle of the year. In many countries, production levels have ceased their decline and there are indications of an incipient recovery leading to cautious optimism that there may be a moderate upturn in labour markets in the fourth quarter. The pace of recovery will vary from one country to the next and is expected to be gradual at best. Even with the return to a growth path, there should be no illusion that the labour problems will immediately disappear. First, the recovery in employment is expected to lag behind the upturn in economic activity. Second, since economic growth is likely to remain moderate in the short term and well below the rates recorded between late 2003 and mid-2008, demand for labour and consequently the generation of good-quality jobs will continue to be weak. Thus, countries should not relax their efforts to defend and create decent jobs, but rather should take steps to improve the effectiveness and efficiency of available instruments. In this way, the region will be in a better position not only to confront the challenges of economic recovery, but also to strengthen the foundations for social inclusion and for advancing under more favourable conditions towards fulfilment of the Millennium Development Goals.

Gamification

Nowadays games are so popular that they have become an important part of our lives. Inspired by the motivational properties of games, some scholars made the proposal of applying game mechanics and elements into other fields thus emerged the concept of “Gamification”, along with various other popular concepts for the realization of the application. The effectiveness of gamification in improving user engagement and changing behaviors is demonstrated not only in theory but also in practice. This thesis aims to introduce the related concepts of gamification and the gamification design framework. In addition, this thesis introduces also the concept of MOOCs and the challenges faced by MOOCs platforms. Some of those challenges such as high dropout rate and low participation rate could be solved by gamification. Through creating a more interesting game experience and consequently fostering user motivation, high engagement will be ensured. Following this logic, this thesis explores how to use gamification on MOOCs platform to improve user engagement and the corresponding impacts. Despite of the lack of a quantitative analysis of the effects of gamification on MOOCs platform, the facts found and observed in this thesis support the effectiveness of gamification in improving user engagement on MOOCs platforms.

Design of removable partial dentures: a survey of dental laboratories in Greece

The aim of this study was to compare data on design and fabrication methods of removable partial dentures (RPDs) in two major cities in Greece. A questionnaire was sent to 150 randomly selected dental technicians. The participation rate was 79.3%. The anterior palatal strap, the lingual bar, and the Roach-type clasp arm designs were preferred. Half of the RPDs fabricated were retained using precision attachments. Differences between the two cities were observed in types of major maxillary connectors used, types of attachments and impression materials used, as well as the design of distal-extension RPDs. Postdoctoral education was found to have an impact on RPD fabrication. Despite the differences observed, design and fabrication of RPDs followed commonly used principles.

Patterns of exposure to infectious diseases and social contacts in early life and risk of brain tumours in children and adolescents: an International Case-Control Study (CEFALO)

BACKGROUND Infectious diseases and social contacts in early life have been proposed to modulate brain tumour risk during late childhood and adolescence. METHODS CEFALO is an interview-based case-control study in Denmark, Norway, Sweden and Switzerland, including children and adolescents aged 7-19 years with primary intracranial brain tumours diagnosed between 2004 and 2008 and matched population controls. RESULTS The study included 352 cases (participation rate: 83%) and 646 controls (71%). There was no association with various measures of social contacts: daycare attendance, number of childhours at daycare, attending baby groups, birth order or living with other children. Cases of glioma and embryonal tumours had more frequent sick days with infections in the first 6 years of life compared with controls. In 7-19 year olds with 4+ monthly sick day, the respective odds ratios were 2.93 (95% confidence interval: 1.57-5.50) and 4.21 (95% confidence interval: 1.24-14.30). INTERPRETATION There was little support for the hypothesis that social contacts influence childhood and adolescent brain tumour risk. The association between reported sick days due to infections and risk of glioma and embryonal tumour may reflect involvement of immune functions, recall bias or inverse causality and deserve further attention.