877 resultados para alt-country
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Signatur des Originals: S 36/F08108
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Signatur des Originals: S 36/G00024
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componirt von Johann Obersteiner
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Alex u. Lotte Baerwald
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von Martin Schultze
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According to the United Nations Program on HIV/AIDS (UNAIDS, 2008), in 2007 about 67 per cent of all HIV-infected patients in the world were in Sub-Saharan Africa, with 35% of new infections and 38% of the AIDS deaths occurring in Southern Africa. Globally, the number of children younger than 15 years of age infected with HIV increased from 1.6 million in 2001 to 2.0 million in 2007 and almost 90% of these were in Sub-Saharan Africa. (UNAIDS, 2008).^ Both clinical and laboratory monitoring of children on Highly Active Anti-Retroviral Therapy (HAART) are important and necessary to optimize outcomes. Laboratory monitoring of HIV viral load and genotype resistance testing, which are important in patient follow-up to optimize treatment success, are both generally expensive and beyond the healthcare budgets of most developing countries. This is especially true for the impoverished Sub-Saharan African nations. It is therefore important to identify those factors that are associated with virologic failure in HIV-infected Sub-Saharan African children. This will inform practitioners in these countries so that they can predict which patients are more likely to develop virologic failure and therefore target the limited laboratory monitoring budgets towards these at-risk patients. The objective of this study was to examine those factors that are associated with virologic failure in HIV-infected children taking Highly Active Anti-retroviral Therapy in Botswana, a developing Sub-Saharan African country. We examined these factors in a Case-Control study using medical records of HIV-infected children and adolescents on HAART at the Botswana-Baylor Children's Clinical Center of Excellence (BBCCCOE) in Gaborone, Botswana. Univariate and Multivariate Regression Analyses were performed to identify predictors of virologic failure in these children.^ The study population comprised of 197 cases (those with virologic failure) and 544 controls (those with virologic success) with ages ranging from 3 months to 16 years at baseline. Poor adherence (pill count <95% on at least 3 consecutive occasions) was the strongest independent predictor of virologic failure (adjusted OR = 269.97, 95% CI = 104.13 to 699.92; P < 0.001). Other independent predictors of virologic failure identified were: First Line NNRTI with Nevirapine (OR = 2.99, 95% CI = 1.19 to7.54; P = 0.020), Baseline HIV-1 Viral Load >750,000/ml (OR = 257, 95% CI = 1.47 to 8.63; P = 0.005), Positive History of PMTCT (OR = 11.65, 95% CI = 3.04-44.57; P < 0.001), Multiple Care-givers (>=3) (OR = 2.56, 95% CI = 1.06 to 6.19; P = 0.036) and Residence in a Village (OR = 2.85, 95% CI = 1.36 to 5.97; P = 0.005).^ The results of this study may help to improve virologic outcomes and reduce the costs of caring for HIV-infected children in resource-limited settings. ^ Keywords: Virologic Failure, Highly Active Anti-Retroviral Therapy, Sub-Saharan Africa, Children, Adherence.^
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The objective of this cross-sectional study was to examine the relationship of provincial economic development indices with incidences of child injury mortality in Thailand from 1999 - 2001. All injury deaths among children age 1-14 years were included. The independent variables included gross provincial product per capita (GPP/c), poverty and inequality indices, material and social deprivation indices, population in rural/ urban areas, and migration. Due to multicollinearity of such variables, the 76 provinces were categorized by GPP/c quartile, and means of overall injury, drowning, and transport-related mortality rates were compared among quartile groups. Spearman’s rho correlation between GPP/c and injury mortality rates was also performed. Finally, factor analysis was employed to create a set of factors to be treated as uncorrelated variables and stepwise multiple regression was carried out for the effects of the factors on injury mortality rates. A significant direct relationship was observed between GPP/c and overall injury mortality among children age 1-4 years, and 10-14 year-olds of both genders. Drowning was the main cause of this relationship among children age 1-4 years, and transport-related injury was the principle cause among children age 10-14 years. Conversely, provinces with lower GPP/c experienced higher injury mortality rates among school-age children 5-9 years old for both genders, mostly due to drowning. Factor analysis, and multiple regression results confirmed the relationships between economic development and injury mortality rates. These findings revealed that economic development had an adverse impact on injury-related mortality among children 1 to 4 and 10 to14 in Thailand.
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Those of us committed to the tenets of Family Preservation must advocate for increased awareness and attention to the needs of children and their families in rural America. "Country roads" and the rural spaces they traverse have been eulogized by many poets and song writers as ideal places to live. But they may not be ideal for everyone. The past few months, it has become all too evident that rural America is not immune to acts of extreme violence by troubled children. Even though almost 1/3 of American youth live in rural areas, they have been "virtually ignored by mental health service planners and providers"(Cutrona, Halvorson, & Russell, 1996, p. 217). Mental health risk factors such as poverty, parental alcohol abuse, and family instability are on the rise in rural areas, and there has been an increase in suicide attempts, family violence, depression, and alcohol abuse (Cutrona, Halvorson, & Russell, 1996; Petti & Leviton, 1986; National Mental Health Association, 1988). Native Americans are especially concerned about the increases in child abuse and neglect, depression, substance abuse, and suicide in their communities.
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A study was carried out to evaluate preferences for two cuts, four countries of origin, two forms of presentation, brand and different prices of beef cattle among supermarket buyers in southern Chile, and to distinguish the existence of different market segments, through a survey of 800 people. Using a fractional factorial design for conjoint analysis, it was determined overall that the origin was more important (44.5%) than price (20.8%), form of presentation (12.2%), cut (12.0%) and brand (10.5%), with preference for Chilean and Argentinean striploin, packaged on trays, with no brand at medium price. Using a cluster analysis, three market segments were distinguished. The largest (52.3%) placed great importance on origin and preferred the highest price. The second (27.5%) also valued origin with the greatest preference for Argentinean beef, and it was the only group that preferred the ribeye as the cut. The third (20.5%) placed the greatest importance on price, and was the only group that preferred Paraguayan meat. The segments differed in the importance of eating meat for their personal well-being. The low importance of packaging and brand indicates poorly developed marketing of this product. In order to properly insert brand beef in the Chilean market, communication strategies must be implemented that identify the product with superior quality and that position the brand in the consumer's mind.
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Los objetivos de este trabajo son: (1) analizar las relaciones de similitud de los indicadores bibliométricos; y (2) estudiar el valor de estos para discriminar/agrupar revistas científicas. Como unidades de estudio se utilizaron los 15 indicadores brindados por SCImago Journal Rank (SCImagoJR), aplicados a las 11 revistas paleontológicas generalistas listadas en dicha fuente durante el lapso 1999-2013. Las relaciones de similitud entre los indicadores se estimaron mediante un fenograma, mientras que el valor de los indicadores para agrupar/discriminar revistas se estimó mediante un análisis de componentes principales. Los resultados permiten concluir que, al menos para las revistas consideradas en este estudio, los 15 indicadores utilizados por SCImagoJR muestran redundancia por grupos, debido a las correlaciones existentes entre indicadores de producción, por una parte, y de citación, por otra. Sin embargo, esto es válido solo a los efectos de agrupar las revistas, ya que al considerar cada indicador por separado se aprecian variaciones entre los mismos, que permiten establecer una caracterización más específica de cada revista e, incluso, colaboran a explicar los resultados del análisis multivariado. Por otra parte, los resultados coinciden con los obtenidos por otros autores al reunir en un mismo grupo al SJR y al número de citas/documento en un período de dos años y en otro al índice h y al indicador número total de citas en un lapso de tres años.