89 research outputs found

    Treatment adherence among sputum smear-positive pulmonary tuberculosis patients in mountainous areas in China

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    <p>Abstract</p> <p>Background</p> <p>We carried out an investigation in five provinces in China to assess treatment adherence and identify factors associated with insufficient treatment adherence in tuberculosis (TB) patients in mountainous, rural areas of China.</p> <p>Methods</p> <p>In each of the five provinces, all counties with > 80% mountainous area were stratified into three groups according to their gross domestic product. In each stratum, one county was randomly sampled. Study subjects were sampled from all smear positive TB cases registered in 2007 in the target counties. TB patients, village doctors, county doctors and directors of the TB prevention and control institutes were interviewed. Insufficient medication adherence was defined as taking less than 90% of anti-TB drug doses prescribed. Insufficient re-examination adherence was defined as having less than the recommended three sputum smear examinations during the treatment course.</p> <p>Results</p> <p>A minority of patients took drugs under direct observation: on average 29% during the intensive phase of treatment. In total, 524 TB patients were included, of whom 49 (9.4%) took less than 90% of all doses prescribed and 92 (17.6%) did not have all sputum smear examinations, with substantial variations between the provinces. In multivariable analysis, no direct observation of treatment during the intensive phase and the presence of adverse events were associated both with insufficient medication adherence and insufficient re-examination adherence. Overall, 79% of patients were adherent both to treatment and re-examinations.</p> <p>Conclusions</p> <p>In these remote and poor areas of China, the TB control program is not fully functioning according to the guidelines. The majority of patients are not treated under direct observation, while direct observation by health care staff was associated with better adherence, both to drug therapy and re-examinations. Insufficient adherence increases the risk of unsuccessful treatment outcomes and development of drug resistance. Measures should be taken urgently in these areas to strengthen implementation of the international Stop TB strategy.</p

    Reproductive rights approach to reproductive health in developing countries

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    Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between.This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women&#x0027;s reproductive health in developing countries. The empowerment strategy for improving reproductive health is theoretically situated on a number of background factors such as economic and social development.Cross-national socioeconomic and demographic data from a number of international organizations on 142 developing countries are used to test a model of reproductive rights and reproductive health.The findings suggest that both economic and democratic development have significant positive effects on levels of gender equality. The level of social development plays a prominent role in promoting reproductive rights. It is found that reproductive rights channel the influences of social structural factors and gender equality on reproductive health

    Fertility and population change in the United Kingdom

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    As in most wealthy countries, the United Kingdom (UK) population is aging and is set to continue to age for the next several decades. Recent and projected rates of change in the share of the elderly population are slow, however, compared to most other European Union (EU)-27 countries. Although since 1998 net migration has played some role, the UK’s relatively benign demographic profile has much to do with its relatively high fertility rates. Population issues, low fertility in particular, are not considered to be a major policy concern or an appropriate target for government intervention. A combination of moderately high fertility and high female employment has (at least historically) been achieved without implementing the kinds of work-family reconciliation policies that are credited with sustaining fertility elsewhere in Europe. A laissez-faire approach to the economy and residual approach to welfare may well have sustained UK fertility levels by facilitating childbearing in more socio-economically disadvantaged families. Recent, path-deviant, work-family reconciliation policies have been adopted, but the wider institutional context has moderated their potential to reduce the costs of childbearing

    British Manual Workers: From Producers to Consumers, c.

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