Nurturing Care for China’s Orphaned Children

As the number of children orphaned or abandoned worldwide rises, we worry about their rights and welfare. Children without parents or loving guardians are vulnerable to neglect, poor health care, and diminished education. Many come to live in institutions where they may experience a host of long-term problems, including malnutrition, growth retardation, sensory processing difficulties, behavioral and attachment disorders, and cognitive and language delays (e.g., Rutter, Quinton, & Hill 1990; Judge 1999; Zeanah 2000; Beckett et al. 2002). Yet, people are finding helpful solutions. Half the Sky Foundation (HTS) conducts infant nurture and preschool enrichment programs that dramatically enhance the quality of life and the development of orphaned children living in Chinese state-run institutions. Launched as two small pilots in 2000 by founder Jenny Bowen and a group of American adoptive parents, Half the Sky (www.halfthesky.org) operates today in partnership with the Chinese government in 34 state-run welfare institutions in 12 municipalities and provinces. The foundation serves over 3,500 children and adolescents, without regard to gender or disability, with funding from individual, foundation, and corporate donors worldwide. More than 12,000 children have benefited already from HTS programs. This article describes the programs for the youngest children: infants, toddlers, and preschoolers

Behavior patterns in hormonal treatments using fuzzy logic models

Assisted reproductive technologies are a combination of medical strategies designed to treat infertility patients. Ideal stimulation treatment has to be individualized, but one of the main challenges which clinicians face in the everyday clinic is how to select the best medical protocol for a patient. This work aims to look for behavior patterns in this kind of treatments, using fuzzy logic models with the objective of helping gynecologists and embryologists to make decisions that could improve the process of in vitro fertilization. For this purpose, a real-world dataset composed of one hundred and twenty-three (123) patients and five hundred and fifty-nine (559) treatments applied in relation to such patients provided by an assisted reproduction clinic, has been used to obtain the fuzzy models. As conclusion, this work corroborates some known clinic experiences, provides some new ones and proposes a set of questions to be solved in future experiments.Ministerio de Economía y Competitividad TIN2013-46928-C3-3-RMinisterio de Economía y Competitividad TIN2016-76956- C3-2-RMinisterio de Economía y Competitividad TIN2015-71938-RED

Hierarchical cluster analysis of labour market regulations and population health: a taxonomy of low- and middle-income countries

<p>Abstract</p> <p>Background</p> <p>An important contribution of the social determinants of health perspective has been to inquire about non-medical determinants of population health. Among these, labour market regulations are of vital significance. In this study, we investigate the labour market regulations among low- and middle-income countries (LMICs) and propose a labour market taxonomy to further understand population health in a global context.</p> <p>Methods</p> <p>Using Gross National Product per capita, we classify 113 countries into either low-income (n = 71) or middle-income (n = 42) strata. Principal component analysis of three standardized indicators of labour market inequality and poverty is used to construct 2 factor scores. Factor score reliability is evaluated with Cronbach's alpha. Using these scores, we conduct a hierarchical cluster analysis to produce a labour market taxonomy, conduct zero-order correlations, and create box plots to test their associations with adult mortality, healthy life expectancy, infant mortality, maternal mortality, neonatal mortality, under-5 mortality, and years of life lost to communicable and non-communicable diseases. Labour market and health data are retrieved from the International Labour Organization's Key Indicators of Labour Markets and World Health Organization's Statistical Information System.</p> <p>Results</p> <p>Six labour market clusters emerged: Residual (n = 16), Emerging (n = 16), Informal (n = 10), Post-Communist (n = 18), Less Successful Informal (n = 22), and Insecure (n = 31). Primary findings indicate: (i) labour market poverty and population health is correlated in both LMICs; (ii) association between labour market inequality and health indicators is significant only in low-income countries; (iii) Emerging (e.g., East Asian and Eastern European countries) and Insecure (e.g., sub-Saharan African nations) clusters are the most advantaged and disadvantaged, respectively, with the remaining clusters experiencing levels of population health consistent with their labour market characteristics.</p> <p>Conclusions</p> <p>The labour market regulations of LMICs appear to be important social determinant of population health. This study demonstrates the heuristic value of understanding the labour markets of LMICs and their health effects using exploratory taxonomy approaches.</p

Diagnostic role of new Doppler index in assessment of renal artery stenosis

Background: Renal artery stenosis (RAS) is one of the main causes of secondary systemic arterial hypertension. Several non-invasive diagnostic methods for RAS have been used in hypertensive patients, such as color Doppler ultrasound (US). The aim of this study was to assess the sensitivity and specificity of a new renal Doppler US direct-method parameter: the renal-renal ratio (RRR), and compare with the sensitivity and specificity of direct-method conventional parameters: renal peak systolic velocity (RPSV) and renal aortic ratio (RAR), for the diagnosis of severe RAS. Methods: Our study group included 34 patients with severe arterial hypertension (21 males and 13 females), mean age 54 (± 8.92) years old consecutively evaluated by renal color Doppler ultrasound (US) for significant RAS diagnosis. All of them underwent digital subtraction arteriography (DSA). RAS was significant if a diameter reduction 200 cm/s with 97% sensitivity, 72% specificity, 81% positive predictive value and 95% negative predictive value; RAR >3 with 77% sensitivity, 90% specificity, 90% positive predictive value and 76% negative predictive value. The optimal sensitivity and specificity cutoff for the new RRR was >2.7 with 97% sensitivity (p 200cm/s and RAR >3). Both RRR and RPSV show better sensitivity than RAR for the RAS diagnosis.Facultad de Ciencias Médica

Occupation and mental health in a national UK survey

This paper and the analyses it describes were funded by the Health and Safety Executive (HSE)

The Latin American Social Medicine database

BACKGROUND: Public health practitioners and researchers for many years have been attempting to understand more clearly the links between social conditions and the health of populations. Until recently, most public health professionals in English-speaking countries were unaware that their colleagues in Latin America had developed an entire field of inquiry and practice devoted to making these links more clearly understood. The Latin American Social Medicine (LASM) database finally bridges this previous gap. DESCRIPTION: This public health informatics case study describes the key features of a unique information resource intended to improve access to LASM literature and to augment understanding about the social determinants of health. This case study includes both quantitative and qualitative evaluation data. Currently the LASM database at The University of New Mexico brings important information, originally known mostly within professional networks located in Latin American countries to public health professionals worldwide via the Internet. The LASM database uses Spanish, Portuguese, and English language trilingual, structured abstracts to summarize classic and contemporary works. CONCLUSION: This database provides helpful information for public health professionals on the social determinants of health and expands access to LASM

Migration and "Low-Skilled" Workers in Destination Countries

In the fourth article in a six-part PLoS Medicine series on Migration & Health, Joan Benach and colleagues discuss the specific health risks and policy needs associated with migration in destination countries, especially for low-skilled and illegal migrant workers

Diagnostic role of new Doppler index in assessment of renal artery stenosis

BACKGROUND: Renal artery stenosis (RAS) is one of the main causes of secondary systemic arterial hypertension. Several non-invasive diagnostic methods for RAS have been used in hypertensive patients, such as color Doppler ultrasound (US). The aim of this study was to assess the sensitivity and specificity of a new renal Doppler US direct-method parameter: the renal-renal ratio (RRR), and compare with the sensitivity and specificity of direct-method conventional parameters: renal peak systolic velocity (RPSV) and renal aortic ratio (RAR), for the diagnosis of severe RAS. METHODS: Our study group included 34 patients with severe arterial hypertension (21 males and 13 females), mean age 54 (± 8.92) years old consecutively evaluated by renal color Doppler ultrasound (US) for significant RAS diagnosis. All of them underwent digital subtraction arteriography (DSA). RAS was significant if a diameter reduction > 50% was found. The parameters measured were: RPSV, RAR and RRR. The RRR was defined as the ratio between RPSV at the proximal or mid segment of the renal artery and RPSV measured at the distal segment of the renal artery. The sensitivity and specificity cutoff for the new RRR was calculated and compared with the sensitivity and specificity of RPSV and RAR. RESULTS: The accuracy of the direct method parameters for significant RAS were: RPSV >200 cm/s with 97% sensitivity, 72% specificity, 81% positive predictive value and 95% negative predictive value; RAR >3 with 77% sensitivity, 90% specificity, 90% positive predictive value and 76% negative predictive value. The optimal sensitivity and specificity cutoff for the new RRR was >2.7 with 97% sensitivity (p < 0.004) and 96% specificity (p < 0.02), with 97% positive predictive value and 97% negative predictive value. CONCLUSION: The new RRR has improved specificity compared with the direct method conventional parameters (RPSV >200cm/s and RAR >3). Both RRR and RPSV show better sensitivity than RAR for the RAS diagnosis