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11.
Access to good-quality health services is crucial for the improvement of many health outcomes, such as those targeted by the
Millennium Development Goals (MDGs) adopted by the international community in 2000. The health-related MDGs cannot be achieved
if vulnerable populations do not have access to skilled personnel and to other necessary inputs. This paper focuses on the
geographical dimension of access and on one of its critical determinants: the availability of qualified personnel. The objective
of this paper is to offer a better understanding of the determinants of geographical imbalances in the distribution of health
personnel, and to identify and assess the strategies developed to correct them. It reviews the recent literature on determinants,
barriers and the effects of strategies that attempted to correct geographical imbalances, with a focus on empirical studies
from developing and developed countries. An analysis of determinants of success and failures of strategies implemented, and
a summary of lessons learnt, is included. 相似文献
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Seok L Ong Gianpiero Gravante Cristina A Pollard M'Balu A Webb Severine Illouz Ashley R Dennison 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2009,11(8):613-621
Pain control is one of the most challenging aspects in the management of chronic pancreatitis. Total pancreatectomy can successfully relieve the intractable abdominal pain in these patients but will inevitably result in insulin-dependent diabetes. Islet autotransplantation aims to preserve, as far as possible, the insulin secretory function of the islet cell mass thereby reducing (or even removing) the requirement for exogenous insulin administration after a total pancreactomy. Despite the relatively small number of centres able to perform these procedures, there are important technical variations in the details of their approaches. The aim of this review is to provide details of the current surgical practice for total pancreatectomy combined with islet autotransplantation, and outline the potential advantages and disadvantages of the variations adopted in each centre. 相似文献
14.
Cristina Benatti Silvia Alboni Giacomo Capone Daniela Corsini Federica Caggia Nicoletta Brunello Fabio Tascedda Joan M.C. Blom 《International journal of developmental neuroscience》2009,27(7):661-668
Protracted or recurrent pain and inflammation in the early neonatal period may cause long-lasting changes in central neural function. However, more research is necessary to better characterize the long-term behavioral sequelae of such exposure in the neonatal period. Objectives: (1) to study whether timing of postnatal exposure to persistent inflammation alters responsiveness to thermal pain in the adult animal; (2) to assess whether animals experiencing early postnatal chronic inflammation display altered anxiety related behavior; (3) to study the importance of genetic background. Newborn mice (outbred strain, CD1 and F1 hybrid strain, B6C3F1) received an injection of Complete Freund's Adjuvant (CFA) or saline on either postnatal day 1 or 14 (PND1; PND14) into the left hind paw. Pain to radiant heat and anxiety were examined in 12-week-old adult animals. Adult baseline PWL was significantly decreased in CD1 mice exposed to CFA on PND 1 and 14 as compared to their saline treated counterparts. B6C3F1 mice exposed to CFA on PND14 showed markedly reduced baseline PWL compared to the PND14 saline group. Persistent inflammation experienced by B6C3F1 mice on PND1 failed to affect baseline adult thermal responsiveness. Adult mice, CD1 and B6C3F1, displayed low anxiety traits only if they had been exposed to persistent inflammation on PND1 and not on PND14. Our research suggests a role for genetic background in modulating long-term behavioral consequences of neonatal persistent inflammation: the data support the hypothesis that pain experienced very early in life differentially affects adult behavioral and emotional responsiveness in outbred (CD1) and hybrid mice (B6C3F1). 相似文献
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Andrew E. Springer Kayan Lewis Steven H. Kelder Maria E. Fernandez Cristina S. Barroso Deanna M. Hoelscher 《Journal of immigrant and minority health / Center for Minority Public Health》2010,12(5):769-780
Research on physical activity (PA) by level of acculturation in Hispanic children is limited and findings have been mixed.
We examined PA participation by primary language used with parents in a representative sample of 4th, 8th, and 11th grade
Texas public school students. Mixed-effects regression models were conducted using cross-sectional data from the 2004–2005
School Physical Activity and Nutrition Study (n = 22,049). Self-reported PA was compared among three language-ethnic groups: Spanish-Hispanic (SH) (referent); English-Hispanic
(EH); and English-Other (EO). EH and/or EO girls were generally between 1.25 and 2.58 [OR] times more likely to participate in PA across grade levels,
with the largest differences found for school sports in 8th grade girls. EH and EO 8th grade boys were 1.71 (CI: 1.40, 2.10)
and 2.06 (CI: 1.68, 2.51) times, respectively, more likely to participate in school sports. Findings indicate important disparities
in Spanish-speaking Hispanic children’s PA participation. 相似文献
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