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This paper examines the phenomena of high rates of youth that are out of school and out of work in Latin America. The analysis pursues a dynamic approach by constructing a pseudo-panel from 234 household surveys for 18 countries in the region that allow tracing the life cycle trajectories of different cohorts over time. The trajectories are associated with a series of variables characterizing the household, community, and macro environment in which schooling and labor market participation decisions take place. The most important result obtained is that the persistently high rates of being out of school and out of work among males are strongly associated with greater labor force participation by women, which can be generating a "crowding out" effect against men, given slow job creation rates across the region. The analysis also explores the possibility of scarring effects, and finds that higher shares of out of school and out of work youth at ages 15–20 years are associated with lower wages for the same cohorts later in life, at ages 35–40 years, for males and females. As for employment prospects, the analysis finds scarring effects only for females, with greater out of school and out of work youth shares being related to lower proportions of women in the labor market later in the life cycle.

Postponed access: the file will be accessible after 2020-05-11 ; Background: Long-term mechanical ventilation (LTMV) is a treatment option for patients with severe chronic respiratory failure. The treatment is carried out in patients' home or in a nursing home, and can completely or partially compensate for their breathing failure. The majority of patients receive ventilation through a mask covering the nose or both mouth and nose (non-invasive), while a small percentage receive ventilation through a tracheostomy, which is an opening in the neck leading directly to the trachea (invasive). The main goal with LTMV is to maintain or increase quality of life and to prolong survival. Previous research examining quality of life and health-related quality of life (HRQoL) in this group have used a large number of different questionnaires, none of which has been sensitive to the specific challenges of living with LTMV. There is limited knowledge about the long-term outcome of LTMV on quality of life, factors associated with changes in HRQoL and the association with mortality. Aims: The overall aim of this thesis was to provide new knowledge about HRQoL in patients treated with LTMV in a six-year follow-up study. To achieve the overall aim, we had to provide a validated Norwegian version of a specific questionnaire to measure HRQoL in patients treated with LTMV. The main aims were to examine changes in HRQoL in patients receiving LTMV, to examine factors associated with changes in HRQoL in relation to socio-demographic background variables, treatment variables and respiratory variables, and to examine mortality in LTMV patients and the associations between HRQoL and mortality. Materials and methods: This thesis was based on data from the Norwegian LTMV Register in West Norway, the Norwegian Patient Register, the Cause of Death Register, and data on patient-reported outcome measures. In 2008, all the potential eligible adult patients on the LTMV Register in three counties in West Norway were requested to participate in the study. Data from this register and the Short Form-36 (SF-36) generic questionnaire were used to examine the psychometric properties of the Norwegian version of the Severe Respiratory Insufficiency (SRI) questionnaire, a specific HRQoL instrument developed together with patients treated with LTMV. All the patients were followed up from 2008 to 2014. Changes in HRQoL in the patients still treated with LTMV were measured by the SRI questionnaire, in relation to socio-demographic background variables, treatment variables and respiratory variables. Mortality and the ability of the SRI questionnaire to predict mortality were measured by adjusting for socio-demographic variables, including age and education level, clinical variables including main disease group, and treatment variables including hours per day on LTMV, time since initiation of LTMV and comorbidity. Data concerning comorbidity was collected from the Norwegian Patient Register and data on mortality was confirmed by the Cause of Death Register. Results: Out of 193 potential patients on the Norwegian LTMV Register, 127 people (66%) agreed to participate in the study in 2008. The patients were categorized into groups according to neuromuscular diseases, chronic obstructive pulmonary diseases, obesity hypoventilation syndrome and chest wall diseases. The mean age was 61.5 years (SD 15.6) and 68 (53.5%) of the patients were male. The most patients received LTMV via a nasal or mouth mask (92%) and 8% received LTMV via a tracheostomy. The Norwegian version of the SRI questionnaire had good reliability and validity. The reliability of was confirmed by Cronbach Alpha between 0.68 and 0.88 for the subscales and 0.94 for the SRI sum score. The validity was confirmed by high correlations between subscales on the SF-36 and SRI questionnaires. In addition, the validity was supported by that the SRI questionnaire was able to confirm known a priori differences among patients receiving LTMV (Paper I). After six years, 60 patients were still receiving LTMV and confirmed their participation in the follow-up study. HRQoL improved significantly in the majority of the patients according to the total SRI sum score and in four subdomains of the SRI questionnaire. Patients reported satisfaction with training, while follow-up from healthcare professionals was associated with changes in HRQoL. Side effects of the treatment such as facial soreness were associated with lower SRI scores and thus changes in HRQoL. Older age was associated with lower HRQoL on SRI physical functioning subscales. Lung function, as measured by high forced vital capacity, was associated with improved HRQoL on the SRI social functioning subscale (Paper Ⅱ). During the 80-month follow-up period, 52 participants died. The highest mortality rate was among patients with chronic obstructive pulmonary disease (75%), followed by patients with neuromuscular disease (46%), obesity hypoventilation syndrome (31%) and chest wall disease (25%). Lower SRI sum scores in 2008 were associated with a higher mortality risk after adjustment for age, education level, time since initiation of LTMV, hours per day on LTMV, comorbidity and disease category. In addition, according to the SRI questionnaire, physical functioning, psychological well-being and social functioning remained significant risk factors for mortality after covariate adjustment (Paper Ⅲ). Conclusions: Based on quality of life as a conceptual framework, this thesis has provided new important knowledge on HRQoL in patients receiving LTMV from a six-year perspective. Improved HRQoL in the majority of the patients also provides new insights for patients and healthcare professionals. Improvements in the subscale related to overall satisfaction with life, reduced anxiety related to breathing, greater capacity among patients to cope with their condition, and contact and relationship with other people are clinically important. There was also an absence of deterioration in the SRI subscales related to physical functioning, respiratory complaints and attendant symptoms, and sleep during six years of ongoing LTMV. From a healthcare perspective, it important that professionals have the potential to influence their patients' HRQoL by helping to reduce side effects and improve training and followup. A greater awareness of the strong association between HRQoL measured by SRI and mortality provides important new knowledge to healthcare professionals and political decision makers responsible for the treatment and care of people treated with LTMV. These results highlight the need to identify patients with low HRQoL and initiate interventions to improve HRQoL. Future research should focus on developing effective interventions to assist patients in living with LTMV as well as improving HRQoL and prognosis for treatment.

Tesis descargada desde TESEO ; Objetivos Esta tesis doctoral tiene como objetivo dar repuesta a una serie de problemas concretos y preguntas en el ámbito de la formación en la empresa y la formación de trabajadores a través de las asociaciones empresariales españolas. Con ella se pretende aportar una conceptualización sobre la formación de trabajadores, el aprendizaje a lo largo de la vida, la formación permanente, y la Formación Profesional para el Empleo (FPE). También intenta analizar si es posible que se desarrolle un proceso educativo (desde todas las perspectivas, tanto en el plano personal como profesional) dentro de un programa de formación de trabajadores, en el ámbito de las empresas y en el ámbito de los programas de FPE, o si por el contrario únicamente podemos aspirar a procesos de instrucción o capacitación instrumental. Igualmente se plantea conocer cuál es la situación actual de la FPE en España y cuál es la percepción que sobre ésta tienen las asociaciones empresariales, así como qué papel juegan estas asociaciones en la formación de los trabajadores y por qué están interesadas en este tipo de actividades. Otra de las temáticas abordadas en el estudio es la relativa a las metodologías empleadas y la percepción que sobre éstas tienen los alumnos / trabajadores, poniendo especial interés en el e-learning. Por último presentamos cómo funcionan los programas de FPE a través de los cuales se forman cada año miles de trabajadores en España. Estructura El estudio consta de tres partes bien diferenciadas, la primera de ellas se centra en los aspectos metodológicos de la investigación, basada en la Grounded Theory de Glasser y Strauss, así como en los objetivos de la misma; la segunda supone una aproximación teórica y epistemológica al ámbito objeto de estudio: la educación de adultos, la formación de trabajadores, el lifelong learning, la formación para el empleo y las asociaciones empresariales; la tercera se centra en el trabajo de campo, que a su vez se subdivide en dos partes: un estudio cuantitativo desde el punto de vista estadístico de un programa de FPE en una asociación empresarial, y un estudio cualitativo basado en entrevistas narrativas a personajes clave dentro de este ámbito, basado en la Teoría Fundamentada. Por último, nos gustaría significar que la investigación no deja de ser, también, un análisis de las representaciones sociales que tiene el colectivo de entrevistados sobre los temas referidos con anterioridad. Conclusiones En primer lugar nos gustaría hacer referencia al proceso metodológico en el que hemos sustentado esta investigación. La aproximación al objeto de estudio se ha realizado de un modo multivectorial, combinando técnicas cuantitativas y cualitativas, si bien el paradigma desde el que se aborda la globalidad de la investigación es el paradigma constructivista- interpretativo. El apoyo en técnicas mixtas se ha realizado con la finalidad de enriquecer la propia investigación; como apuntaban Denzin y Lincoln (2012) o Flick (2002), la investigación cualitativa se caracteriza, entre otras cosas, por ser inherentemente multimetodológica, y el uso de distintos métodos de cara a la triangulación refleja la intención del investigador de asegurar la comprensión del fenómeno objeto de estudio. A lo largo de esta investigación hemos realizado un primer abordaje de la formación de trabajadores desde la perspectiva de la educación de adultos. Nuestro punto de partida epistémico sitúa a ésta como el eje que ha de vertebrar los procesos educativos que tienen lugar durante la adultez, incluyendo aquéllos que se desarrollan en el entorno laboral o empresarial. Respecto a las metodologías de impartición, se ha constatado que existe una clara tendencia al alza en la formación a distancia (incluyendo la distancia convencional y el e-learning) y una evidente tendencia a la baja en la formación presencial, al menos en lo referente a las acciones formativas desarrolladas por las empresas, como es el caso de la formación de demanda (bonificada). El e-learning se constituido en una de las metodologías más apreciadas y la más utilizada en los programas de FPE. Además, la función docente, el papel del tutor, sigue siendo lo más importante y a la par lo mejor evaluado por los trabajadores. Respecto al objetivo de la investigación que estaba centrado en conocer si era posible llevar a cabo un proceso educativo dentro de un programa de formación de trabajadores desarrollado por una asociación empresarial, o si por el contrario únicamente podríamos aspirar a desarrollar procesos de instrucción o capacitación instrumental, concluimos que sí es posible desarrollar un proceso educativo. En relación con las distintas motivaciones de los trabajadores para realizar actividades formativas, hemos visto en este estudio como están en su mayoría relacionadas con el desarrollo personal y profesional. Es por ello que concluimos que, aunque a priori se pueda pensar que un plan de formación para trabajadores organizado por una organización empresarial iría dirigido únicamente a conseguir los intereses de los empresarios, también responde a los intereses e inquietudes personales de aquéllos, es decir, a su evolución y progresión en la vida. Respecto a cuál es la situación actual de la FPE en España y cómo perciben a esta las asociaciones empresariales, se ha constatado en el análisis cualitativo que existe una clara sensación de derrumbe de este sistema de formación de trabajadores construido a lo largo de los años por los agentes sociales, y por ende por trabajadores y empresarios, quienes a través del diálogo social, del consenso y del convencimiento de la importancia que la formación tiene, han contribuido a la génesis, expansión y consolidación del mismo en el tejido productivo y en la sociedad de nuestro país. Identificamos a la administración pública, especialmente en esta última legislatura, como la responsable de este derrumbe, ya que percibe injustificadamente a sindicatos y patronales como actores deshonestos que practican habitualmente el fraude con los fondos de formación, lo cual conduce a aquélla a querer prescindir de éstos, tanto a nivel de participación en el diálogo que ha de conformar el nuevo sistema de FPE como a nivel de dirección del mismo. Lo que está ocurriendo es que la administración está intentando desacreditar sistemáticamente a los agentes sociales con la finalidad de expulsarlos de la dirección del sistema de FPE y dictaminar por qué cauces debe discurrir la formación, confiriéndole a ésta un carácter marcadamente mercantil, excluyendo a sindicatos y patronales de la toma de decisiones sobre las acciones formativas más apropiadas para los trabajadores e identificándoles con prácticas fraudulentas. Respecto a qué papel juegan las asociaciones empresariales en la formación de trabajadores y cuál es el interés que tienen en esta, en su rol como entidades que prestan servicios a sus afiliados, las asociaciones empresariales están interesadas en organizar ellas mismas los programas formativos que atañen a sus diversos sectores productivos, concentrándose en la formación que más interese a sus empresas. Renunciar a esta actividad como gestores de la formación sería renunciar a la toma de decisiones sobre la misma por parte de los empresarios. Las organizaciones empresariales ven en la formación una gran oportunidad para conseguir una cualificación de los trabajadores en el área del ¿saber hacer¿, es decir de las destrezas, que aumente su polivalencia y su productividad, lo que conducirá a un aumento de la rentabilidad de las empresas y, en definitiva, de los beneficios. También, las organizaciones empresariales de hoy en día mantienen estructuras de personal estables y numerosas que les permiten prestar servicios a sus asociados, por lo que la gestión de grandes proyectos con financiación pública, como es el caso de la formación, les aporta fondos y actividad para soportarlas. A lo largo de estos últimos veinte años estas estructuras han pasado a ser muy numerosas y ¿pesadas¿ en todas sus áreas y departamentos, no sólo en la de formación, como consecuencia de haber dispuesto de unas grandes cantidades de fondos y de no haber pensado que estos podrían minorar. La enorme cantidad de fondos existentes hasta ahora en materia de formación les ha llevado a cargarse de plantillas y estructuras sobredimensionadas, que en momentos como los actuales de recortes presupuestarios, hacen peligrar la existencia de muchas de ellas desde el punto de vista financiero. Quizás algunas de estas asociaciones han errado al querer crecer con unas estructuras que no les correspondía por su número de empresas asociadas, ya que han soportado las mismas con fondos provenientes de la formación, en vez de hacerlo con fondos provenientes de las cuotas de sus afiliados. Realmente deberían haberse limitado a ampliar sus estructuras y dimensión en función del número de empresas asociadas que tuviesen y no según la cantidad de proyectos que eventualmente desarrollasen. Finalmente, nuestra propuesta de actuación y mejora consiste en la creación de un organismo genuino, un Instituto de Formación Permanente de Trabajadores, que vele por la autenticidad, la mejora continua, la pulcritud, las buenas prácticas, la prolongación y el crecimiento de la formación en el ámbito del trabajo. Este organismo debería tener un marcado carácter científico de manera que no sólo participasen los sindicatos y las patronales, como representantes de aquéllos que pagan el sistema de formación y que se benefician de él, sino también académicos y especialistas relacionados con la investigación científica en el ámbito de la educación permanente, la formación a lo largo de la vida, la formación empresarial y la educación de personas adultas. Consistiría, grosso modo, en conferir al sistema de una entidad que actualmente no tiene, fuera de toda sospecha interesada, dándole un carácter científico, por encima incluso de la propia Fundación Tripartita para la Formación en el Empleo, en la cual estuviesen presentes los sindicatos, las patronales, la administración y los científicos especialistas en el tema, quienes estarían investigando y trabajando por la mejora continua de la FPE. Sería una estructura sin implicaciones políticas, sin intereses partidistas, sin afán de representación de ningún colectivo interesado, cuya finalidad principal fuese la investigación sobre el sistema de formación en el mundo del trabajo, que aportase ideas, soluciones, tendencias y pautas al mismo. De esta manera habría una entidad velando por él cuyo único interés sería desarrollarlo y contribuir a su mejora continua. ; This doctoral thesis aims to answer a number of specific problems and questions framed in the field of training in enterprises and workers training through employers¿ associations in Spain. The thesis aims to provide a conceptualization of workers training, training throughout life, lifelong learning, and training for employment (VET). It also tries to analyse whether it is possible to develop an educational process (from all perspectives, being personal or professional) within the field of companies, of VET programmes, and workers training programmes or, on the contrary, we only can aspire to processes of instrumental education or training. At the same time, it tries to know what the current status of VET in Spain is and what the perception of employers¿ associations about it is. Another key aspect is focused on finding out what is the role that employers¿ associations play and why they are interested in this type of activities. Another topic approached in the research is: methodologies used in training through employers¿ associations and what the perception about it of themselves and workers/students is, with a special focus on the online training methodology or e-learning. Finally, I show how the VET programmes work. VET provides training to thousands of workers in Spain each year. The study consists of three well distinguished parts. The first is focused on the methodological aspects of the research, based on the Grounded Theory of Glasser and Strauss, as well as on its objectives; the second is a theoretical and epistemological approach to the study¿s aimed fields: adult education, workers training, lifelong learning, workers training programmes, and employers¿ associations; the third part is focused on the field work, which is divided in two parts: a quantitative study of a VET programme in a business association from an statistical point of view, and a qualitative study based on interviews to key characters in this field.

Surveillance for chronic fatigue syndrome : four U.S. cities, September 1989 through August 1993: PROBLEM/CONDITION: Although chronic fatigue syndrome (CFS) has been recognized as a cause of morbidity in the United States, the etiology of CFS is unknown. In addition, information is incomplete concerning the clinical spectrum and prevalence of CFS in the United States. REPORTING PERIOD COVERED: This report summarizes CFS surveillance data collected in four U.S. cities from September 1989 through August 1993. DESCRIPTION OF SYSTEM: A physician-based surveillance system for CFS was established in four U.S. metropolitan areas: Atlanta, Georgia; Wichita, Kansas; Grand Rapids, Michigan; and Reno, Nevada. The objectives of this surveillance system were to collect descriptive epidemiologic information from patients who had unexplained chronic fatigue, estimate the prevalence and incidence of CFS in defined populations, and describe the clinical course of CFS. Patients aged > or = 18 years who had had unexplained, debilitating fatigue or chronic unwellness for at least 6 months were referred by their physicians to a designated health professional(s) in their area. Those patients who participated in the surveillance system a) were interviewed by the health professional(s); b) completed a self-administered questionnaire that included their demographic information, medical history, and responses to the Beck Depression Inventory, the Diagnostic Interview Schedule, and the Sickness Impact Profile; c) submitted blood and urine samples for laboratory testing; and d) agreed to a review of their medical records. On the basis of this information, patients were assigned to one of four groups: those whose illnesses met the criteria of the 1988 CFS case definition (Group I); those whose fatigue or symptoms did not meet the criteria for CFS (Group II); those who had had an identifiable psychological disorder before onset of fatigue (Group III); and those who had evidence of other medical conditions that could have caused fatigue (Group IV). Patients assigned to Group III were further evaluated to determine the group to which they would have been assigned had psychological illness not been present, the epidemiologic characteristics of the illness and the frequency of symptoms among patients were evaluated, and the prevalence and incidence of CFS were estimated for each of the areas. RESULTS: Of the 648 patients referred to the CFS surveillance system, 565 (87%) agreed to participate. Of these, 130 (23%) were assigned to Group I; 99 (18%), Group II; 235 (42%), Group III; and 101 (18%), Group IV. Of the 130 CFS patients, 125 (96%) were white and 111 (85%) were women. The mean age of CFS patients at the onset of illness was 30 years, and the mean duration of illness at the time of the interview was 6.7 years. Most (96%) CFS patients had completed high school, and 38% had graduated from college. The median annual household income/for CFS patients was $40,000. In the four cities, the age-, sex-, and race-adjusted prevalences of CFS for the 4-year surveillance period ranged from 4.0 to 8.7 per 100,000 population. The age-adjusted 4-year prevalences of CFS among white women ranged from 8.8 to 19.5 per 100,000 population. INTERPRETATION: The results of this surveillance system were similar to those in previously published reports of CFS. Additional studies should be directed toward determining whether the data collected in this surveillance system were subject to selection bias (e.g., education and income levels might have influenced usage of the health-care system, and the populations of these four surveillance sites might not be representative of the U.S. population). ACTIONS TAKEN: In February 1997, CDC began a large-scale, cross-sectional study at one surveillance site (Wichita) to describe more completely the magnitude and epidemiology of unexplained chronic fatigue and CFS. ; Malaria surveillance : United States, 1993: PROBLEM/CONDITION: Malaria is caused by infection with one of four species of Plasmodium (P. falciparum, P. vivax, P. ovale, and P. malariae), which are transmitted by the bite of an infective female Anopheles sp. mosquito. Most malaria cases in the United States occur among persons who have traveled to areas (i.e., other countries) in which disease transmission is ongoing. However, cases are transmitted occasionally through exposure to infected blood products, by congenital transmission, or by local mosquito-borne transmission. Malaria surveillance is conducted to identify episodes of local transmission and to guide prevention recommendations. REPORTING PERIOD COVERED: Cases with onset of illness during 1993. DESCRIPTION OF SYSTEM: Malaria cases confirmed by blood smear are reported to local and/or state health departments by health-care providers and/or laboratories. Case investigations are conducted by local and/or state health departments, and the reports are transmitted to CDC. RESULTS: CDC received reports of 1,275 cases of malaria in persons in the United States and its territories who had onset of symptoms during 1993; this number represented a 40% increase over the 910 malaria cases reported for 1992. P. vivax, P. falciparum, P. ovale, and P. malariae were identified in 52%, 36%, 4%, and 3% of cases, respectively. The species was not determined in the remaining 5% of cases. The 278 malaria cases in U.S. military personnel represented the largest number of such cases since 1972; 234 of these cases were diagnosed in persons returning from deployment in Somalia during Operation Restore Hope. In New York City, the number of reported cases increased from one in 1992 to 130 in 1993. The number of malaria cases acquired in Africa by U.S. civilians increased by 45% from 1992; of these, 34% had been acquired in Nigeria. The 45% increase primarily reflected cases reported by New York City. Of U.S. civilians who acquired malaria during travel, 75% had not used a chemoprophylactic regimen recommended by CDC for the area in which they had traveled. Eleven cases of malaria had been acquired in the United States: of these cases, five were congenital; three were induced; and three were cryptic, including two cases that were probably locally acquired mosquito-borne infections. Eight deaths were associated with malarial infection. INTERPRETATION: The increase in the reported number of malaria cases was attributed to a) the number of infections acquired during military deployment in Somalia and b) complete reporting for the first time of cases from New York City. ACTIONS TAKEN: Investigations were conducted to collect detailed information concerning the eight fatal cases and the 11 cases acquired in the United States. Malaria prevention guidelines were updated and disseminated to health-care providers. Persons who have a fever or influenza-like illness after returning from a malarious area should seek medical care, regardless of whether they took antimalarial chemoprophylaxis during their stay. The medical evaluation should include a blood smear examination for malaria. Malaria can be fatal if not diagnosed and treated rapidly. Recommendations concerning prevention and treatment of malaria can be obtained from CDC. ; Tetanus surveillance : United States, 1991-1994: PROBLEM/CONDITION: Despite the widespread availability of a safe and effective vaccine against tetanus, 201 cases of the disease were reported during 1991-1994. Of patients with known illness outcome, the case-fatality rate was 25%. REPORTING PERIOD COVERED: 1991-1994. DESCRIPTION OF SYSTEM: Physician-diagnosed cases of tetanus are reported to local and state health departments, the latter of which reports these cases on a weekly basis to CDC's National Notifiable Disease Surveillance System. Since 1965, state health departments also have submitted supplemental clinical and epidemiologic information to CDC's National Immunization Program. RESULTS: During 1991-1994, 201 cases of tetanus were reported from 40 states, for an average annual incidence of 0.02 cases per 100,000 population. Of the 188 patients for whom age was known, 101 (54%) were aged > or = 60 years and 10 (5%) were aged or = 80 years was more than 10 times greater than the risk for persons aged 20-29 years. All deaths occurred among persons aged > or = 30 years. The case-fatality rate (overall: 25%) increased with age, from 11% in persons aged 30-49 years to 54% in persons aged > or = 80 years. Only 12% of all patients were reported to have received a primary series of tetanus toxoid before onset of illness. For 77% of patients, tetanus occurred after an acute injury was sustained. Of patients who obtained medical care for their injury, only 43% received tetanus toxoid as part of wound prophylaxis. INTERPRETATION: The epidemiology of reported tetanus in the United States during 1991-1994 was similar to that during the 1980s. Tetanus continued to be a severe disease primarily of older adults who were unvaccinated or inadequately vaccinated. Most tetanus cases occurred after an acute injury was sustained, emphasizing the need for appropriate wound management. ACTIONS TAKEN: In addition to decennial booster doses of tetanus-diphtheria toxoid during adult life, the Advisory Committee on Immunization Practices (ACIP) recommends vaccination visits for adolescents at age 11-12 years and for adults at age 50 years to enable health-care providers to review vaccination histories and administer any needed vaccine. Full implementation of the ACIP recommendations should virtually eliminate the remaining tetanus burden in the United States. ; Surveillance for chronic fatigue syndrome : four U.S. cities, September 1989 through August 1993 / Michele Reyes, Howard E. Gary, Jr., James G. Dobbins, Bonnie Randall, Lea Steele, Keiji Fukuda, MGary P. Holmes, David G. Connell, Alison C. Mawle, D. Scott Schmid, John A. Stewart, Lawrence B. Schonberger, Walter J. Gunn, William C. Reeves -- Tetanus surveillance : United States, 1991-1994 / Hector S. Izurieta, Roland W. Sutter, Peter M. Strebel, Barbara Bardenheier, D. Rebecca Prevots, Melinda Wharton, Stephen C. Hadler, Epidemiology and Surveillance Division. National Immunization Program; Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases -- Malaria surveillance : United States, 1993 / Lawrence M. Barat, Jane R. Zucker, Ann M. Barbe,r Monica E. Parise, Lynn A. Paxton, Jacqueline M. Roberts, Carlos C. Campbell, Division of Parasitic Diseases National Center for Infectious Diseases. ; February 21, 1997 ; Includes bibliographical references.

The incentives of politicians to provide broad public goods and reduce poverty vary across countries. Even in democracies, politicians often have incentives to divert resources to political rents and private transfers that benefit a few citizens at the expense of many. These distortions can be traced to imperfections in political markets that are greater in some countries than in others. This article reviews the theory and evidence on the impact on political incentives of incomplete information for voters, the lack of credibility of political promises, and social polarization. The analysis has implications for policy and for reforms to improve public goods provision and reduce poverty.

This study was supported by grants FPU16/01093 (Dr Carneiro-Barrera), FPU14/04172 (Dr Amaro-Gahete), and FPU19/01609 (Mr Jurado-Fasoli) from the Spanish Ministry of Education and Vocational Training; grant SOMM17/6107/UGR (via European Regional Development Funds) from the Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades (Dr Ruiz); and funding from the University of GranadaLoMonaco S.L. Sleep Research Cathedra and the University of Granada Plan Propio de Investigacion 2016Excellence Actions: Unit of Excellence on Exercise and Health. ; IMPORTANCE Obesity is the leading cause of obstructive sleep apnea (OSA); however, the effects of weight loss and lifestyle interventions on OSA and comorbidities remain uncertain. OBJECTIVE To evaluate the effect of an interdisciplinary weight loss and lifestyle intervention on OSA and comorbidities among adults with moderate to severe OSA and overweight or obesity. DESIGN, SETTING, AND PARTICIPANTS The InterdisciplinaryWeight Loss and Lifestyle Intervention for OSA (INTERAPNEA) study was a parallel-group open-label randomized clinical trial conducted at a hospital-based referral center in Granada, Spain, from April 1, 2019, to October 23, 2020. The study enrolled 89 Spanish men aged 18 to 65 years with moderate to severe OSA and a body mass index (calculated as weight in kilograms divided by height in meters squared) of 25 or greater who were receiving continuous positive airway pressure (CPAP) therapy. The sole inclusion of men was based on the higher incidence and prevalence of OSA in this population, the differences in OSA phenotypes between men and women, and the known effectiveness of weight loss interventions among men vs women. INTERVENTIONS Participants were randomized to receive usual care (CPAP therapy) or an 8-week weight loss and lifestyle intervention involving nutritional behavior change, aerobic exercise, sleep hygiene, and alcohol and tobacco cessation combined with usual care. MAIN OUTCOMES AND MEASURES The primary end point was the change in the apnea-hypopnea index (AHI) from baseline to the intervention end point (8 weeks) and 6 months after intervention. Secondary end points comprised changes in other OSA sleep-related outcomes, body weight and composition, cardiometabolic risk, and health-related quality of life. RESULTS Among 89 men (mean [SD] age, 54.1 [8.0] years; all of Spanish ethnicity; mean [SD] AHI, 41.3 [22.2] events/h), 49 were randomized to the control group and 40 were randomized to the intervention group. The intervention group had a greater decrease in AHI (51% reduction; change, –21.2 events/h; 95%CI, –25.4 to –16.9 events/h) than the control group (change, 2.5 events/h; 95% CI, –2.0 to 6.9 events/h) at the intervention end point, with a mean between-group difference of –23.6 events/h (95%CI, –28.7 to –18.5 events/h). At 6 months after intervention, the reduction in AHI was 57%in the intervention group, with a mean between-group difference of –23.8 events/h (95% CI, –28.3 to –19.3 events/h). In the intervention group, 18 of 40 participants (45.0%) no longer required CPAP therapy at the intervention end point, and 6 of 40 participants (15.0%) attained complete OSA remission. At 6 months after intervention, 21 of 34 participants (61.8%) no longer required CPAP therapy, and complete remission of OSA was attained by 10 of 34 participants (29.4%). In the intervention vs control group, greater improvements in body weight (change, –7.1 kg [95%CI, −8.6 to −5.5 kg] vs −0.3 kg [95%CI, −1.9 to 1.4 kg]) and composition (eg, change in fat mass, −2.9 kg [95%CI, −4.5 to −1.3 kg] vs 1.4 kg [95%CI, −0.3 to 3.1 kg]), cardiometabolic risk (eg, change in blood pressure, −6.5mmHg [95%CI, −10.3 to −2.6mmHg] vs 2.2mmHg [95%CI, −2.1 to 6.6mm Hg]), and health-related quality of life (eg, change in Sleep Apnea Quality of Life Index, 0.8 points [95%CI, 0.5-1.1 points] vs 0.1 points [95%CI, −0.3 to 0.4 points]) were also found at the intervention end point. CONCLUSIONS AND RELEVANCE In this study, an interdisciplinary weight loss and lifestyle intervention involving Spanish men with moderate to severe OSA and had overweight or obesity and were receiving CPAP therapy resulted in clinically meaningful and sustainable improvements in OSA severity and comorbidities as well as health-related quality of life. This approach may therefore be considered as a central strategy to address the substantial impact of this increasingly common sleepdisordered breathing condition. ; Spanish Government FPU16/01093 FPU14/04172 FPU19/01609 ; Junta de Andalucia SOMM17/6107/UGR ; University of GranadaLoMonaco S.L. Sleep Research Cathedra ; University of Granada Plan Propio de Investigacion 2016Excellence Actions: Unit of Excellence on Exercise and Health

The article is devoted to the study of the legal status of the family, including families with children as a subject of social security relations in the field of state social benefits. Analyzing a number of legislative acts that contain provisions on the procedure for providing social security to families, it was concluded that when it comes to the field of social insurance, the subjects of social security relations is mostly a single family member, and in the field of providing state social benefits legislator distinguishes the family as a collective entity, enshrining its rights and guarantees in the field of social protection. The peculiarities of the legal personality of the data of the participants of social security legal relations are determined and analyzed. The fact of origin of the right and legal capacity of families is established. The legal capacity of the family as a collective subject of social security relations arises from the moment of its creation. Legal facts confirming this action are acts of civil status, such as marriage, adoption of a child, as well as court decisions and a notarized agreement between a man and a woman establishing the existence of family relations (cohabitation, joint management and mutual rights and duties). The legal capacity of families with children arises from the moment of the child's maintenance and upbringing in the family. In turn, the sectoral capacity of such an entity in the field of state social assistance arises from the moment of poverty or legally significant circumstances that are not related to the income received by the family. It is concluded that additional features of the legal personality of families with children are: 1) the presence of children; 2) a legal relationship has been established between the child and the subjects caring for him / her (blood relationship, adoption, establishment of guardianship or custody, transfer of the child to a foster family or family-type orphanages); 3) cohabitation of the child with the persons who take care of him, but the latter criterion is not mandatory for all legal relations. The definition of a family with children as an independent subject of sectoral legal relations, which is a person (at least two) who live together, except for the education of a child under 23 years of age, one of which is a minor or a person under 23 years, as well as an adult who lives with his parents on the basis of the fact of disability, others are persons who care for the child and are in a relevant legal relationship with her. ; Стаття присвячена дослідження правового статусу сім'ї, в т. ч. сім'ї з дітьми як суб'єкта соціально-забезпечувальних правовідносин у сфері надання державних соціальних допомог. Проводячи аналіз ряду законодавчих актів, які містять положення щодо порядку надання соціального забезпечення сім'ям, зроблено висновок, що коли йдеться про сферу соціального страхування, то суб'єктами соціально-забезпечувальних правовідносин виступає здебільшого окремий член сім'ї, а у сфері надання державних соціальних допомог законодавець виділяє сім'ю як колективного суб'єкта, закріплюючи її права та гарантії у сфері соціального захисту. Визначено та проаналізовано особливості право-суб'єктності цих учасників соціально-забезпечувальних правовідносин. Встановлено факт виникнення права та дієздатності сімей. Правоздатність сім'ї як колективного суб'єкта соціального-забезпечуваль-них правовідносин виникає з моменту її створення. Юридичними фактами, які підтверджують цю дію, є акти громадянського стану, наприклад, взяття шлюбу, усиновлення дитини, а також рішення суду та нотаріально посвідчений договір між чоловіком і жінкою, що встановлює факт наявності сімейних правовідносин (спільне проживання, спільне ведення господарства та взаємні права й обов'язки). Правоздатність сімей із дітьми виникає з моменту появи на утриманні та вихованні у сім'ї дитини. У свою чергу, галузева дієздатність такого суб'єкта у сфері надання державних соціальних допомог виникає з моменту настання ма-лозабезпеченості чи юридично значимих обставин, не пов'язаних із отримуваним сім'єю доходом. Зроблено висновок, що додатковими особливостями правосуб'єктності сімей із дітьми є: 1) наявність дітей; 2) встановлений правовий зв'язок між дитиною та суб'єктами, які здійснюють за нею догляд (кровний зв'язок, усиновлення, встановлення опіки чи піклування, передання дитини до прийомної сім'ї чи дитячих будинків сімейного типу); 3) спільне проживання дитини з особами, котрі здійснюють догляд за нею, проте останній критерій не є обов'язковим для всіх правовідносин. Сформульовано дефініцію сім'ї з дітьми як самостійного суб'єкта галузевих правовідносин: особи (мінімум двоє), які спільно проживають, крім випадку навчання дитини до досягнення нею 23 років, однією з яких виступає неповнолітня особа чи особа віком до 23 років, а також повнолітня особа, котра спільно проживає із батьками на підставі факту встановлення інвалідності, інші особи, що здійснюють турботу про дитину та перебувають із нею у відповідному правовому зв'язку.

Improving access to banking services, or in a broader sense, promoting the level of financial inclusion is simply defined as the rate of individuals and businesses that are able to use basic financial services, including: savings, credit, payments and insurance. The financial access plays an extremely important role in reducing poverty, approach an equitable distribution of wealth, supporting a comprehensive and sustainable development (WB, 2014). Conversely, lack of access to finance is the underlying cause which leads to income inequality, poverty trap and lower growth. Accessing banking services helps individuals and businesses to find affordable financial resources and/or funds to meet needs as business opportunities comes, for an investment in children's education or for retirement savings. Bank loans also helps farmers and the poor protecting themselves against in life financial shocks such as illness, disease, crop failures and natural disasters. These poor people would be able to avoid the vicious circle of borrowing unofficial funds from shark borrowers at high interest rates. This increases the burden of higher repayment in value which could possibly cause the poor people to become even worse off. Owning no bank accounts may also cause people to be excluded from other services such as healthcare, insurance, being the basic instruments keeping them healthy and safe. Expanding the access to banking services also helps to reduce the cost of government programs regarding social activities, to have better management through increased transparency, and to have a better approach against corruption. A society with access to financial services will enhance the social participation level of people in general, improve fairness and equality, thus, the whole society's capability also raised. Improving access to banking services is one of the important measures to enforce the role of the banking system for economic growth, improve the quality and living standards of citizens, promote the omission of poverty and strive for sustainable economic growth. The Action plan to implement the "Overall strategy to develop the Service industry of Vietnam until 2020", issued under Decision No.808 / QD-TTG on 29th June 2012 of the Prime Minister identified a task of conducting the "Improving access to banking services for the economy" project and approved in 2015. The implementation of such project would be of great significance, not only to promote growth and omit poverty in Vietnam but also helps to support financial stability, creating precedents and content for Vietnam to participate in the implementation of the Millennium goals after 2015 that the United Nations set out (UN, 2014). Some findings regarding the level of access and barriers have been identified. The popularity of banking services in rural Vietnam is currently still low as (i) type of banking services in rural areas are less diverse, local residence mostly know and use credit services, whereas savings and payment services are hardly used; (ii) the proportion of people that open and use bank accounts are low compared to urban areas of Vietnam and rural areas of other countries. The demand for credit in rural areas are reasonably high, the proportion of people having access to credit from formal institutions are also good, however, the informal sector remains to keep an important role in the provision of capital for rural areas. Besides the demand for credit, the demand for savings within the rural population is relatively high but the proportion of adults having a savings account with formal institutions remains low. Along with the development and changes in the socio-economy, the needs to make transfers and payments increases rapidly in rural areas. Barriers to access banking servives have also been identified for the rural population, allocated to different sources of the found causes, relating to banks, people themselves and policies. Relating to banks: (i) the operational network of formal financial institutions in rural and remote areas is still sparse; (ii) the loan product lines are designed for all areas without customization to suit with each and every specific region, aiming especially to the rural population; (iii) the promotion activities of financial institutions regarding product and services in rural areas are still very limited. Relating to the people: (i) the perception of rural people on the existence of the series of banking services is low; (ii) the ability to adopt rural banking services such as the ability to set up business plans, understanding production process and financial literacy is limited. And other findings regarding policy settings. This paper aims to solve the followings: 1. Assessing the current status of financial inclusion in Vietnam 2. Finding gaps within the Financial Accessibility spectrum of Vietnam and setting out goals to be achieved in 2020. 3. Proposing recommendations and solutions to enhance financial access for households and from which promote sustainable economic growth in general.

2017 Fall. ; Includes bibliographical references. ; Traditional production system has exhausted natural resources and depleted soil nutrients reducing farm productivity and forcing farmers to expand farm lands, which, increases deforestation and pollution. Global warming and an increasing global population pose additional strain to the already fragile global food security, making it urgent for innovative production systems to be developed. Such systems, adapted to local circumstances and designed to reduce deforestation and increase food production, must emerge to provide an expanding global food demand while enabling preservation of natural resources. In Mexico, a five-year research project, derived from a national initiative has proposed a silvopastoral model for the Tepalcatepec valley, in the State of Michoacan, as an alternative to conventional livestock ranching in the tropics. The primary objective for this research project was to characterize the advantages and disadvantages of an alternative livestock farming model, the silvopastoral system. One hundred and fifteen farmers in the Tepalcatepec valley were surveyed to characterize their farms, their family demographics, main cattle breed, crops farmed, cattle diet, measures of animal performance (productivity) commercialization (marketing practices) and animal health management practices. An analysis of the progress of the various national SPS initiatives was also performed in order to identify gaps in research, collaboration, stakeholder education, and application of SPS farming in Mexico. A systems analysis was conducted on the research project using the information compiled from the team of scientists surveyed. Components related to carbon capture, biodiversity, soil quality, nutrient recycling, and larger-scale cycles such as water cycle need to be incorporated into future research. An accurate measure of the true economic and ecological impact of SPS farming is an essential goal. Improved communication among scientists, government agencies, and stakeholders is also essential for successful research into SPS farming. The animal health component of the five-year Mexican national SPS project is the focus of this dissertation. Traditional livestock health practices on participating small farms were characterized, and common health problems of cattle were identified. A community based livestock syndromic surveillance system was developed, implemented, and observed for two years on five selected farms. Observations from farmers and veterinarians were triangulated to validate data on animal health collected by laypeople. For each farm under study, monthly cumulative incidence per animal category (calf, grower or adult), the most frequent disease syndrome, and the syndrome that carried the greatest economic impact were calculated. Most Rho correlation coefficients for farmer's and veterinarian's observations were high. Farmers that implemented the silvopastoral model were considered typical of those who practiced this farming method elsewhere within the region. Because participating farms shared production system, husbandry, livestock health status, disease preventive measures, products, and commercialization channels, they were considered an epidemiological compartment for quantitative risk analysis. Six different scenarios were created and analyzed using the software @Risk™ to measure the risk of introduction of bovine tuberculosis into this epidemiological compartment. The Mexican national program for control and eradication of bovine tuberculosis norm, regional prevalence on bovine tuberculosis, and current cultural practices in Tepalcatepec valley were considered for this analysis. The introduction of replacement heifers or sires into the farms, and the probability of the introduction of at least one infected animal was estimated. The least probable scenario for the introduction of tuberculosis into this compartment was the introduction of at least one infected animal, despite the prevalence of source herd, after applying tuberculin caudal fold test and cervical comparative test in parallel. Although some farmers are aware that the silvopastoral system is profitable, environmental friendly, and socially acceptable, initial investment appears to be the first barrier for adoption. Alternatives for funding SPS development are needed such as preferable interest rates, credit, and loans; notably, an accurate assessment of the costs for establishment of SPS should be more thoroughly studied. The initial three years of SPS implementation have the highest amount on investment; for those years, special attention should be placed on recording the contributions of timber and/or fruit to financial returns, since these products may be the key for offsetting the cost of SPS implementation Further research is needed to more accurately measure the economic, ecological, animal health, and human health impact of the silvopastoral model of farming in the tropics. An ample variety of species combinations, suitable for silvopastoral production, should be studied and different arrays proposed to encourage scaling up the model. Research funding is scarce; however, public awareness of the need for a change in production practices and the allure of environmental friendly-produced animal products can produce a market-driven change in these small-scale food production operations. This could engender greater research support from industry and government sources, as well as non-governmental organizations dedicated to promoting sustainable agricultural practices in a changing global environment.

Andrea Luka Zimmerman's first UK solo exhibition + curated events Common Ground catalogue entry: The work of Andrea Luka Zimmerman explores the impact of globalisation, power structures, militarism and denied histories. Common Ground, Zimmerman's first UK solo exhibition, celebrates strategies of social and cultural resistance and proposes new ways of living together in the face of a threatened idea of the 'common good'. Central to the exhibition, Zimmerman's essay film Estate, a Reverie (2015) tracks the long drawn out closure of the Haggerston Estate in East London and the utopian promise of social housing it once offered. Filmed over seven years, Estate, a Reverie reveals the spirited everyday humanity and resilience of residents who, in circumstances like these, are habitually overlooked by media representations and wider social responses. The film portrays the complex relationships between people and the conditions in which they find themselves; asking how we might resist stereotypes of class, gender, ability, disability and geography. The themes of Estate, a Reverie resonate in further films, images, documents and events brought together for Common Ground. Taskafa - Stories of the Street (2013), is a film about survival and co-existence told through the lives of the street dogs of Istanbul and the citizens who care for them. It is voiced by the late writer and storyteller John Berger from his own novel King: A Street Story (1988). Zimmerman's Merzschmerz (2014) is a series of short videos in which children retell (from memory) fairy tales written by the German artist Kurt Schwitters to an adult neighbour or friend. These short scenes draw attention to the process of remembering and forgetting – as well as addition and subtraction – that is essential to the handing on of stories from one person to another. They are tender portraits which show the role of a listener to be as important as that of a narrator in the telling of a tale. Common Ground provides an environment for open discussion, research and debate about the issues at the heart of these films and the other work in the exhibition. A series of talks, discussions, readings and screenings are organised over three weekends during the exhibition. There is a library area within the gallery with books and archival material related to the projects, where visitors are welcome to sit and look, listen or read. --- ADDITIONAL EVENTS: (Un) Common Saturday 29 April 2017, 2–5pm Andrea Luka Zimmerman hosts a drop in event with collaborators on her film Estate, a Reverie; David Roberts, Elam Forrester and Lorna Forrester. Elam Forrester Born in London, Elam Forrester is a young filmmaker and photographer who has worked on a number of film projects and exhibitions both in the UK and in Central America, focusing on social issues such as housing, London's vanishing markets, issues affecting young Londoners and Women's Rights in El Salvador. In 2015 she produced her own film and photographic exhibition called Stories of El Salvador, which included her short films and photographs that she made while volunteering there. Elam is also a graduate of University of the Arts, London College of Communication. Lorna Forrester Lorna was born in Jamaica, and came to Bristol in the late 70s to join her family. After leaving school she moved to London where she's lived ever since and now works in Education. She lived on Haggerston Estate for nearly 20 years until its demolition. Discussion: Common Wealth Saturday 20 May 2017, 12–5pm This afternoon open discussion about housing and redevelopment addresses how these issues affect people in and around Bristol today. Andrea Luka Zimmerman invites guest campaigners, activists and others who are involved in related projects or research to take part. Before this event at Spike Island, join us at Knowle West Media Centre at 10am for a local walking tour and introduction to their project We can make…homes, exploring how communities can lead and influence the development of housing in their area. This is also an opportunity to see the exhibition We can make…, which includes work by artists Caitlin Shepherd and Charlotte Biszewski made with Knowle West residents. Caitlin and Charlotte are joining the afternoon discussion at Spike Island. This local walking tour is led by Melissa Mean, Head of Arts Programme at KWMC. In Common Saturday 17 June 2017, 2–8pm Share on Twitter Share on Facebook Share on Google + Join us to celebrate the work of John Berger, a prolific writer of powerful art criticism, poetry and fiction. This event combines talks, screenings and an audio recording of Berger reading Andrey Platonov's short story A Sparrow's Journey, heard by candlelight.

Анализ проблем и перспектив развития спортивнооздоровительного туризма в Крыму был проведён с целью модернизации данного туристского региона Российской Федерации. Объектом исследования является спортивно-оздоровительный туризм в Крыму, предметом – содержание и организация услуг в сфере спортивно-оздоровительного туризма. Актуальность исследования данной проблемы обусловлена тем, что туризм никогда не был значимой частью хозяйственного комплекса Крыма. На данный момент только 6% прямых отчислений в местный бюджет поступает от туристской индустрии, хотя в 2010 году именно туризм во всех его проявлениях был провозглашён приоритетным направлением экономической политики региона. Этот факт ещё раз подчеркивает необходимость проведения аналитического исследования как потенциала Крыма в области туризма в целом, так и его спортивно-оздоровительной направленности в частности. Результаты исследования позволят определить основные конкурентные преимущества данного субъекта Российской Федерации на международном рынке туриндустрии и перспективы развития спортивно-оздоровительного туризма в Крыму. Модернизация этого региона будет способствовать превращению его в центр занятий спортом, а также привлечению средств финансирования для развития этого направления туризма и увеличению турпотока на полуостров со всей России, стран ближнего и дальнего зарубежья. Исследования экспертов Федерального агентства по туризму Министерства культуры РФ по анализу туристского потенциала Крыма выявили, что увеличение притока туристов в регион для занятий спортом, улучшение материально-технической базы и качества оказываемых услуг в сфере спортивно-оздоровительного туризма, особенно в условиях импортозамещения, является одной из первоочередных задач Российского Правительства. В региональном разрезе туристский поток по-прежнему ориентирован в основном на «пляжный» отдых, а не на занятия спортивно-оздоровительным туризмом (спелеотуризм, велотуризм, пешеходный туризм, скалолазание, дайвинг, дельта-пара-аэротуризм, спортивное ориентирование или рогейн). И как следствие, в настоящее время Крым значительно отстаёт по качеству предоставляемых услуг и развитой инфраструктуры от таких «спортивных» центров России, как Краснодарский край, Ставрополье, Алтай, Камчатка и Прибайкалье, хотя имеет огромный потенциал в области развития услуг спортивнооздоровительной направленности (горные леса, бурные реки, многочисленные ущелья, Азовское и Черное море, соленые озера и многое другое). Проведённый анализ состояния спортивно-оздоровительной инфраструктуры региона может иметь важное значение при разработке практических рекомендаций, позволяющих использовать туристские ресурсы Крыма как источник финансовых доходов бюджетной системы Российской Федерации, средство повышения занятости и качества жизни населения, место для поддержания здоровья туристов, занятий спортивно-оздоровительным туризмом (как молодёжи, так и более взрослого населения), основу для развития социокультурной среды и воспитания патриотизма. ; The article gives an analysis of the problems and prospects of the sports and health tourism development in Crimea for modernization of this tourist region of the Russian Federation. The article is focused on the sports and health tourism in Crimea and namely on the content and organization of services in this field of tourism. The relevance of the study stems from the fact that tourism has never been a significant part of the economic complex of Crimea. Currently, only 6% of direct payments to the local budget come from the tourism industry, but in 2010 it is tourism in all its forms was proclaimed a priority of economic policy in the region. Results of the study can help to identify the main competitive advantages of this entity of the Russian Federation on the international tourism market and development prospects of sports and health tourism in Crimea. Modernization of the region will contribute to its transformation into a center of sports, as well as attraction of financing tools for the development of tourism destinations and an increase in tourist traffic to the peninsula from all over Russia, neighbouring countries and beyond. Wide experience of studies of Crimean touristic potential confirms that increasing the tourist flow for sports, improving the material and technical base and the quality of services in the field of sports and health tourism in the region, especially in the context of import substitution, is one of the Russian Government's priorities. Regionally, the tourist flow is still focused mainly on the "beach" recreation, not on sports tourism (caving, biking, hiking, rock climbing, diving, aero-tourism, orienteering, etc.). As a consequence, currently Crimea is significantly behind in quality of services and infrastructure of such Russian centers of sports as Krasnodar, Stavropol, Altai, Kamchatka and Baikal region. Although Crimea has great potential for health and of sports tourism services (mountain forests, turbulent rivers, numerous gorges, the Sea of Azov and the Black sea, the salt lakes and more). Analysis of sports and health infrastructure of the region can be applied to the development of practical recommendations for the use of touristic potential of Crimea as a source of financial income in the Russian Federation budget, means of improving employment and quality of life, a place for the maintenance of tourists' health and for their involvement to sports tourism activities (as young people, and adult population), the basis for the development of social and cultural environment and patriotic education.

This dissertation deals with the development activities of rural household of developing world, where poverty is wide spread and agriculture sector alone is insufficient to provide subsistence. In Pakistan, more than sixty percent of the population lives in the rural areas. Agricultural labor is the most common way of employment. The exponential increase in population has further stressed the depleting rural resources and created inability of the agricultural sector to absorb large labor force ; consequently resulting in social and economic problems. Moreover, rural community is characterized by imperfect land and credit markets, missing insurance facilities and limiting access to inputs such as credit, fertilizer etc. Due to imperfect labor markets and lack of resources, household's decision of labor allocation is affected. Thus, production and consumption decisions of the household are not separable, so household faces shadow wages which depend on the production technology and household's preferences. Chapter 3 evaluates the labor supply behavior of rural households in Pakistan by using shadow wages which is vital for policy design to improve the welfare of the rural household. The functioning of labor market in Pakistan is tested by applying three tests of separability. All these tests strongly rejected the presence of perfect markets in Pakistan. Chapter 4 estimates the impact of non-farm work on the household welfare. The rural non-farm sector is growing rapidly, becoming an important source of income, attracting the large labor force, and contributing to rural growth. With regards to factors that influence the participation in non-farm work, probability of participation increases with increased level of education, adult household size, and physical infrastructure, while lack of access to land, livestock, and credit decrease the likelihood of participation in non-farm work, for both male and female. The study shows that non-farm work increases the welfare and reduces the poverty level of rural household. One of the key challenges in the developing countries is to increase investment in order to enhance productivity in small-scale farming, which is the main source of income and food security for poor rural households. The poor households are unable to do agricultural investment due to liquidity constraints and insecure property rights. Chapter 5 investigates the role of non-farm work and land rights on the investment in soil conservation and productivity enhancing practices. The study shows that non-farm participation and secure land rights tend to encourage more investment in long-term soil-improving measures and less to short-term productivity-enhancing chemical fertilizers. The findings also show that non-farm participation and secure tenancy arrangements have a positive effect on agricultural productivity. Findings suggest boosting up high return employment opportunities by reducing entry barriers and implying changes in land tenure system for agricultural growth. ; In den letzten Jahrzehnten wurde die Landwirtschaft als übliche Einkommensquelle in den ländlichen Regionen von Entwicklungsländern betrachtet. Aufgrund des starken Bevölkerungswachstums hat dieser Sektor jedoch mittlerweile ein geringeres Wachstumspotential. Darüber hinaus haben Risiken in der Landwirtschaft wie Wetter, Saisonabhängigkeit oder haushaltsspezifische und wirtschaftliche Schocks das Potential zusätzlich verringert. Deshalb ist es notwendig, sich auf den Sektor der ländlichen Entwicklung zu fokussieren. Die Entwicklung des nicht-landwirtschaftlichen Sektors wir oft als nutzenbringend bezüglich der Schaffung von Arbeitsplätzen, der Milderung von Armut sowie der Ernährungssicherheit, der Stabilität der ländlichen Einkommen und der Haushaltswohlfahrt. Diese Dissertation beschäftigt sich mit den Entwicklungsaktivitäten in ländlichen Haushalten in Entwicklungsländern, in denen Armut weit verbreitet ist und der Agrarsektor allein unzureichend ist, um den Lebensunterhalt zu sichern. In Pakistan leben mehr als 60% der Bevölkerung in ländlichen Gegenden. Die Landwirtschaft bietet die meisten Arbeitsplätze. Der stark ausgeprägte Bevölkerungszuwachs übt zusätzlichen Druck auf vorhandene Ressourcen aus und bringt soziale und ökonomische Themen an die Tagesordnung. Andere Faktoren betreffen unvollkommene Land- und Kreditmärkte, fehlende Absicherungsmöglichkeiten und eingeschränkten Zugang zu Ressourcen etc. Durch unvollkommene Arbeitsmärkte und den Mangel an Ressourcen wird die Haushaltsentscheidung bezügliche der Arbeitsverteilung beeinflusst. Daher sind Produktions- und Konsumentscheidungen eines Haushalts nicht voneinander zu trennen, da dieser sich mit Schattenlöhnen konfrontiert sieht, die wiederum von der Produktionstechnologie und den Haushaltspräferenzen abhängen. Das dritte Kapitel der Dissertation evaluiert das Arbeitsangebotsverhalten von ländlichen Haushalten in Pakistan mithilfe von Schattenlöhnen. Diese Bewertung ist grundlegend für die Politik, um die Wohlfahrt ländlicher Haushalte zu verbessern. Die Funktionsfähigkeit der Arbeitsmärkte in Pakistan wird durch die Anwendung von drei sogenannten "tests of separability". Alle Tests lehnen das Vorhandensein von perfekten Märkten in Pakistan ab. Im vierten Kapitel wird die Wirkung von nicht-landwirtschaftlicher Arbeit auf die Haushaltswohlfahrt beurteilt. Der ländliche nicht-landwirtschaftsbezogene Sektor wächst stetig und entwickelt sich damit zu einer wichtigen Einkommensquelle, zieht Arbeitskräfte an und leistet einen wesentlichen Beitrag zur ländlichen Entwicklung. Unter Berücksichtigung von Faktoren, welche die Teilnahme an nicht-landwirtschaftlicher Arbeit beeinflussen, steigt die Wahrscheinlichkeit der Teilnahme mit einem höheren Bildungsniveau, der Haushaltsgröße und physischer Infrastruktur und sinkt hingegen bei einem mangelnden Zugang zu Land, Vieh und Krediten. Dies gilt für Männer gleichermaßen wie für Frauen. Die Studie zeigt, dass nicht-landwirtschaftliche Arbeit die Wohlfahrt erhöht und das Armutsniveau von ländlichen Haushalten verringert. Eine der wichtigsten Herausforderungen in Entwicklungsländern ist der Einsatz von Investitionen, um die Produktivität kleinlandwirtschaftlicher Betriebe zu verbessern, welche die Hauptquelle für Einkommen der armen Haushalte in ländlichen Regionen darstellt und Nahrungsmittelsicherheit bietet. Arme Haushalte sind aufgrund von Liquiditätseinschränkungen und ungewisse Eigentumsrechte, nicht in der Lage agrarbezogene Investitionen zu tätigen. Kapitel fünf erforscht die Rolle von nicht-landwirtschaftlicher Arbeit und Landrechten auf die Investitionstätigkeit in Bezug auf Bodenerhaltung und produktivitätssteigernde Maßnahmen. Die Studie beweist darüber hinaus, dass die nicht-landwirtschaftliche Teilnahme und gesicherte Landnutzungsrechte langfristige, Boden verbessernde Maßnahmen begünstigen und den Einsatz von kurzfristig, produktionsverstärkenden chemischen Düngern einschränkt. Die Resultate zeigen zudem, dass nicht-landwirtschaftliche Teilnahme und gesicherte Pachtverträge einen positiven Einfluss auf die landwirtschaftliche Produktivität haben. Basierend auf unseren Ergebnissen wird eine Verstärkung von Beschäftigungsmöglichkeiten mit einem hohen Einkommensniveau vorgeschlagen, indem Eintrittsbarrieren verringert und Veränderungen in Grundbesitzstrukturen vorangetrieben werden, die ein landwirtschaftliches Wachstum fördern.

The three essays conforming this thesis are representative pieces of my approach to analyzing the causes and consequences of economic underdevelopment. The overaching topic that ties together these essays is role that institutions and culture play in affecting specific behaviors that undermine development. The approach to the questions addressed in each essay is empirical, using data from Per\'{u} and Sierra Leone, and relies on economic theory to provide a general framework and deepen our understanding of the observed behaviors. Below, I provide a more detailed summary of the main findings of each chapter in this thesis:In Chapter 1, ''Turnout, Political Preferences, and Information: Evidence from Perú'', I explore the role of electoral institutions that encourage citizens to vote on voter behavior. These institutions are widely used around the world, and yet little is known about the effects of such institutions on voter participation and the composition of the electorate. In this paper, I combine a field experiment with a change in Peruvian voting laws to identify the effect of fines for abstention on voting. Using the random variation in the fine for abstention and an objective measure of turnout at the individual level, I estimate the elasticity of voting with respect to cost to be -0.21. Consistent with the theoretical model presented in this essay, the reduction in turnout is driven by voters who (i) are in the center of the political spectrum, (ii) are less interested in politics, and (iii) hold less political information. However, voters who respond to changes in the cost of abstention do not have different preferences for policies than those who vote regardless of the cost. Further, involvement in politics, as measured by the decision to acquire political information, seems to be independent of the level of the fine. Additional results indicate that the reduction in the fine reduces the incidence of vote buying and increases the price paid for a vote. Chapter 2, ''Civil Conflict and Human Capital Accumulation: The Long Term Consequences of Political Violence in Perú'', analyzes the consequences of a long lasting civil conflict on human capital accumulation. In this chapter, I provide empirical evidence of thelong- and short-term effects of exposure to political violence on human capital accumulation. Using a novel data set that registers all the violent acts and fatalities during the Peruvian civil conflict, I exploit the variation in conflict location and birth cohorts to identify the effect of the civil war on educational attainment. Conditional on being exposed to violence, the average person accumulates 0.31 less years of education as an adult. In the short-term, the effects are stronger than in the long run; these results hold when comparing children within the same household. Further, children are able to catch up if they experience violence once they have already started their schooling cycle, while if they are affected earlier in life the effect persists in the long run. I explore the potential causal mechanisms, finding that supply shocks delay entrance to school but don't cause lower educational achievement in the long-run. On the demand side, suggestive evidence shows that the effect on mother's health status and the subsequent effect on child health is what drives the long-run results.In the third and final chapter of this dissertation, "Transportation Choices, Fatalism, and the Value of Statistical Life in Africa", joint work with Edward Miguel, we take a look at the role culture plays in determining the willigness to pay to avoid life thretening situations. Specifically, we exploit a unique transportation setting to estimate the value of a statistical life (VSL) in Africa. We observe choices made by travelers to and from the airport in Freetown, Sierra Leone (which is separated from the city by a body of water) among transport options -namely, ferry, helicopter, speed boat, and hovercraft - each with differential historical mortality risk and monetary and time costs, and estimate the trade-offs individuals are willing to make using a discrete choice model. These revealed preference VSL estimates also exploit exogenous variation in travel risk generated by daily weather shocks, e.g. rainfall. We find that African travelers have very low willingness to pay for marginal reductions in mortality risk, with an estimated average VSL close to zero. Our sample of African airport travelers report high incomes (close to average U.S. levels), and likely have relatively long remaining life expectancy, ruling out the two most obvious explanations for the low value of life. Alternative explanations, such as those based on cultural factors, including the well-documented fatalism found in many West African societies, appear more promising.

Russian Jews who left the Former Soviet Union (FSU) and its Successor States after 1989 are considered as one of the best qualified migrants group worldwide. In the preferred countries of destination (Israel, the United States and Germany) they are well-known for cultural self-assertion, strong social upward mobility and manifold forms of self organisation and empowerment. Using Suzanne Kellers sociological model of "Strategic Elites", it easily becomes clear that a huge share of the Russian Jewish Immigrants in Germany and Israel are part of various elites due to their qualification and high positions in the FSU – first of all professional, cultural and intellectual elites ("Intelligentsija"). The study aimed to find out to what extent developments of cultural self-assertion, of local and transnational networking and of ethno-cultural empowerment are supported or even initiated by the immigrated (Russian Jewish) Elites. The empirical basis for this study have been 35 half-structured expert interviews with Russian Jews in both countries (Israel, Germany) – most of them scholars, artists, writers, journalists/publicists, teachers, engineers, social workers, students and politicians. The qualitative analysis of the interview material in Israel and Germany revealed that there are a lot of commonalities but also significant differences. It was obvious that almost all of the interview partners remained to be linked with Russian speaking networks and communities, irrespective of their success (or failure) in integration into the host societies. Many of them showed self-confidence with regard to the groups' amazing professional resources (70% of the adults with academic degree), and the cultural, professional and political potential of the FSU immigrants was usually considered as equal to those of the host population(s). Thus, the immigrants' interest in direct societal participation and social acceptance was accordingly high. Assimilation was no option. For the Russian Jewish "sense of community" in Israel and Germany, Russian Language, Arts and general Russian culture have remained of key importance. The Immigrants do not feel an insuperable contradiction when feeling "Russian" in cultural terms, "Jewish" in ethnical terms and "Israeli" / "German" in national terms – in that a typical case of additive identity shaping what is also significant for the Elites of these Immigrants. Tendencies of ethno-cultural self organisation – which do not necessarily hinder impressing individual careers in the new surroundings – are more noticeable in Israel. Thus, a part of the Russian Jewish Elites has responded to social exclusion, discrimination or blocking by local population (and by local elites) with intense efforts to build (Russian Jewish) Associations, Media, Educational Institutions and even Political Parties. All in all, the results of this study do very much contradict popular stereotypes of the Russian Jewish Immigrant as a pragmatic, passive "Homo Sovieticus". Among the Interview Partners in this study, civil-societal commitment was not the exception but rather the rule. Traditional activities of the early, legendary Russian "Intelligentsija" were marked by smooth transitions from arts, education and societal/political commitment. There seem to be certain continuities of this self-demand in some of the Russian Jewish groups in Israel. Though, nothing comparable could be drawn from the Interviews with the Immigrants in Germany. Thus, the myth and self-demand of Russian "Intelligentsija" is irrelevant for collective discourses among Russian Jews in Germany. ; Russischsprachige Juden, die nach 1989 die Sowjetunion und ihre Nachfolgestaaten verlassen haben, zählen weltweit zu den bestqualifizierten Migranten. In ihren bevorzugten Zielländern (Israel, USA, Deutschland) zeichnen sie sich durch sichtbare Formen der kulturellen Selbstbehauptung, eine starke Aufstiegsmobilität und einen relativ hohen Grad der Selbstorganisation aus. Auf Grund des hohen Bildungsgrades und der dominierenden Berufsbilder konnte in Anlehnung an das Modell der "Strategic Elites" von Suzanne Keller ein generell hoher Anteil an Eliten in der untersuchten Gruppe von Immigranten in Deutschland und Israel ausgemacht werden – v.a. professionelle, kulturelle und intellektuelle Eliten. Die Studie fragte danach, inwiefern Prozesse der kulturellen Selbstbehauptung, der lokalen und transnationalen Vernetzung und der ethno-kulturellen Selbstorganisation von den zugewanderten Eliten unterstützt oder sogar selbst befördert werden. Als empirische Grundlage dienten je 35 Experten-Interviews mit russisch-jüdischen Immigranten in beiden Ländern – dabei vorwiegend Wissenschaftler, Künstler, Schriftsteller, Publizisten/Journalisten, Lehrer, Ingenieure, Sozialarbeiter, Studenten und Politiker. Die qualitative Auswertung des Interviewmaterials in Deutschland und Israel ergab zahlreiche Gemeinsamkeiten, aber auch markante Unterschiede. Auffällig war, dass fast alle Interviewpartner mit russischsprachigen Netzwerken und Community-Strukturen gut verbunden blieben – unabhängig vom bisherigen Erfolg ihrer individuellen Integration. Fast durchweg waren sie sich ihrer überdurchschnittlichen beruflichen Kompetenzen (70% Akademiker) bewusst, die kulturellen, beruflichen und häufig auch politischen Ressourcen wurden mindestens als ebenbürtig zu jenen der Aufnahmegesellschaften betrachtet. Das Interesse an direkter gesellschaftlicher Partizipation und Akzeptanz war entsprechend hoch. Für das Zusammengehörigkeitsgefühl der Immigranten in Israel und Deutschland bilden russische Sprache, Kunst und (Alltags-) Kultur nach wie vor eine Schlüssel-Rolle. Dabei entsteht für die meisten Immigranten kein zwingender Widerspruch, sich "russisch" im kulturellen, "jüdisch" im ethnischen und "israelisch" / "deutsch" im nationalen Sinne zu fühlen - insofern ein klassischer Fall von additiver Identitätsbildung, der auch die zugewanderten Eliten charakterisiert. Assimilation in die Mehrheitsgesellschaft ist keine Option. Tendenzen ethno-kultureller Selbstorganisation, die erfolgreiche individuelle Integrationsverläufe im neuen Umfeld keineswegs ausschließen, zeigten sich am intensivsten in Israel. So reagiert ein Teil der russisch-jüdischen Eliten auf allgemeine Ausgrenzungserfahrungen und/oder Schließungsprozesse der lokalen Eliten bewusst mit der Bildung eigener Vereine, Medien, Bildungseinrichtungen und sogar politischer Parteien. Insgesamt widersprechen die Ergebnisse der Studie dem weitverbreiteten Stereotyp vom russisch-jüdischen Migranten als eines pragmatisch-passiven "Homo Sovieticus". Zivilgesellschaftliches Engagement war bei den untersuchten Eliten eher der Regelfall. Zu den Traditionen der frühen, legendären russischen "Intelligentsija" gehörten fließende Übergänge zwischen Kunst, Bildung und gesellschaftspolitischem Engagement. Dies setzt sich in Israel in einigen Gruppierungen der russisch-jüdischen Immigranten nahtlos fort. Dagegen machten die Experten-Interviews in Deutschland deutlich, dass ein vergleichbarer "Intelligentsija"-Effekt hier nicht zu erwarten ist - und daher für kollektive Orientierungsprozesse der russischen Juden irrelevant bleibt.

Four years ago, the largest single mistake in U.S.
public health history began its commencement, leaving former Democrat Gov. John
Bel Edwards to manufacture the most unsavory portion of his legacy, along with
others.

With a paucity of information about the Wuhan
coronavirus in mid-March, 2020, it's difficult to fault the extreme steps taken
initially over the next few months. These comprised of closing schools, closing
of all but the smallest public gatherings, restricting commercial activities,
and requiring social distancing including face coverings.

Yet
within three months it had become clear enough that much of this was or had
been ineffective. Because the virus was quite selective in who got hit hardest –
those with co-morbidities, followed by the elderly – the overwhelming majority
of the public, and especially children, would face no more than an inconvenient
respiratory virus of relatively short duration. In this time span, it became
clear that these punitive measures Edwards imposed for the vast
majority cost much more than any benefits that might accrue – learning and
developmental loss among children, tremendous economic dislocation, and assaults
on personal liberties.

Alternative models already existed for Edwards'
consideration by the time the 2020 school year commenced. Internationally, on
almost every measure the light touch practiced by Sweden avoided these costs.
Nationally, other
states' governors far less severely locked down their states and reaped the
same benefits.

Edwards made matters worse, when availability
arrived by the end of the year, by imposing unnecessary and intrusive
vaccination policies on adults and worst of all on children without
co-morbidities. The research has shown because of the extremely low benefit for
children that becomes microscopic for those below the age of 5 since almost
none suffer more than minorly, because detrimental side effect risks remained,
even if very low in probability, overall children were put at unnecessary risk
with vaccinations.

Even
if he backed off from his goal of forcing vaccinations and/or frequent testing
on state employees for its impracticality and bad optics (by the fall of 2021),
for a time he tried to strongarm educational institutions into forcing their employees
and students to have the same. Colleges were allowed free rein, and they
stupidly did, to impose such rules. Worse, he pushed through a rule forcing
that vaccination on school children that, again, proved so at odds with the science
and public that only months later he had
to retreat sheepishly.

Chalk up his enthusiasm for defying the science to
his leftist impulse towards command and control, where mandates increased
government power. As well, being a politician who focused more on retaining power
than in deferring it to allow individuals greater autonomy, he fell prey to the
zero
COVID fantasy and attendant myths
(such as acquired immunity wasn't as good as vaccination, vaccines would prevent
spread, and a host of others) to stave of fear that his political standing
would be injured significantly with every single death that could be traced
back to the virus.

Which ended
up spreading blood on his hands. While overaggressive pandemic policies may
have saved some lives, statistics would verify over time that on net they cost
more. People couldn't access crucial medical interventions and restrictions
produced mental stress that, the data showed, led to Louisiana ranking among
the highest in excess deaths not attributable directly to the virus.

It's not like any of these warts and alternative
approaches to his weren't known within months of the pandemic descending, yet
for the next couple of years that he continued to insist on strict measures (and
ineffective ones; besides indicating that through the links in this post and
the links within those, there's here,
here,
here,
here,
and here,
among many others). Unfortunately, he had many other enablers who either didn't
stand up to speak necessary truth to power, or who actively aided him in leaving
this miserable legacy.

If it was Edwards who had blood on his hands from
his pandemic policy, the apparatchik most responsible for handing him
the knife was former state epidemiologist Joe Kanter. He came to the office a
few months into the pandemic when it was peaking, upon the previous occupant
resigning for what he said were personal reasons (who months
later took a private sector job on the east coast). If Edwards was wanting
a yes man to add a veneer of respect to his decisions, he found the right guy.

Kanter supplied
full-throated support to a number of now-discredited policy choices by
Edwards, with whom he shares political ideology. He kept up a drumbeat of alarmist
rhetoric that never panned out and acted as chief cheerleader for every
restriction or as thugee
trying to suppress dissent. Even as recently as a year ago, in his official
capacity he was pimping vaccination for infants. He didn't last two months into
Republican Gov. Jeff Landry's
term, either or both because Landry couldn't stomach his policy preferences and
history or he knew because of that Landry would show him the door sometime soon;
regardless, he has been shamelessly unrepentant
to the end.

If Kanter was Edwards' consigliere in the
unfolding poor and unscientific policy choices, a pair of milquetoast Republican
legislative leaders ended up facilitating these. Former House Speaker Clay
Schexnayder and former Sen. Pres. Page Cortez, despite multiple opportunities
offered by their party members, did little to put up resistance to Edwards'
agenda. They allowed many bills that would have clipped Edwards' wings, if not
reverse his moves, either to die
in their chambers or didn't
back their revival as part of veto override votes. They even refused until
too late to back a petition
that could have done the same.

While a number of almost exclusively Republicans
in the legislature and in some local governments did their best to overcome Edwards'
destructive pandemic agenda, one prominent appointed official stood out
heroically: Superintendent of Education Cade
Brumley, who didn't assume the post until a couple of months into the
pandemic. He defied Edwards and Kanter by refusing to order students out of
classrooms statewide after the last couple months of the 2020 academic year, leaving
it up to districts to decide, and he eventually he scrapped the rule that said
students without symptoms but who had family members come down with the virus couldn't
attend in-person instruction.

In fact, as a result of Brumley's decisions, Louisiana
students' learning weathered better than just about any states' students in the
pandemic period, and the dismal overall rankings the state received for
pandemic policy didn't hit bottom solely because its education policy
performance turned out near the top. (I was anything but his many media critics,
but if it helps, "OK,
Brumley was right").

Four years have passed, and what did and didn't
work and who were the responsible villains and heroes need public refreshing so
that those whose moves disserved the state and those moves don't get lost in a
memory hole (a binning no doubt encouraged by those at fault) that would hinder
future publics from avoiding the same mistakes again.