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THE COST OF DEMOCRATIC DEVELOPMENT - THE PRICE TAG ATTACHED TO BUILDING DEMOCRATIC INSTITUTIONS, ELECTORAL PROCESSES, AND EVEN POLITICAL PARTIES AND CIVIL-SOCIETY ORGANIZATIONS - IS AN ISSUE THAT HAS RECEIVED SCANT ATTENTION. THE AUTHORS ARGUE THAT LESS DEVELOPED COUNTRIES (LDC) NEED DEMOCRACY, BUT THE DEMOCRATIC INSTITUTIONS AND PROCESSES THEY CAN AFFORD ARE LIMITED, DIFFERENT FROM THOSE IN USE IN THE ESTABLISHED INDUSTRIAL DEMOCRACIES, AND PROBABLY LESS THAN IDEAL. IN TRYING TO PROMOTE DEMOCRACY, DONORS NEED TO CONSIDER THE COST TO A MUCH GREATER EXTENT THAN THEY DO NOW. IN THREE KEY AREAS - ELECTIONS, POLITICAL PARTIES, AND CIVIL SOCIETY - PATTERN OF SUPPLY-DRIVEN CHANGE, INSTITUTIONAL MODELS BASED ON THE CONTEMPORARY EXPERIENCE OF INDUSTRIAL SOCIETIES, AND RELIANCE ON EXTERNAL SUPPORT IS MAKING DEMOCRACY TOO EXPENSIVE FOR LDCS TO SUPPORT ON THEIR OWN.

BACKGROUND: Poor access to healthcare facilities and consequently nutrition counseling services hinders the uptake of recommended infant and young child feeding (IYCF) practices. To address these barriers and improve IYCF practices, Alive & Thrive (A&T) initiated community support groups in remote villages across nine provinces in Vietnam. OBJECTIVE: This study examines the effectiveness of the support group model and related project costs for reaching underserved areas to improve IYCF practices. METHODS: To evaluate the model's implementation and project costs, we reviewed implementation guidelines, expenditure and coverage reports, monitoring data, and budgets for the nine provinces. To evaluate the model's effectiveness, we used a 3-stage sampling method to conduct a cross-sectional survey from April to May 2014 in three provinces entailing interviewing mothers of children aged 0–23 months in communes with (intervention; n = 551) and without support groups (comparison; n = 559). FINDINGS: Coverage: From November 2011 to November 2014, in partnership with the government, A&T supported training for 1513 facilitators and the establishing 801 IYCF support groups in 267 villages across nine provinces. During this period, facilitators provided ~ 166,000 meeting/support contacts with ~ 33,000 pregnant women and mothers with children aged 0–23 months in intervention villages. Costs: The average project costs for supporting the meetings, compensating village collaborators, and providing supportive supervision through staff in commune health stations were USD 5 per client and USD 1 per contact. After adding expenditures for training, supportive supervision, and additional administrative costs at central and provincial levels, the average project cost was USD 15 per client and USD 3 per contact. Effectiveness: Survey participants in intervention and comparison communes had similar maternal, child, and household characteristics. Multiple logistic regression models showed that living in intervention communes ...

Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%–15% among young people in several Asian countries and of 1%–10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11.