Changes in medical research trends of North Korea after economic sanctions: A PRISMA-compliant systematic literature review of North Korean medical journals.

BACKGROUND: In the 1980s, North Korea established a socialist health care system. However, following the food crisis and the economic sanctions, it is estimated that North Korea's health care system has experienced continuous deterioration. Thus, in the present study, we estimated the current medical research trends of North Korea through an analysis of the medical journal Korean Medicine, published in North Korea. METHODS: We analyzed the studies in Korean Medicine, which is the only North Korean medical journal accessible to foreigners with more than 30 years of data available, based on PRISMA guidelines. We analyzed the issues of the journal published for a total of 7 years, from 1985 onwards at 5-year intervals until 2015. To evaluate changes in the North Korean medical research trends, we compared and analyzed the issues published before and after the implementation of economic sanctions against North Korea. RESULTS: In this study, we analyzed 775 articles of Korean Medicine. Following economic sanctions, the number of publications on approved services (conventional therapy and diagnosis)-related articles was decreased. In contrast, the articles related to non-conventional therapy increased sharply in number. This showed a similar pattern to North Korean medical research trends seen during the food crisis of 1995 to 1997. CONCLUSIONS: After placement of economic sanctions on North Korea, North Korean medical research trends changed significantly. These could be indirectly estimated results suggesting that recently, the North Korean health care system had deteriorated, similarly to in the food crisis of 1995 to 1997.

Narrating health and scarcity: Guyanese healthcare workers, development reformers, and sacrifice as solution from socialist to neoliberal governance.

In oral history interviews, Guyanese healthcare workers emphasize continuity in public health governance throughout the late twentieth century, despite major shifts in broader systems of governance during this period. I argue that these healthcare workers' recollections reflect long-term scarcities and the discourses through which both socialist politicians and neoliberal reformers have narrated them. I highlight the striking similarities in discourses of responsibility and efficiency advanced by socialist politicians in 1970s Guyana and by World Bank representatives designing the country's market transition in the late 1980s, and the ways these discourses have played out in Guyana's health system. Across diverging ideologies, politicians and administrators have promoted severe cost-control as the means to a more prosperous future, presenting short-term pains as necessary to creating new, better, leaner ways of life. In the health sector this has been enacted through a focus on self-help, and on nutrition as a tool available without funds dedicated for pharmaceuticals, advanced medical technologies, or a fully staffed public health system. I argue that across these periods Guyanese citizens have been offered a very similar recipe of ongoing sacrifice. I base my analysis on oral histories with forty-six healthcare workers conducted between 2013 and 2015 in Guyana in Regions 3, 4, 5, 9, and 10, as well as written records from World Bank and Guyanese national archives; I analyze official discourses as well as recollections and experiences of public health governance by those working in Guyana's health system.

What's 'left' in the 'Garden of Sweden'?

Liberalization, restructuring, and retrenchment have been underway in Sweden for more than two decades and have rapidly accelerated under the current non-socialist coalition government. It is uncertain how much of the Swedish social policy model is "left" now, in terms of both what remains of it and its political character. A cross-temporal look at developments within Sweden reveals striking and continual rollbacks and marketization since the 1990s. However, this view must be qualified, both because Sweden's undisputed descent is from a comparatively lofty position and because there have been some noteworthy, but often ignored, gains even amidst marked decline over the past few decades. A cross-national examination indicates that, despite rapidly rising rates of income and wealth inequality, Sweden remains an egalitarian leader in several respects. This view must be qualified, too, because, while it continues to routinely out-perform Anglo nations such as Canada, the United Kingdom, and the United States, Sweden is less often, and less notably, distinct from several of its continental counterparts in Europe now. Moreover, the foundation of the model, labor strength, has been significantly undermined.

A heuristic blunder: notes on an ethnographic situation in southwest China.

During long-term fieldwork the increasing involvement of the ethnographer in the lives of others raises a series of methodological and ethical issues. These can become even more pronounced when one is working with ethnic minorities in a socialist country. Yet, a seldom acknowledged reality of ethnographic fieldwork experience are the 'little failures' that occur along the way, alongside ethnographic blunders. I argue that these are difficult to avoid and can be part of an important learning process, oftentimes for both researcher and researched. Through the detailed description of a blunder that the author made during his research in southwest China with members of the Drung ethnic minority, this article advocates for the heuristic value of such mishaps, suggesting that one can learn a lot from accidents and unexpected events while undertaking in-depth ethnographic fieldwork. In this case, this helped to shed light on the micropolitics of Drung village life in southwest Yunnan, and the place of a 'minority nationality' in wider Chinese society.

The gift of health: Socialist medical practice and shifting material and moral economies in post-Soviet Cuba.

Drawing on ethnographic data collected over 13 months of fieldwork in family doctor clinics in Havana from 2004 to 2005, I examine the shifting moral and material economies of Cuban socialist medical practice. In both official ideology and in daily practice, the moral economy of ideal socialist medicine is based on an ethos of reciprocal social exchange-that is, the gift-that informs not only doctors' relationships with the Cuban state and with individual patients but also the state's policies of international medical service to developing nations. The social and economic upheavals after the fall of t Soviet Union, however, have compelled both the state and individual doctors to operate in a new local and global economy. The gift remains the central metaphor of Cuban medical practice. Nonetheless, as ideologies and practices of gifting and reciprocity encounter an emerging market economy, gifts--whether on the level of the state policies of international humanism or in patient-doctor relations--are open to new significations that highlight the shifting material and moral economies of post-Soviet Cuba.

Manpower of neurologists in the post-socialist countries of Central and Eastern Europe.

BACKGROUND AND PURPOSE: Manpower of neurologists from the post-socialist countries of Central and Eastern Europe differs very much from the number of neurologists in most of the countries of Western Europe. With the enlargement of the European Union (EU), it is necessary to consider the tendencies of manpower evolution amongst the 'new' European countries to be able to consider future developments, particularly in regard to education and migration. METHODS: A survey was performed to study distribution and tendencies to migrate amongst neurologists from the post-socialist countries of Central and Eastern Europe. RESULTS: The number of neurologists per 10,000 inhabitants varies from one country to another, but is higher in the countries of Central and Eastern Europe than in most Western European countries. There are almost no available positions for neurologists in Eastern Europe, and the majority of neurologists are keen to migrate to EU countries -- for further education and for financial reasons. CONCLUSIONS: The number of neurologists in the 'reforming and transition' countries is considerably higher than in the countries of the EU. Many neurologists from these countries would like to migrate to countries of the EU or USA, but the existing barriers are difficult to overcome.

Argentina: no lesson learned.

This article examines the political, ideological, social, and economic processes by which the Argentinean economy was transformed, the structural consequences, and the policies responsible for dismantling the welfare state. The health care system reform during the 1990s was an important component in accomplishing the last objective. Analyses of the policies adopted after the crisis of 2001 reveal that, despite the discourse against international financial institutions, President Nestor Kirchner, elected in 2002, followed the same approach by accepting and applying the second generation of health reforms recommended by the World Bank and the Inter-American Development Bank with additional pressure from the World Trade Organization and several free trade agreements. This "new reform" furthered business opportunities for multinational corporations while further shrinking the state administration's role in supplying health, education, and other social services to people who need them more than ever. Social movements have emerged that are developing alternative projects and showing that, when the base is solidarity, "another world is possible."

A critique of Jeffrey D. Sachs's The end of poverty.

Jeffrey Sachs's The End of Poverty is a manifesto and how-to guide on ending extreme poverty around the world; it promotes the U.N. Millennium Development Goals. Sachs achieved fame with his policy package for the "stabilization" of Bolivia (which did nothing to relieve Bolivia's poverty), and became advisor to the Yeltsin government in Russia and to Poland, Slovenia, and Estonia as they began their transitions to capitalism (the last three mixed successes; Russia a thorough disaster). Sachs later became more prominent as a critic of development orthodoxy, and was economic advisor to the Jubilee 2000 movement. The End of Poverty is full of sharp critiques of Western imperialism, but his views on the rest of the development business are more conventional.

Comparison of health care financing in Egypt and Cuba: lessons for health reform in Egypt.

Egypt and Cuba are both lower-middle income countries with a history of socialist rule, which have embarked on economic liberalization since the 1990s. Cuba has achieved exemplary health status whereas health status in Egypt is lower than could be expected for its level of income. In this article, health care financing mechanisms in both countries are analysed on their effectiveness, efficiency, and equity, with the objective of identifying the determinants of success in the Cuban health system from which valuable lessons for current health reforms in Egypt may be derived.

The British National Health Service: lessons from the "Socialist Calculation Debate".

The "Socialist Calculation Debate" is little known outside the economics profession, yet this inter-war debate between liberal and socialist economists on the practical feasibility of socialism has important implications for all contemporary public sector bureaucracies. This article applies the Mises-Hayek critique of central planning that emerged from this debate to the crisis presently facing the British National Health Service. The Mises-Hayek critique suggests that the UK government's plan for a renewal of the National Health Service will fail because of the epistemological pathologies that face any centrally planned system. It is argued that the key lesson of the Socialist Calculation Debate is that market prices and private property rights are essential for the efficient allocation of resources and the attainment of the best possible health outcomes.

A critique of social capital.

This article critiques the concepts of communitarianism and social capital as used in the United States and in Europe. For the United States, the author focuses on Robert Putnam's understanding of both concepts, showing that the apolitical analysis of the Progressive Era, of the progressive developments in Northern Italy, and of the situation of labor unions in the United States is not only insufficient but wrong. The critique also includes the difference between U.S. communitarianism and its European versions, Christian democracy and New Labour, and the limitations of both approaches. The uses and misuses of these concepts in the political debate are discussed.

The globalization of capital, the welfare state, and old age policy.

A new political economy is shaping the lives of present and future generations of older people. The key change has been the move from the mass institutions that defined growing old in the period from 1945 through the late 1970s to the more individualized structures--privatized pensions, privatized health and social care--that increasingly inform the current period. The authors examine the role of international governmental organizations in promoting this trend, with examples drawn from the work of the World Bank, World Trade Organization, and Organization for Economic Cooperation and Development, and the relationship between international governmental organizations and the state. The article concludes with an assessment of the changes to citizenship that accompany globalization and the implications for political organization among older people themselves.

The future of the welfare state: crisis myths and crisis realities.

Accounts of the future of the welfare state are often presented in crisis terms. Some commentators identify globalization as a force that has already led to a major retreat by the state and is likely to lead to further downsizing of the public sector. Others see the future burden of an aging population as creating huge public expenditure pressures that can be countered only by increased parsimony in most areas of spending. Although both crisis scenarios contain elements of truth, analysis of recent public expenditure trends shows that both are substantially exaggerated as general representations of likely developments over the next two or three decades. However, unnoticed by most commentators, a real, longer-term crisis is beginning to make itself felt. This crisis arises, in part, from the demographic impact of a cultural transformation in the labor market, in progress for several decades. Extreme scenarios of possible consequences over the next 50 to 100 years include population implosion, mass migration, increasingly dangerous eruptions of right-wing populism, and, possibly, territorial conflict between developed and underdeveloped nations. This is not a crisis of the welfare state but rather a crisis for which the welfare state may be an essential part of the answer. The only way Western societies can lessen the future impact of the ongoing cultural transformation of the labor market is through the redesign of welfare state institutions to confront these new challenges.