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Housing and health transition in Thailand.

Over the past half-century, Thailand's health profile has been undergoing an epidemiologic transition in association with various fundamental societal changes, shifting from one with a predominant burden of communicable disease to one in which noncommunicable diseases and accidents now predominate. The primary question is why have the disease rates in the Thai population changed? Answering this question requires an examination of the underlying transitions in social and contextual factors. This paper explores, using published data, how housing conditions, as one set of environmental health risks, have undergone transition in recent years and how this change maps on the health-transition process. A combination of economic development, urbanization, modernization, and increased health literacy resulted in a range of health-protecting changes in housing design and materials. Pre-eminent among such changes are improvements in household sanitation and in equipment, ventilation, and fuel pertaining to indoor cooking and heating. In tropical countries like Thailand, gains have been made in mosquito-proofing houses and in minimizing open pools of water to combat the risks of malaria, dengue fever, and other mosquito-borne infections. Meanwhile, the growth in shantytown and slum housing around the urban fringe, often in precarious environmental settings, introduced a negative dimension to the evolving profile of housing-related health risks, whereas the urban sprawl of modern residences creates health risks that are due to traffic crashes and the lack of walking in daily transport.

Accidents↗

Primary health care in an unsettled area of northern Thailand.

The implementation of primary health care by nurses in poor and geographically isolated areas of the world is a complex and difficult task. When the area is also unsettled and insecure the task becomes increasingly formidable. Under these conditions primary health care is bound by not only the allocation of resources and restricted mobility but also the instability of changing government policies that influence all parameters of life. Mounting evidence has demonstrated that self-determination--derived from community-based socio-economic development--is a prerequisite to the initiation of a successful health care system. In turn, socioeconomic development is possible only when people are secure from expulsion from their land and the country. In addition, they must also be protected against outside coercion and violence that undermines community stability. The following is a report on health care problems related to the socioeconomic instability of an unsettled area that has global implications for nurses in similar areas worldwide.

Community Participation↗

Changing circumstances for accepting of behavioral patterns in connection with food preparation.

Food habits in a family are the results of many factors, e.g. the local traditions, availability of food, economic, social and cultural situation, and many others depending on the particular environment. Key role in this respect in the family have women, especially mothers. The transmission of the experiences on the choice and preparation of daily meals, their characteristic, frequency of their intake is also a result of previous generation of mothers, i.e. grandmothers. However, this situation has started to vary during more recent period of time according to the global changes in lifestyle. This resulted especially from the economic development and changing social situation. The analysis of this situation, when the role of mother and family declines, in the transmission of food choice and habits will be presented.

Cooking↗

Health research, the MDGs and policy making in Mozambique.

Health research can play an important part in achieving the goals of improving health, economic development and reducing poverty, even though a review of the literature suggests that little attention is given to the subject. Mozambique as a developing country has scarce resources for health research and so its health research efforts need targeted at pressing concerns and be capable of influencing policy-making. A way forward is being developed so that position of policy-makers and researchers is clarified and co-ordination better organised. This will also involve a review of financing, formulation of agendas, the avoidance of wasted resources and improving management skills.

Health Policy↗

[Hazardous medical waste management as a public health issue].

The amount of waste produced is connected with the degree of a country's economic development; more developed countries produce more waste. This paper reviews the quantities, manipulation and treatment methods of medical waste in Croatia, as well as hazardous potentials of medical waste for human health. Medical waste must be collected and sorted in containers suitable for its characteristics, amount, means of transportation and treatment method in order to prevent contact with environment and to protect people who are working with waste. Hazardous medical waste in Croatia is largely produced by hospitals. Even though only one hospital has a licence to incinerate infectious medical waste, many other hospitals incinerate their hazardous waste in inappropriate facilities. Healthcare institutions also store great amounts of old medical waste, mostly pharmaceutical, anti-infectious, and cytostatic drugs and chemical waste. Data on waste treatment effects on human health are scarce, while environmental problems are covered better. Croatian medical waste legislation is not being implemented. It is very important to establish a medical waste management system that would implement the existing legislation in all waste management cycles from waste production to treatment and final disposal.

Croatia↗

[Parental attitude to psychoactive drug use in adolescents].

Drug abuse is a problem worldwide, that destroys ones social, economical and family life. Our country is in a transition period and consist of postwar society. Therefore all risk factors for supstances abuse are present here such as social, economical, medical. Parental impact and peers seems to have strong impact on adolsecent with almost the same epidemiological characteristics in economical developed and undeveloped coutries. To find all risk factors is necessary for appropriate prevention approach. The aim of this investigation is finding some aspects of parenteral attitude related to drug abuse among early adolescents. Research covers 600 participants. Adolescents are equal gender and age distribution. It was used Q 2000 as research tool. Study design is prospective, epidemiological, analytica. Results showes that out of total number of adolescents (600) 15.55% were abusing alcohol, 6.69% smoke, 3.34% use cannabis. Parental impact and attitude which is presented in this study related to adolescent's drug abuse could be use as base for preventive activities.

Adolescent↗

The NUS MBBS-PhD programme: nurturing clinician-scientists for tomorrow.

The MBBS-PhD programme is a significant milestone in medical education in Singapore. In July 2000, the Faculty of Medicine, National University of Singapore launched this programme in collaboration with the Institute of Molecular and Cell Biology, with support from the Economic Development Board, and the Agency for Science, Technology and Research, Singapore. The objectives of the programme are to nurture and develop the talents of the brightest medical students by integrating clinical and basic biomedical research training, as well as to stimulate advanced basic and applied research in areas of growing importance to clinical medicine. The programme also aims to train clinician-scientists who will interface basic biology and clinical practice to solve biomedical problems and spearhead biomedical research initiatives in Singapore. Successful MBBS-PhD graduates can pursue career tracks in clinical research, basic biomedical research or in the biotechnology industry.

Curriculum↗

Geospatial indicators of emerging water stress: an application to Africa.

This study demonstrates the use of globally available Earth system science data sets for water assessment in otherwise information-poor regions of the world. Geospatial analysis at 8 km resolution shows that 64% of Africans rely on water resources that are limited and highly variable. Where available, river corridor flow is critical in augmenting local runoff, reducing impacts of climate variability, and improving access to freshwater. A significant fraction of cropland resides in Africa's driest regions, with 39% of the irrigation nonsustainable. Chronic overuse and water stress is high for 25% of the population with an additional 13% experiencing drought-related stress once each generation. Paradoxically, water stress for the vast majority of Africans typically remains low, reflecting poor water infrastructure and service, and low levels of use. Modest increases in water use could reduce constraints on economic development, pollution, and challenges to human health. Developing explicit geospatial indicators that link biogeophysical, socioeconomic, and engineering perspectives constitutes an important next step in global water assessment.

Africa↗

[Traffic accidents from the view of neurologist].

Review article deals with traffic accidents in our country and the problems of their causes. In comparison with economically developed countries traffic accidents prevalence raised since 1990 till 1995 and with small decline in 2004 it remains on a high level of 140 deaths in traffic accidents for I million of inhabitants, which makes the Czech Republic one of the worst among the compared countries. In agreement with present views, the main course of accidents is the human error. Attention is given to traffic accidents prevalence of young men versus young women, and to the evaluation of psycho-physiologic functions in elderly drivers. Personal qualities are among the most important in the neglecting of traffic rules, in the aggressivity, non-tolerance and disrespect to the freedom of others. Besides the building of the more perfect infrastructure, it is necessary to improve the register of accident recidivist drivers and for accidents and repeated accidents to promote compulsory psycho-neurological examination. Similarly to preventive check outs for alcohol, it s necessary to introduce similar measures to cope with growing effects of drugs.

Accidents, Traffic↗

[Ecological footprint and available ecological capacity in Chongqing region].

Based on the statistical data of Chongqing, the ecological footprint of Chongqing was calculated in this paper. The results showed that the per capita ecological footprint was 1.653566 hm2, per capita ecological capacity was 0.280393 hm2, and ecological surplus of deficit was 1.373173 hm2. The per capita ecological footprint was 0.5335 hm2 (47.64%) higher but the per capita ecological capacity was 0.5196 hm2 (64.95%) lower, and the ecological surplus of deficit was about 3.43 times of the average national level. These results showed that the ecological footprint of Chongqing was beyond the available ecological capacity, and its social and economic development was not sustainable. The strategies on reducing ecological deficit in this region, such as reducing ecosystem population, increasing public finance income, and controlling environmental pollution, were also put forward.

China↗

[The current prevalence status of body overweight and obesity in China: data from the China National Nutrition and Health Survey].

OBJECTIVE: To study on the prevalence of body overweight and obesity in China and its distribution in age, sex and economic development status. METHODS: A total of 209,849 in all ages from the 2002 China National Nutrition and Health Survey (NNAHS) database were analyzed. The year 2000 population census data was used for age standardization. 1978 WHO criteria using Z scores was applied to age 0-7 years, criteria recommended by the Working Group on Obesity in China was applied to those aged 7-17 years and criteria in the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults was applied to those aged 18 years and above. RESULTS: The overall prevalence was 17.6% for overweight and 5.6% for obesity. The combined prevalence of overweight and obesity was 23.2%. The prevalence of overweight was 25.0%, 21.6%, 17.4%, 15.1%, 19.2% and 12.8%, respectively for large city, middle-and-small city, class 1 rural, class 2 rural, class 3 rural and class 4 rural. For obesity, the rate was 10.6%, 7.2%, 6.4%, 4.3%, 6.0% and 2.7%, respectively for large city, middle-and-small city, class 1 rural, class 2 rural, class 3 rural and class 4 rural. By age groups, the prevalence of overweight was 3.4% in children age 0-6, 4.5% in adolescents age 7-17, 22.8% in adults age 18 and above; the prevalence of obesity was 2.0% in children age 0-6, 2.7% in adolescents age 7-17, 7.1% in adults age 18 and above. The sex difference in overweight and obesity differed between urban and rural, and among age groups. CONCLUSION: Overweight and obesity should have affected nearly 1 quarter of the country's total population, and became a threatening hazard to resident's health. As the urbanization progress, obesity might doubly increase. Prevention and control of this hazard should be urgently needed.

Adolescent↗

Health research in the Pacific.

The Pacific Island countries are geographically scattered, with contrasting environmental, social, and political systems, and in varying stages of economic development, but all are going through a rapid epidemiological transition. Processes that took place over thousands of years in Western countries have been very much compacted in time in the Pacific. These processes have produced major changes in environment and lifestyle, which have produced epidemics of non-communicable disease. While it is important to consider non-communicable diseases as a group, it is also important to conduct research into their specific causes. There has been a great deal of research into cardiovascular disease and diabetes in the Pacific, but it is only recently that the importance of cancer as a major source of mortality and morbidity in the Pacific has been recognised, even though it appears to carry a similar burden of morbidity and mortality. It is therefore important that research into the causes and control of cancer in the Pacific is conducted. However, it is also crucially important that this research both learns from the successes and avoids the mistakes of the past. In particular, it is crucial that cancer research in the Pacific is not another opportunity for "research colonialism," but instead provides opportunities for Pacific-training of Pacific health researchers and the conduct of Pacific-led research.

Biomedical Research↗

Diabetes care in China: meeting the challenge.

In both human and economic terms, diabetes is becoming one of the most serious and costly health conditions worldwide. Economic development, bringing changes from a traditional to a modernized lifestyle, is driving a huge increase in the number of people with obesity-related type 2 diabetes in China. The extraordinary size of the problem is worrying; if current trends continue, diabetes will become a massive health burden in China. In this article, Changyu Pan looks at the status of diabetes care in China and highlights the need for regional and national initiatives to increase awareness amongst the general population of the risk factors for diabetes, and thus prevent a further rapid increase in the prevalence of the condition.

China↗

Qualitative analysis and quantitative simulation on Yin-Huang water salinization mechanism in Bei-Da-Gang Reservoir.

Yellow River water transfer for Tianjin is important in solving the water shortage in Tianjin, which facilitate economic development and social progress for many years. Fresh water drawn from Yellow River (i.e., Yin-Huang water) becomes saltier and saltier when being stored in the Bei-Da-Gang reservoir. We qualitatively analyze the water salinization mechanism based on mass transfer theory. The main factors are salinity transfer of saline soil, evaporation concentrating, and the agitation of wind. A simulative experimental pond and an evaporation pond were built beside the Bei-Da-Gang reservoir to quantitatively investigate the water salinization based on water and solute balance in the simulative pond. 80% of increased [Cl-] is due to the salinity transfer of the saline soil and the other 20% is due to evaporation concentrating, so the former is the most important factor. We found that the salinization of Yin-Huang water can be described with a zero-dimension linear model.

China↗

[Epidemiology of obesity and overweight and relation thereof to the prevalence of hypertension in 14 provinces/municipality in China].

OBJECTIVE: To investigate the current epidemiological characteristics of obesity and overweight in the middle-aged and elderly populations of china and to disclose their relation with such chronic diseases as hypertension. METHODS: A questionnaire survey and physical examination were conducted among the 35-85-years-old persons from 14 densely populated residential areas representative in economic development and medical conditions in 14 provinces/municipality in China (i.e., Henna, Hebei, Shandong, Shanxi, Guangdong, Jiangxi, Tianjin, Inner Mongolia, Shaanxi, Hunan, Hubei, Yunnan, Sichuan, and Zhejiang) where a large-scale epidemiological survey of atrial fibrillation were being conducted, one residential area for a province, selected by cluster sampling to investigate the health-related personal conditions and examine the blood pressure (BP), body height, weight, body mass index (BMI), etc. so as to understand the prevalence of overweight and obesity based on the diagnostic criteria of Chinese adults recommended by the Working Group on Obesity in China. RESULTS: 29056 persons, 13549 males with the average body height of 168 cm +/- 7 cm, average weight of 68 kg +/- 11 kg, and average body mass index (BMI) of 24 kg/m(2) +/- 3 kg/m(2), and 15507 females with the average body height of 156 cm +/- 6 cm, average weight of 60 kg +/- 10 kg, and average BMI of 24 kg/m(2) +/- 4 kg/m(2), were surveyed. The BMI of women was significantly higher than that of men (P = 0.005). The total prevalence of overweight in the 14 provinces/municipality was 38.93%, and the standardized prevalence of overweight was 37.17%, the total prevalence of obesity was 13.94%, and the standardized prevalence was 12.63%. The prevalence of obesity of men was 12.29%, significantly lower then that of women (15.39%, P < 0.001). The prevalence of overweight of men was 412.18%, significantly higher then that of women (36.97%, P < 0.001). The prevalence rates of obesity and overweight increased with age in the age group 35-64; and decreased with age in the age group 65 and over. In the men, the prevalence of overweight was the highest in the age group 45-54 (44.57%), and the prevalence of obesity was the highest in the age 55-64 (13.60%). In the women, the prevalence of overweight was the highest in the age group 55-64 (40.10%), and the prevalence of obesity was the highest in the age group 65-74 (19.97%). The prevalence of hypertension increased obviously with the BMI in these populations. CONCLUSION: Overweight and obesity are prevalent in China. Control of body weight is of great importance to the prevention and treatment of such chronic diseases as hypertension.

Adult↗

[Ecological protection and sustainable utilization of Erhai Lake, Yunnan].

Economic development and increase of population pressure have caused a series of ecological environmental problems of Erhai Lake. These problems include: (1) Quickening of eutrophication process, (2) Decrease of water level and water resources, (3) Habitat deterioration of lakeside zone, and (4) Overfishing and slow depletion of aboriginal fish. Pollutant loading of Erhai Lake is as follows: COD(Cr) 3 008 t x a(-1), TP 137.31 t x a(-1), TN 1 426.35 t x a(-1). According to the mestrophic target of water quality, loading of nitrogen and phosphorus is far above environmental capacity of Erhai Lake. Erhai Lake is now in a pivotal and hypersensitive period of trophic states change, and the position is very critical. Therefore, some countermeasures to solve the problems are presented as follows: (1) Defining the dominant functions of Erhai Lake, (2) Paying attention to the adjustment of the industrial structure and distribution in the course of urbanization, (3) Setting up lakeside zone reserve, (4) Strengthening the control of tourism pollution, (5) Properly adjusting the water level of Erhai Lake, and (6) Some ecological engineering measures for water resources protection in the basin should be taken through collecting and treating of urban sewages, ecological rehabilitating of the main inflowing rivers, constructing of ecological agricultures and improving of rural environment, ecological restoring of aquatic ecosystem, and soil and water conservation.

China↗

Prevalence of dyslipidemia in rural Thai adults: an epidemiologic study in Khon Kaen province.

Dyslipidemia is an important, modifiable CHD risk factor. Previous studies have reported the prevalence of dyslipidemia particularly in urban populations. However, its prevalence in rural Northeast Thailand has not been well documented since extensive dietary and lifestyle transitions induced by the rapid socio-economic development of the late 1990s and early 2000s. The authors, therefore, conducted a cross-sectional assessment for the prevalence of dyslipidemia among rural Thais (in Khon Kaen province) using the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP III) Guidelines. The 325 subjects recruited (136 men; 189 women) averaged 53.8 +/- 17.6 years of age (range, 20-88). After having the subjects fast 12 hours, serum samples were collected. Total cholesterol, triglycerides, low-density lipoprotein (LDL-C) and high-density lipoprotein (HDL-C) cholesterols were measured. The prevalence of hypercholesterolemia (> 200 mg/dL), hypertriglyceridemia (> 150 mg/dL), high LDL-C (> 130 mg/dL) and low HDL-C (< 40 mg/dL) was 31, 40, 20 and 14 per cent, respectively. Women had a 2- to 3.5-fold higher prevalence of hypercholesterolemia and high LDL-C than men, while the prevalence of hypertriglyceridemia was comparable. The prevalence of dyslipidemia increased with advancing age and increasing BMI; notwithstanding, a high prevalence of dyslipidemia was observed in the youngest tertile as well. In conclusion, the present study demonstrated a high prevalence of dyslipidemia in rural Thai adults; consequently, primary lipid screening should be considered for all ages.

Adult↗

Utilization and management of organic wastes in Chinese agriculture: past, present and perspectives.

Recycling and composting of organic materials such as animal waste, crop residues and green manures has a long tradition in China. In the past, the application of organic manures guaranteed a high return of organic materials and plant mineral nutrients and thus maintained soil fertility and crop yield. As a result of rapid economic development coupled with the increasing urbanization and labour costs, the recycling rate of organic materials in Chinese agriculture has dramatically declined during the last two decades, in particular in the more developed eastern and southeastern provinces of China. Improper handling and storage of the organic wastes is causing severe air and water pollution. Because farmers are using increasing amounts of mineral fertilizer, only 47% of the cropland is still receiving organic manure, which accounted for 18% of N, 28% of P and 75% of K in the total nutrient input in 2000. Nowadays, the average proportion of nutrients (N+P+K) supplemented by organic manure in Chinese cropland is only 35% of the total amount of nutrients from both inorganic and organic sources. In China, one of the major causes is the increasing de-coupling of animal and plant production. This is occurring at a time when "re-coupling" is partly being considered in Western countries as a means to improve soil fertility and reduce pollution from animal husbandry. Re-coupling of modern animal and plant production is urgently needed in China. A comprehensive plan to develop intensive animal husbandry while taking into account the environmental impact of liquid and gaseous emissions and the nutrient requirements of the crops as well as the organic carbon requirements of the soil are absolutely necessary. As a consequence of a stronger consideration of ecological aspects in agriculture, a range of environmental standards has been issued and various legal initiatives are being taken in China. Their enforcement should be strictly monitored.

Agriculture↗

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