Communicable and non-communicable diseases: what are the priority questions?
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The increasing use of all types of cellular telephones requires the formulation of new standards to ensure the immunity of electronic medical equipment to electromagnetic radiation. It will be many years before all hospital medical equipment conforms to new and higher standards. Until that time, the medical, security, maintenance, and other staff will need to be ever vigilant regarding restrictions on the use of wireless equipment within the hospital, to prevent potential danger to the lives of the patients. A comprehensive hospital policy must be formulated to reduce risks to patients from equipment susceptible to electromagnetic interference (EMI). Such an aim should address the following needs: To devise a uniform policy for the instruction of hospital staff, visitors, and patients, thereby reducing confusion regarding the use of cellular telephones, beepers, and portable transceivers. To implement a policy that avoids unwarranted restrictions but does not ignore statistical evidence regarding potential EMI problems. To allow comparison, with other clinical facilities, of the benefits derived from such a policy.
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OBJECTIVE: To study changes in the prevalence of risk factors for cardiovascular disease after a five year population-wide intervention programme promoting a healthy lifestyle in a developing country. DESIGN: Cross sectional cluster surveys in 1987 and 1992. Methodology included a two hour 75 g oral glucose tolerance test, measurement of body mass index, waist:hip ratio, basal lipid concentrations, and blood pressure; and a lifestyle questionnaire. SETTING: Mauritius, in the Indian Ocean. SUBJECTS: All adults aged 25-74 years residing in geographically defined clusters. MAIN OUTCOME MEASURES: Age standardised prevalence of categorical disease and risk factor conditions and mean levels and frequency distributions of continuous variables. RESULTS: Response rates were 86.2% (5080/5892) in 1987 and 89.5% (5162/5770) in 1992. Significant decreases were found in the prevalence of hypertension (15.0% to 12.1% in men and 12.4% to 10.9% in women); cigarette smoking (58.2% to 47.2% and 6.9% to 3.7% respectively); and heavy alcohol consumption (38.2% to 14.4% and 2.6% to 0.6% respectively). Moderate leisure physical activity increased from 16.9% to 22.1% in men and from 1.3% to 2.7% in women. Mean population serum total cholesterol concentration fell appreciably from 5.5 mmol/l to 4.7 mmol/l (P < 0.001). The prevalence of overweight or obesity increased, and the rates of glucose intolerance changed little. The population frequency distributions of blood pressure, serum lipid concentration, and a composite risk factor score shifted advantageously. CONCLUSIONS: Lifestyle intervention projects can be implemented and have positive effects in developing countries. A pronounced improvement in the population lipid profile in Mauritius was probably related to a change in the saturated fat content of a widely used cooking oil.
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