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PubMed2002

Influenza and the work of the World Health Organization.

Before World War I, influenza was not considered a particularly serious problem. The great pandemic of 1918-1919 changed all that, and the possibility that such a catastrophe could occur again has conditioned all subsequent developments. In epidemiological terms, the hallmark of an influenza is the excess mortality that it causes combined with an enormous burden of ill-health that saps the energy of individuals, families and communities throughout the whole world. In order to engage in influenza prevention and control, the global influenza surveillance network was set up by World Health Organization (WHO) in 1948 as a worldwide alert system for the identification of new influenza viruses, gathering information from 110 participating laboratories in 82 countries and four WHO Collaborating Centers for Influenza reference and research: Centers for Disease Control and Prevention, Atlanta (USA), National Institute for Medical Research, London (UK), WHO Collaborating Centre for Influenza Reference and Research, Melbourne (Australia) and the National Institute for Infectious Diseases, Tokyo (Japan). This network helps WHO to monitor influenza activity all over the world and provides the organization with the viral isolates and information it requires to decide which new virus strains will be used to produce influenza vaccines during the following season. Each year, information about the isolates over the previous 12 months is analyzed and used to determine the composition of the influenza vaccine to be administered during the coming influenza season both for the northern and southern hemisphere. If necessary, the recommendations for the southern hemisphere differ from the ones formulated for the northern hemisphere vaccine. The information supplied by this network enables the organization to regularly update its World Wide Web (WWW) site (FluNet), which reports on the situation of diseases. This network will also enable the WHO to detect a new influenza pandemic as early as possible.

Animals↗
PubMed2004

Use of the World Health Organization (WHO) classification of non-Hodgkin's lymphoma in Mumbai, India: a review of 200 consecutive cases by a panel of five expert hematopathologists.

This study aims to answer the question whether the World Health Organization (WHO) classification of non-Hodgkin's lymphoma (NHL) can be practised to international standards at the Lymphoma Registry (LR) established at the Tata Memorial Hospital, Mumbai, India. Furthermore, the study aims to identify differences in the distribution of NHL subtypes at this LR (likely to be representative of India) as compared to the rest of the world. A panel of 5 expert hematopathologists from the NHL Classification Project reviewed 200 consecutive NHL cases at the LR in January of 2001. These cases were accrued during August and September, 2000. On all cases, hematoxylin and eosin stains and appropriate immunostains were available for review. The diagnosis made by the host pathologist at the LR (KNN) and the initial diagnosis made by each of the expert hematopathologists was compared with the consensus diagnosis. A consensus diagnosis was made by the 5 experts in 197 cases. The agreement of the host pathologist with the consensus diagnosis was 82% and the agreement of the individual experts with the consensus diagnosis varied from 76-88% (mean 82%). According to the consensus diagnosis, 80% of NHLs were of B-cell type, 18% were of T-cell type, and the immunophenotype could not be determined in the remaining 2% of cases. In conclusion, the WHO classification of NHL was properly utilized at the Lymphoma Registry, Mumbai, India, and geographic differences were noted in the distribution of NHL subtypes at the LR as compared to the rest of the world. Precursor T lymphoblastic leukemia/lymphoma was more common in India (7%) than the rest of the world (1-4%), and indolent B-cell NHLs (29%) were less common than in the West. As compared to China and Japan, peripheral T-cell lymphoma (4.6%), extranodal NK/T cell lymphoma, nasal type (0.5%) and extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-lymphoma) (2.6%) were less common, but follicular lymphoma (15%) and chronic lymphocytic leukemia/small lymphocytic lymphoma (5%) were more common. This suggests that the distribution of the B-cell and T-cell lymphomas in the Indian population, except for lymphoblastic lymphoma, lies in between the Western world (mainly Caucasian) and the Orientals.

Adolescent↗
PubMed2003

Building integrated health systems in central and eastern Europe: an analysis of WHO and World Bank views and their relevance to health systems in transition.

BACKGROUND: Two questions are addressed. i) What are the views on health and health systems as expressed in the World Development Report 2000/2001 of the WB and the World Health Report 2000 and Health 21 of the World Health Organization, and how compatible are those views? ii) To what extent will compliance of CEEC and NIS with the WHO and WB recommendations result in health systems that produce maximum health for all by adequately addressing the needs of their populations? METHOD: The reports prepared by the World Bank and the World Health Organization were assessed against the theoretical framework of a needs-based public health approach. RESULTS: It is observed that the WHO and WB approaches are currently converging, although there remain differences in their respective focuses. The main merit of the WHO approach is its focus on performance and the systems approach towards health (care). The merit of the WB view is the integrated approach to health, education and poverty. It is argued that CEEC and NIS need to anticipate an ageing population and growing numbers of chronically ill. This calls for integrated health care systems and more integrated funding and payment systems. CONCLUSION: The recommendations provided in the WHR and the WDR with regard to integrated care and integrated financing remain rather abstract. Advisors of CEEC and NIS on health care reform and Western assistance projects should focus more on future needs, in order to avoid building health systems that consistently lag behind the needs of their populations.

Delivery of Health Care, Integrated↗
PubMedDate not supplied

Trends in world population: how will the millenium compare with the past?

This paper reviews historical and projected trends in world population numbers, and the underlying determinants of those trends. Whereas the world's population has shown little change over most of its one million-year history, the past 200 years have witnessed dramatic changes in fertility, mortality and population growth rates. Recent decades, in particular, have seen unprecedented demographic events, with more people added to the world's population in the past 50 years than in the preceding million. The demographic impact of HIV/AIDS, selective as it is to young adults and infants, is also unprecedented, with life expectancy among some populations reduced by almost 20 years. As we approach the end of the 20th century, further demographic changes are underway with, for the first time in recent human history, a slowing down of world population growth. Nonetheless, world population is projected to grow from 6 billion currently to about 9.4 billion by 2050 (medium fertility assumption), with ageing emerging as the most pressing demographic issue facing humanity in the millenium.

Acquired Immunodeficiency Syndrome↗
PubMed1995

The world economic system and international migration in less developed countries: an ecological approach.

"This paper analysed net migration within the context of [the] world economic system and urban ecological framework using the structural equation model." The author "employs linear structural equation modelling to examine determinants of international migration, using data from the World Bank World Tables, World Development Reports and the World Bank." (SUMMARY IN FRE AND SPA)

Agriculture↗
PubMed2001

Epidemiology of violent deaths in the world.

OBJECTIVE: This study describes epidemiologic patterns of mortality due to suicide, homicide, and war for the world in order to serve as a benchmark against which to measure future progress and to raise awareness about violence as a global public health problem. SETTING: The world and its eight major regions. METHOD: Data were derived from The Global Burden of Disease series and the US National Center for Health Statistics to estimate crude rates, age adjusted rates, sex rate ratios, and the health burden for suicide, homicide, and war related deaths for the world and its eight major regions in 1990. RESULTS: In 1990, an estimated 1,851,000 people died from violence (35.3 per 100,000) in the world. There were an estimated 786,000 suicides. Overall suicide rates ranged from 3.4 per 100,000 in Sub-Saharan Africa to 30.4 per 100,000 in China. There were an estimated 563,000 homicides. Overall homicide rates ranged from 1.0 per 100,000 in established market economies to 44.8 per 100,000 in Sub-Saharan Africa with peaks among males aged 15-24 years old, and among females aged 0-4 years old. There were an estimated 502,000 war related deaths with peaks in rates for both sexes among people aged 0-4, 15-29, and 60-69 years old. CONCLUSION: The number of violence related deaths in the world is unacceptably high. Coordinated prevention and control efforts are urgently needed.

Adolescent↗
PubMedDate not supplied

Rattlesnake envenomation in 12 New World camelids.

BACKGROUND: Rattlesnake envenomation of New World camelids is a seasonal problem with often dramatic clinical signs. HYPOTHESIS: The purpose of this study was to identify the clinical signs, laboratory results, treatment methods, and outcome for rattlesnake envenomation in New World camelids. ANIMALS: Medical records from 1988 to 2004 were searched for New World camelids presented for rattlesnake bite or clinical signs suspected to be related to recent envenomation. Twelve records were identified. METHODS: From these records a retrospective study was performed. RESULTS: Nine camelids presented for acute disease (2/9 arrived dead), whereas 3 presented for subacute onset of disease. Swelling of the lips, head and neck, tachypnea, dyspnea, tachycardia, and lethargy were the most common presenting signs. Snake bites were most commonly located to the muzzle (10/12). Common complete blood count (CBC) and serum biochemical abnormalities were neutrophilia, lymphopenia, increased muscle enzyme activity, hypoalbuminemia, hyperglycemia, hypokalemia, and thrombocytopenia. Treatment included combinations of intravenous fluid therapy, antimicrobials, anti-inflammatory drugs, tetanus prophylaxis, tracheostomy, supplemental oxygen, antivenom, total parenteral nutrition, and nursing care. Five of the 10 animals with acute onset of clinical signs survived, and all animals with subacute presentation died. The mortality rate for New World camelids with severe local tissue reaction and systemic signs of envenomation was 58%. CLINICAL IMPORTANCE: New World camelids that sustain rattlesnake envenomation and severe facial swelling precluding prehension and mastication have a guarded prognosis for survival. Aggressive treatment is recommended to optimize the chances of survival. Animals with less severe local tissue reaction and absence of systemic signs have a better prognosis.

Animals↗
PubMed2006

The impact of the World Health Organization classification and clonality assessment of posttransplant lymphoproliferative disorders on disease management.

CONTEXT: The World Health Organization classification of posttransplant lymphoproliferative disorders divides them into 4 main categories. OBJECTIVE: To classify cases of posttransplant lymphoproliferative disorders diagnosed in our institution according to the World Health Organization scheme and correlate the classification and clonality with clinical data. DESIGN: Cases of posttransplant lymphoproliferative disorders were reviewed. They were classified according to the World Health Organization scheme. Clonality was determined by flow cytometry and/or polymerase chain reaction. Patients' charts were reviewed. RESULTS: Thirty-one cases were identified. Median age was 33 years. There were 19 cases of kidney, 8 cases of liver, and 4 cases of bone marrow transplant. Immunosuppression consisted of cyclosporin A and prednisone (N = 24) or FK506 and prednisone (N = 7). Twenty cases (63%) were World Health Organization type 3, 7 cases (23%) type 2, 3 cases (6.4%) type 1, and 1 case type 4 posttransplant lymphoproliferative disorder. Ten patients received chemotherapy, 20 patients had reduction of immunosuppression, and 1 had no treatment. Follow-up was available on 25 patients. Seven (43.75%) of 16 with type 3 lesions with available follow-up died of their disease. Five of these patients received reduction of immunosuppression alone. Only 2 of 9 patients with type 3 disease who received chemotherapy died of disease. Two patients with type 2 disease died of unrelated causes. One patient is alive with disease; the remaining patients with types 1 and 2 disease are alive with no disease. CONCLUSIONS: The World Health Organization classification of posttransplant lymphoproliferative disorders is valuable in the identification of subtypes. It helps identify early lesions (1 and 2) requiring reduction of immunosuppression and type 3 disease, which requires chemotherapy from the outset.

Adolescent↗
PubMed1997

Rationalizing health care in a changing world: the need to know.

The World Development Report 1993 announced that global life expectancy was then 65. Experience in the developed world suggests that the World Health Organization's dictum, 'health is a state of complete physical, mental and social well-being', is simply not attainable for the foreseeable future. As physical health has improved, mental problems have become more prominent and a sense of well-being has declined. Furthermore, as the population ages and medical technology improves, the cost of health care grows almost exponentially. Since the population of the developed world is continuing to age and aging is spreading rapidly throughout the developing world, knowledge is the principal way of dealing with this seemingly intractable problem: we must know, quantitatively, the age-specific causes of ill health, and we must know which means of prevention and treatment are effective. Finally, we must apply that knowledge rationally.

Developing Countries↗
PubMed1981

World food resources and population: the narrowing margin.

This bulletin examines the narrowing margin between global food production and population growth. Between 1950 and 1971, world grain production nearly doubled and per capita production increased 31%. During the 1970s, gains in output barely kept pace with population growth, consumption/person declined in sub-Saharan Africa and parts of Asia, food prices were volatile, and over 100 food deficit countries came to depend on the exportable surplus of North America, now the only major grain exporting region. The world fish catch levelled off in the early 1970s and beef production, still dependent mainly on grassland grazing, levelled off in the mid-1970s. With little new land left to plow, satisfying increased food demand now depends on sharp increases in yields on existing crop land. Worldwide, this effort is hampered by loss of topsoil and irrigated land, conversion of cropland to nonfarm uses, rising energy costs, inefficient agrarian structures, particularly in the Soviet Union, the falling yield response to chemical fertilizers in agriculturally advanced countries, and the emerging competition between food and agriculturally based energy crops. Green Revolution successes in some developing countries deomonstrate that, given the right inputs, 3rd world farmers can increase crop yields dramatically. Feeding the world's poor also requires more equitable income and food distribution, including a reduction in the proportion of grain and fish consumed indirectly as livestock products by the affluent. Most important in meeting food needs on a finite planet is braking population growth. The author concludes that every effort should be made to stabilize world production at abour 6 billion by 2020, rather than 10.5 billion by 2110, as is now projected by the UN.

Agriculture↗
PubMed2003

[Shifting of emphasis in the world health sector strategy; from political concerns to economic ones].

Primary Health Care, proclaimed by WHO in 1978, is a health strategy that aims to achieve the ultimate objective "Health For All", with underlying political concerns for ideals such as social justice, equity and human rights. Meanwhile, "globalization", urged by the U.S.A., other developed countries and multinational corporations, has since promoted liberalization of trade, capital and finance, which has in the past few decades been sweeping all over the world. With this "new economic liberalism", values that put much emphasis on economic efficiency are now at the forefront. The World Bank, which supports the tendency along with the International Monetary Fund and the World Trade Organization, has become an influential actor in helping developing countries to prosper economically. The World Bank, whose basic idea is that investment in health is basic for economic growth, has in the 1990s also exerted considerable influence on the international health sector with its overwhelming provision of financial assistance. Instead of political concerns like equity and human rights, 'economic concerns' such as fairer budget allocation, cost-effectiveness, cost reduction and efficiency have now become main points for discussion in the international health field. This shift in emphasis poses fundamental questions for the core goal of the World Health Organization; "Health For All".

Economics↗
PubMed1987

The World Health Organization's global strategy for the prevention and control of AIDS.

The magnitude of the human immunodeficiency virus (HIV) pandemic and its broad impact have been seriously underestimated and underappreciated. The Special Programme on AIDS (acquired immunodeficiency syndrome) of the World Health Organization (WHO) was created on February 1, 1987, as the architect and keystone of the global AIDS plan. The Special Programme on AIDS has designed the global strategy, has raised sufficient funds to begin implementing the strategy and, for this effort, has marshalled the support of every nation in the world. AIDS affects both the developing and the industrialized worlds; therefore, every country will need a national AIDS program. This is vital not only for national interests but also because ultimately AIDS cannot be stopped in any one country unless it is stopped in all countries. National AIDS programs are being rapidly established throughout the world with the technical and financial support of WHO's Special Programme on AIDS. At the global level, the Special Programme is responsible for strategic leadership, developing consensus, coordinating scientific research, exchanging information, assuring technical cooperation and mobilizing and coordinating resources. National AIDS committees have already been established in more than 150 countries and, by the end of 1988, the Special Programme will support every country in the world that requests collaboration.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Craniofacial morphology of the first Americans: Pattern and process in the peopling of the New World.

The peopling of the New World has been the focus of anthropological attention since the last century. Proponents of multiple migration models have claimed that patterns of variation among extant New World populations reflect ancient, discrete migrations to the Americas during the terminal Pleistocene. Although multiple migration models appear to explain patterns of both past and present craniometric variation, this interpretation rests on a number of key assumptions that require further investigation. We examined a series of Paleoindian (n = 11) and Archaic (n = 384) crania from North and South America, and compare these early samples to a large world-wide sample of late Holocene (n = 6,742) remains to assess within- and among-group variability in early samples, and to determine how patterns of variation could be viewed as a reflection of both population history and population structure. Analyses included univariate and multivariate analysis of variance, principal component analysis, calculation of biological distances, and multivariate allocation methods. We also performed model-bound analyses of these data, including Relethford-Blangero analysis and calculation of F(ST). Our results indicate that under the assumptions of migration/founder models, the data are consistent with Paleoindians having derived from an undifferentiated Asian population that was not ancestral to modern American Indians. This view can be accommodated into existing models of multiple founders (migrations) in the New World. However, the assumptions required for such an interpretation are not realistic, and the diversity of early populations could as easily reflect population structuring processes such as genetic drift, demographic growth, and other phenomena. When the data were analyzed controlling for the effects of genetic drift (i.e., with smaller long-term effective population sizes for Paleoindians), the Paleoindian samples were no longer distinct from modern Native American populations. Other factors that need to be considered include processes involved in craniofacial change and adaptation during the past 10,000 years. Finally, patterns of variation in the North and South American Paleoindian samples are different, suggesting that the process of New World colonization is more complex than previously assumed.

Anthropometry↗
PubMed1996

Morphology of retinal ganglion cells in a new world monkey, the marmoset Callithrix jacchus.

We studied the morphology of retinal ganglion cells in a diurnal New World primate, the marmoset Callithrix jacchus. This species is of interest as a model for primate vision because it has good behavioural visual acuity, and the retina and subcortical visual pathways are very similar to those of Old World monkeys and humans. Ganglion cells were labelled by placing small crystals of the carbocyanin dye DiI into the optic fibre layer, or by intracellular injection of neurobiotin. Two main classes of ganglion cell were labelled. We call these Group A cells and Group B cells: they are respectively homologous to parasol and midget cell classes. Group A and Group B cells show similar patterns of dye coupling, dendritic stratification and dendritic field size as their counterparts in Old World monkeys and humans. A third group of cells, which we call Group C, is morphologically heterogeneous. Examples corresponding to wide-field ganglion cell types described in Old World primates were encountered. One subgroup of C cells has a morphology very similar to that of the small bistratified (blue-on) cell described in macaque retina, suggesting that this functional pathway is common to all primates. As for other New World monkeys, the marmoset shows a sex-linked polymorphism of cone pigment expression, such that all males are dichromats and the majority of females are trichromats. No systematic differences in Group B cells were seen between male and female retinas, suggesting that trichromacy is not accompanied by specific changes in ganglion cell morphology.

Animals↗
PubMed2001

The rejection of natural science approaches to psychotherapy: language and the world.

Many postmodernists appeal to theses about the relationship between language and reality as one basis for rejecting natural science approaches to psychotherapy. The theses include one or more of the following: (a) There are multiple worlds rather than just one, (b) worlds are constructed rather than discovered, and (c) worlds are not independent of mind and language. I refer to the conjunction of these three propositions as the multiple worlds-constructionist view. After examining the most systematic defense of the multiple worlds-constructionist view. I conclude that it fails, and that each component of the view is false.

Humans↗
PubMed2005

Possible steps to the emergence of life: the [GADV]-protein world hypothesis.

Based on the fact that RNA has not only a genetic function but also a catalytic function, the RNA world theory on the origin of life was first proposed about 20 years ago. The theory assumes that RNA was amplified by self-replication to increase RNA diversity on the primitive earth. Since then, the theory has been widely accepted as the most likely explanation for the emergence of life. In contrast, we reached another hypothesis, the [GADV]-protein world hypothesis, which is based on pseudo-replication of [GADV]-proteins. We reached this hypothesis during studies on the origins of genes and the genetic code, where [G], [A], [D], and [V] refer to Gly, Ala, Asp, and Val, respectively. In this review, possible steps to the emergence of life are discussed from the standpoint of the [GADV]-protein world hypothesis, comparing it in parallel with the RNA world theory. It is also shown that [GADV]-peptides, which were produced by repeated dry-heating cycles and by solid phase peptide synthesis, have catalytic activities, hydrolyzing peptide bonds in a natural protein, bovine serum albumin. These experimental results support the [GADV]-protein world hypothesis for the origin of life.

Alanine↗
PubMed2002

World water dynamics: global modeling of water resources.

The growing scarcity of fresh and clean water is among the most important issues facing civilization in the 21st century. Despite the growing attention to a chronic, pernicious crisis in world's water resources our ability to correctly assess and predict global water availability, use and balance is still quite limited. An attempt is documented here in modeling global world water resources using system dynamics approach. Water resources sector (quantity and quality) is integrated with five sectors that drive industrial growth: population; agriculture; economy; nonrenewable resources; and persistent pollution. WorldWater model is developed on the basis of the last version of World3 model. Simulations of world water dynamics with WorldWater indicate that there is a strong relationship between the world water resources and future industrial growth of the world. It is also shown that the water pollution is the most important future water issue on the global level.

Agriculture↗
PubMed2001

Higher-level phylogeny of new world vireos (aves: vireonidae) based on sequences of multiple mitochondrial DNA genes.

Interfamilial relationships of the New World songbird family Vireonidae are uncertain. Thus, we sequenced 3069 bp of four mitochondrial genes (cyt b, ND2, ND3, COI) from 19 taxa in five families and two outgroups, to examine higher-level alliances with proposed relatives. We also sequenced cyt b and ND2 from an additional five vireonids to examine intergeneric relationships within the Vireonidae and incorporated 14 sequences of cyt b from GenBank to test the effects of taxon sampling on gene tree resolution. Families appeared monophyletic in all analyses, and the affinity of vireonids to Old World corvoids was corroborated. However, relationships among the Vireonidae and other families were not resolved. Sequences of vireonids revealed high levels of divergence within and between genera, with either Cyclarhis or Vireolanius positioned basally, depending on the analysis. On the basis of mitochondrial DNA and biogeographic evidence, vireonids represent a deep lineage derived from an Old World ancestor that colonized the New World, most likely via Beringia, with subsequent radiation in the Middle American tropics. We hypothesize postcolonization dispersal of the ancestor into Middle America, followed by extinction of the ancestor in North America. This extinction event left the North Temperate Zone unoccupied by any vireonid until northward reinvasion by some species of Vireo. Although the closest living relative of vireonids remains unidentified, broad-scale sequencing of additional extant corvoids with multiple molecular markers should further elucidate Old World alliances.

Animals↗