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PubMed1993

Health care in Moscow.

In the Russian Federation privatisation is affecting the health care sector as much as it is industry and commerce. That the general public support the transfer of state clinics to the private sector is a mark of their dissatisfaction with the old state run system. Doctors too see better opportunities to practise good medicine and be paid better for doing so. In Moscow the health department has set up a commission to license all clinics providing treatment, which should ensure standards of safety, training, and equipment. The Russian Federation is also trying to establish a medical insurance system to cover its citizens for health care, but in Moscow and elsewhere its implementation has been delayed by arguments and bureaucracy. In the meantime the health of Muscovites remains poor, with a high incidence of birth defects, and illnesses among the young.

Delivery of Health Care↗

PubMed2000

A systematic review of interventions for preventing tobacco sales to minors.

OBJECTIVE: To assess the effectiveness of interventions to reduce underage access to tobacco by deterring shopkeepers from making illegal sales. METHOD: Systematic literature review. DATA SOURCES: The Cochrane Tobacco Addiction group specialised register and Medline. Studies of interventions to alter retailer behaviour were identified. The terms used for searching combined terms for smoking and tobacco use with terms for minors, children or young people, and retailers, sales or commerce. STUDY SELECTION: Studies in which there was an intervention with retailers of tobacco, either through education about, or enforcement of, local ordinances. The outcomes were changes in retailer compliance with legislation (assessed by test purchasing), changes in young people's perceived ease of access to tobacco products, and changes in smoking behaviour. Controlled studies with or without random allocation of retail outlets or communities, and uncontrolled studies with pre- and post intervention assessment, were included. DATA EXTRACTION: Two reviewers assessed studies for inclusion. One extracted data with checking by the second. DATA SYNTHESIS: The results were synthesised qualitatively, with greater weight given to controlled studies. Thirteen of 27 included studies used controls. RESULTS: Giving retailers information was less effective in reducing illegal sales than active enforcement and/or multicomponent educational strategies. No strategy achieved complete, sustained compliance. In three controlled trials, there was little effect of intervention on youth perceptions of access or prevalence of smoking. CONCLUSIONS: Interventions with retailers can lead to large decreases in the number of outlets selling tobacco to youths. However, few of the communities studied in this review achieved sustained levels of high compliance. This may explain why there is limited evidence for an effect of intervention on youth perception of ease of access to tobacco, and on smoking behaviour.

Adolescent↗

PubMed1989

Eugenics and American social history, 1880-1950.

Eugenics, the attempt to improve the human species socially through better breeding was a widespread and popular movement in the United States and Europe between 1910 and 1940. Eugenics was an attempt to use science (the newly discovered Mendelian laws of heredity) to solve social problems (crime, alcoholism, prostitution, rebelliousness), using trained experts. Eugenics gained much support from progressive reform thinkers, who sought to plan social development using expert knowledge in both the social and natural sciences. In eugenics, progressive reformers saw the opportunity to attack social problems efficiently by treating the cause (bad heredity) rather than the effect. Much of the impetus for social and economic reform came from class conflict in the period 1880-1930, resulting from industrialization, unemployment, working conditions, periodic depressions, and unionization. In response, the industrialist class adopted firmer measures of economic control (abandonment of laissez-faire principles), the principles of government regulation (interstate commerce, labor), and the cult of industrial efficiency. Eugenics was only one aspect of progressive reform, but as a scientific claim to explain the cause of social problems, it was a particularly powerful weapon in the arsenal of class conflict at the time.

Attitude to Health↗

PubMed1999

Bionomics of the Anthocoridae.

The family Anthocoridae (Hemiptera:Heteroptera) contains between 400 and 600 species distributed worldwide, chiefly on the continents but also on oceanic islands. They are small (1.4-4.5 mm) and common to a wide variety of habitats. Many are found in cryptic habitats such as galls, several widespread genera are surface feeders on small arthropods (Anthocoris, Orius, and Tetraphleps), and others can be found in ant nests and, especially, under bark. Wing polymorphism is common in this family, often associated with the cryptic habit. Most known species are predaceous, though some take plant food as well (e.g. Orius insidiosus, Orius pallidicornis). A few of these are believed to be entirely phytophagous (Paratriphleps laeviusculus). Their small size and often generalized feeding habits have resulted in about 30 introduced species, mostly accidental. A few have been introduced deliberately as biological control agents (Anthocoris spp., Montandoniola moraguesi, O. insidiosus, Orius tristicolor, and Tetraphleps spp.). Most nonindigenous species seem to have been distributed as a result of human activities, especially commerce. The predaceous habits of many Anthocoridae have attracted the attention of researchers who work in agroecosystems. Integrated pest management programs often include these predators, which has given us greater knowledge about these species than those found in natural ecosystems. Exciting discoveries about the attractiveness to these bugs of certain volatile plant and arthropod compounds are opening new areas of investigation into their chemical ecology. The reactions of these tiny predators will surely become better understood as a result.

Journal Article↗

PubMed1995

International aspects of the AIDS/HIV epidemic.

This review provides the reader with pertinent information on the epidemiology, prevention, and new technologies of the ongoing HIV pandemic. These aspects are key to international policy discussions surrounding the public health response to the international spread of HIV. Our understanding of the impact of AIDS on other diseases is evolving, as is our insight into the demographic and economic effects of the epidemic on the global community. Observations on the success of certain prevention strategies allow rational allocation of resources in newly affected epidemic areas. Information on the origin and nature of HIV transmission exemplifies the phenomenon of global emerging infections. As world populations are brought closer together through transportation, communication, trade, and commerce, insight into emerging infections of epidemic potential becomes increasingly important to the practitioner of public health. Although important, legal and social aspects of the epidemic will not be emphasized here. The epidemics of HIV/AIDS in the United States and Europe are not reviewed here. The global pandemic has recently been described in an overview in this publication to which the reader is also referred.

AIDS Vaccines↗

PubMed1999

Lessons in environmental health in the twentieth century.

Environmental health has evolved rapidly in recent decades, drawing largely on new analytic technologies, advanced data acquisition and modeling, mechanistic studies in toxicology, and the conceptual framework of risk assessment. The latter combines toxicologic and epidemiologic data with improved techniques for quantifying exposure, producing estimates of risks from environmental hazards or conditions to selected target populations. The public and governments have become increasingly concerned with environmental health and quality. The major lessons have been (a) environmental-health scientists must participate in policy debates; (b) environmental health problems are exceedingly complex and require interdisciplinary research; and (c) environmental health is a global issue. The globalization of commerce, the untested impact of international trade agreements, increased migration, and especially increased population, have profound impact on the quality as well as availability of air, water, land, and food. Global atmospheric transport of pollutants and the effect on atmosphere and climate are two examples of globalization of environmental health.

Environmental Health↗

PubMed2001

Minisymposium on obesity: overview and some strategic considerations.

The high and still increasing prevalence of obesity in US children, adolescents, and adults poses a major economic and health threat to our society. The three reviews in this minisymposium on obesity explore the health issues by: 1) describing the public health impact of obesity; 2) examining the multiple and complex environmental influences on eating and physical activity patterns; and 3) considering how the development of obesity during childhood and adolescence can be prevented through interventions in school, family, and primary care settings. This overview explains the importance, for effective long-term obesity prevention and control, of intersectoral policy and environmental initiatives-in addition to behavior change approaches aimed at individuals. The need for public health professionals to influence and operate within a variety of non-health sectors such as transportation, education, urban planning, and commerce may be seen as the greatest barrier but may also be the greatest opportunity.

Adolescent↗

PubMed2002

Health issues of air travel.

Every day in the United States the airline industry boards over 1.7 million passengers for a total of 600 million passengers per year. As these passengers enter the cabin of their aircraft few are aware of the artificial environment that will protect them from the hazards of flight. Passengers are exposed to reduced atmospheric pressure, reduced available oxygen, noise, vibration, and are subject to below zero temperatures that are only a quarter inch away-the thickness of the aircraft's skin. Over the past decade there have been both technical and lay articles written on the perception of poor cabin air quality. Studies have, in part, supported some of those concerns, but, in general, the air quality exceeds that found in most enclosed spaces on terra firma. Since the events of September 11th, passengers have not only been exposed to the physical stress of flight, but also to social and emotional stress preceding departure. There has been a significant increase in air rage on board aircraft, which poses a threat to flight safety and a fear of harm to passengers and crew. The phrase "economy class syndrome" has received popular press attention and refers to the possibility of deep vein thrombosis (DVT) in the tight confines of an aircraft cabin. Studies have been conducted that demonstrate DVT can occur in flight just as it occurs in other modes of transportation or with prolonged sitting. In part, because of the stress related to commercial flight it is not a mode of transportation for everyone. Certain cardiovascular, pulmonary, and neuropsychiatric conditions are best left on the ground. Although medical problems and death are rare in flight, they do occur, and one major airline reported 1.52 medical diversions per billion revenue passenger miles flown. To provide medical support at 36,000 ft (11,000 m) most airlines now carry on-board medical kits as well as automatic external defibrillators. A recent survey conducted by a major airline revealed that there was at least one physician on 85% of all its flights. Both passenger and cargo aircraft have proven to be vectors of disease in that they transport humans, mosquitoes, and other insects and animals who, in turn, transmit disease. Transmission to other passengers has occurred with tuberculosis and influenza. Vectors for yellow fever, malaria, and dengue have been identified on aircraft. Although there are numerous health issues associated with air travel they pale in comparison to the enormous benefits to the traveler, to commerce, to international affairs, and to the public's health.

Air Pollution, Indoor↗

PubMed1988

Accuracy of respiratory inductive plethysmographic cross-sectional areas.

The present study was undertaken to evaluate whether the respiratory inductive plethysmograph (RIP) 1) reflects changes of cross-sectional area enclosed by its transducer band in the presence of deformations of shape or whether it 2) has a stable base line. Testing of RIP was carried out with a device incorporating a thermally compensated oscillator and digital demodulatory circuitry. This system, introduced to commerce in 1983, superceded the nonthermal compensated oscillatory and analog demodulator circuitry first used in 1977. Testing the effects of changing cross-sectional area was accomplished by stretching a standard RIP transducer band around wooden dowels placed in holes on a peg board grid to form 23 curved and 5 rectangular shapes. The output voltage from RIP was linear for both the curved and rectangular shapes for changes of cross-sectional area within a physiological range. However, the regression line of voltage vs. cross-sectional area for the rectangular shapes was parallel and slightly displaced from the regression line for the curved shapes due to mutual coupling of inductance in the corners. Base-line drift from a RIP transducer band stretched to enclose an elliptical shape was less than 2.5 mV over a 12-h observation period. Current RIP technology accurately reflects changes of cross-sectional area of physiological shapes and has a stable base line.

Humans↗

PubMed2000

Current experiences with internet telepathology and possible evolution in the next generation of Internet services.

The last five years experience has definitely demonstrated the possible applications of the Internet for telepathology. They may be listed as follows: (a) teleconsultation via multimedia e-mail; (b) teleconsultation via web-based tools; (c) distant education by means of World Wide Web; (d) virtual microscope management through Web and Java interfaces; (e) real-time consultations through Internet-based videoconferencing. Such applications have led to the recognition of some important limits of the Internet, when dealing with telemedicine: (i) no guarantees on the quality of service (QoS); (ii) inadequate security and privacy; (iii) for some countries, low bandwidth and thus low responsiveness for real-time applications. Currently, there are several innovations in the world of the Internet. Different initiatives have been aimed at an amelioration of the Internet protocols, in order to have quality of service, multimedia support, security and other advanced services, together with greater bandwidth. The forthcoming Internet improvements, although induced by electronic commerce, video on demand, and other commercial needs, are of real interest also for telemedicine, because they solve the limits currently slowing down the use of Internet. When such new services will be available, telepathology applications may switch from research to daily practice in a fast way.

Humans↗

PubMed1993

The senna drug and its chemistry.

Senna consists of the dried leaflets or fruits of Cassia senna (C. acutifolia) known in commerce as Alexandrian senna and of Cassia angustifolia commonly known as Tinnevelly senna. The senna plants are small shrubs of Leguminosae cultivated either in Somalia, the Arabian peninsula and near the Nile river. Tinnevelly senna is obtained from cultivated plants mainly in South India and Pakistan. Owing to the careful way in which the plant is harvested, the leaflets of the drug are usually little broken. Damaged leaves and lower quality products are often used for making galenicals. The senna pods (fruits) are collected during the same period as the leaves, then dried and separated into various qualities. The active principle of Senna was first isolated and characterized by Stoll in 1941. The first two glycosides were identified and attributed to the anthraquinone family. These were found to be dimeric products of aloe emodin and/or rhein which were named sennoside A and sennoside B. They both hydrolyze to give the aglycones sennidin A and B and two molecules of glucose. Later work confirmed these findings and further demonstrated the presence of sennosides C and D. Small quantities of monomeric glycosides and free anthraquinones seem to be present as well. The active constituents of the pods are similar to those of the leaves but present in larger quantities. Two naphthalene glycosides isolated from senna leaves and pods are 6-hydroxymusicin glucoside and tinnevellin glucoside. Both compounds can be utilized to distinguish between the Alexandrian senna and the India senna, since tinnevellin glucoside is only found in the latter and the first only in the C. senna.(ABSTRACT TRUNCATED AT 250 WORDS)

Anthraquinones↗

PubMed2006

Objective accommodative amplitude and dynamics with the 1CU accommodative intraocular lens.

PURPOSE: To compare the objective accommodative amplitude and dynamics of eyes implanted with the one-compartment-unit (1CU; HumanOptics AG, Erlangen, Germany) accommodative intraocular lenses (IOLs) with that measured subjectively. METHODS: Twenty eyes with a 1CU accommodative IOL implanted were refracted and distance and near acuity measured with a logMAR (logarithm of the minimum angle of resolution) chart. The objective accommodative stimulus-response curve for static targets between 0.17 and 4.00 D accommodative demand was measured with the SRW-5000 (Shin-Nippon Commerce Inc., Tokyo, Japan) and PowerRefractor (PlusOptiX, Nürnberg, Germany) autorefractors. Continuous objective recording of dynamic accommodation was measured with the SRW-5000, with the subject viewing a target moving from 0 to 2.50 D at 0.3 Hz through a Badal lens system. Wavefront aberrometry measures (Zywave; Bausch & Lomb, Rochester, NY) were made through undilated pupils. Subjective amplitude of accommodation was measured with the RAF (Royal Air Force accommodation and vergence measurement) rule. RESULTS: Four months after implantation best-corrected acuity was -0.01 +/- 0.16 logMAR at distance and 0.60 +/- 0.09 logMAR at near. Objectively, the static amplitude of accommodation was 0.72 +/- 0.38 D. The average dynamic amplitude of accommodation was 0.71 +/- 0.47 D, with a lag behind the target of 0.50 +/- 0.48 seconds. Aberrometry showed a decrease in power of the lens-eye combination from the center to the periphery in all subjects (on average, -0.38 +/- 0.28 D/mm). Subjective amplitude of accommodation was 2.24 +/- 0.42 D. Two years after 1CU implantation, refractive error and distance visual acuity remained relatively stable, but near visual acuity, and the subjective and objective amplitudes of accommodation decreased. CONCLUSIONS: The objective accommodating effects of the 1CU lens appear to be limited, although patients are able to track a moving target. Subjective and objective accommodation was reduced at the 2-year follow-up. The greater subjective amplitude of accommodation is likely to result from the eye's depth of focus of and the aspheric nature of the IOL.

Accommodation, Ocular↗

PubMed1991

Neurasthenia and chronic fatigue syndrome: the role of culture in the making of a diagnosis.

Chronic fatigue syndrome is an increasingly popular diagnosis consisting of multiple psychiatric and somatic symptoms. It bears a striking resemblance to the nineteenth-century diagnosis of neurasthenia. Both disorders arose during periods characterized by a preoccupation with commerce and material success and major changes in the role of women. They illustrate the role of culture in the development of a new diagnosis that emphasizes a "medical" rather than "psychiatric" etiology. The authors argue that chronic fatigue syndrome will meet the same fate as neurasthenia--a decline in social value as it is demonstrated that the majority of its sufferers are experiencing primary psychiatric disorders or psychophysiological reactions and that the disorder is often a culturally sanctioned form of illness behavior.

Culture↗

PubMed1989

Pharmaceutical production in space? The case of the USA.

Globally, over $100 billion are spent annually on space goods and services. These include space shuttles, space stations ('factories'), transportation into space and materials processing in space (MPS). Many countries are involved, such as the USA, USSR, Japan and China. A current, fascinating area of space commerce--albeit in its infancy--is the production in space of vital pharmaceuticals such as urokinase, interferon and Factor VIII. This article discusses space-based pharmaceutical production, marketing-related obstacles and other concerns in the USA.

Drug Industry↗

PubMed1978

Randomized field experiments for program planning, development, and evaluation: an illustrative bibliography.

This bibliography lists references to over 300 field experiments undertaken in schools, hospitals, prisons, and other social settings, mainly in the U.S. The list is divided into 10 major categories corresponding to the type of program under examination. They include: criminal and civil justice programs, mental health, training and education, mass media, information collection, utilization, commerce and industry, welfare, health, and family planning. The main purpose of the bibliography is to provide evidence on feasibility and scope of randomized field tests, since despite their advantages, it is not always clear from managerial, political, and other constraints on research that they can be mounted. Dates of publications range from 1944 to 1978.

Bibliographies as Topic↗

PubMed2004

A historical context of municipal solid waste management in the United States.

Municipal solid waste management (MSWM) in the United States is a system comprised of regulatory, administrative, market, technology, and social subcomponents, and can only be understood in the context of its historical evolution. American cities lacked organized public works for street cleaning, refuse collection, water treatment, and human waste removal until the early 1800s. Recurrent epidemics forced efforts to improve public health and the environment. The belief in anticontagionism led to the construction of water treatment and sewerage works during the nineteenth century, by sanitary engineers working for regional public health authorities. This infrastructure was capital intensive and required regional institutions to finance and administer it. By the time attention turned to solid waste management in the 1880s, funding was not available for a regional infrastructure. Thus, solid waste management was established as a local responsibility, centred on nearby municipal dumps. George Waring of New York City organized solid waste management around engineering unit operations; including street sweeping, refuse collection, transportation, resource recovery and disposal. This approach was adopted nationwide, and was managed by City Departments of Sanitation. Innovations such as the introduction of trucks, motorized street sweepers, incineration, and sanitary landfill were developed in the following decades. The Resource Conservation and Recovery Act of 1976 (RCRA), is the defining legislation for MSWM practice in America today. It forced the closure of open dumps nationwide, and required regional planning for MSWM. The closure of municipal dumps caused a 'garbage crisis' in the late 1980s and early 1990s. Private companies assumed an expanded role in MSWM through regional facilities that required the transportation of MSW across state lines. These transboundary movements of MSW created the issue of flow control, in which the US Supreme Court affirmed the protection of garbage under the Commerce Clause of the Constitution. Thus MSWM in America today is largely managed by municipalities, and operated by a relatively small number of private companies. It consists of a mixture of landfill, incineration, recycling, and composting, and is regulated under RCRA, the Clean Air Act and other related federal and state laws.

Cities↗

PubMed1998

Risk management for plausibly hormetic environmental carcinogens: the case of radon.

Risk management typically involves efforts to reduce human exposures by establishing regulations that limit the concentration of the substance in environmental media. In cases where a substance is widely used in commerce or is naturally occurring in the environment, compliance costs can be substantial because of nationwide requirements to add expensive control technologies. Uncertainties in a dose-response function further impact risk management decisions because they may correspond to large differences in health benefit per unit exposure reduction. These problems are highlighted in the case of plausibly hormetic environmental carcinogens, for which a linear-no-threshold (LNT) dose-response model has been the traditional regulatory default assumption. In this case, model uncertainty is pivotal, and risk management is consequently inherently controversial. However, marginal cost functions that arise for plausibly hormetic carcinogens are expected to possess a common analytic feature that may be particularly useful for this type of risk management problem. Specifically, marginal cost functions in this context are expected to have roots reflecting contaminant concentration values above which regulatory goals may be optimally placed subject to cost constraints. Here we illustrate this heuristic feature in the case of residential radon, using both a LNT model and a biologically plausible hormetic model to predict associated risks of lung cancer mortality.

Air Pollution, Indoor↗

PubMed2003

A vital fluid: risk, controversy and the politics of blood donation in the era of "mad cow disease".

This article examines the reasons for, and likely impact of, the decision by the US and other countries to permanently defer blood donors who have spent time in Britain or Europe, for fear they may transmit new variant Creutzfeldt-Jakob disease (vCJD), the human form of "mad cow disease". It begins by discussing how vCJD and blood transfusion are linked, and how these have been translated into policy. First, maintaining a safe and stable supply of blood entails not only maintaining the trust of recipients in the system, but also that of donors, who need to be assured that their blood will be welcomed and used. Often, the balance, once upset, is regained by sacrificing donors, but accompanying costs might also be high. Second, the article highlights the impact of various forms of globalization -of commerce, disease and travel, and immigration- on blood policies and public and policy attitudes. Third, it assesses the decision by the US to restrict blood donations from Europeans and travelers to combat such a pervasive risk. The conclusion discusses how donor deferral policies may be interpreted by the public in the light of earlier discussions, and raises issues for future research.

Animals↗