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PubMed1995

Tropical rheumatology. Epidemiology and community studies: Asia/Pacific region.

It has been recognized that the remarkable decline in infant mortality and the extension in human lifespan involving both developing and developed countries alike, has been influenced by social and economic developments and public health orientated measures (such as clean water and sewerage) rather more than by developments in medical research. However, the identification of important disease risk factors for a number of common conditions such as smoking, solar exposure, dietary fat and alcohol has led to further reductions in disease prevalence and mortality, at least in some countries. The varied success of strategies to reduce the mortality from circulatory, nutritional and diseases due to infection has had the predictable result of leaving communities more exposed to the chronic non-communicable diseases, especially those affecting the elderly. The COPCORD community-based studies, carried out largely in tropical Asia/Pacific countries, have indicated that the burden of musculoskeletal conditions as far as pain and disability, as well as from an economic point of view, are substantial and WHO has called for increased research and educational activities into the causes and consequences of chronic disease and in particular rheumatic diseases. To the problems of an increasing ageing population can be added the rapid growth of urban populations, new occupational stresses, lifestyle changes and a number of other factors (WHO, 1984). The common community-based rheumatic diseases are not RA or SLE that dominate admissions to hospital arthritis clinics. Pain and disability are most often caused by osteoarthritis, especially knee OA, and various soft tissue rheumatic problems producing neck, back, shoulder and elbow pain. Viral and reactive arthritis cannot be ignored and the complications from osteoporosis (although not normally considered a rheumatic condition), are a significant threat to ageing populations worldwide. It is clear that for many of these conditions, certain risk factors have been identified and that preventative strategies are becoming available although far more detailed research is still required (Wigley, 1993). Community education is an essential part of prevention and treatment and the ILAR-sponsored publication Aches and Pains--Living with Arthritis and Rheumatism (Hampton, 1992) is available in at least 10 different languages and fills an important need. Education helps to influence not only knowledge but also skills and attitudes.(ABSTRACT TRUNCATED AT 400 WORDS)

Asia↗
PubMed1993

Development and health in the Pacific: which way to die?

Development in the Pacific has largely ignored the importance of health as a pathway and an outcome. This paper reviews the effects of development on health and health services in the region. It aims to highlight the plight of development that happens without considering the sociocultural and physical environments of the small island countries. The review shows that health and social conditions in the Pacific are deteriorating. The process of development has been externally controlled without community participation. Pacific leaders have been preoccupied with economic development and have not been cognisant of health and social consequences. During progress an enjoyable life can be achieved through sustainable development with community participation. However, indicators of economic growth in the Pacific do not correlate with those of health. The increase of rape, suicide, drug abuse, sexual promiscuity and crime suggests that Pacific islanders are increasingly disillusioned by the present developmental approach: they have ceased to enjoy life before death. It is suggested that decentralized development planning with community involvement, integrating health and social considerations, would be the way out of this dilemma.

Attitude to Health↗
PubMed1989

Female immigrants and labor in colonial Malaya: 1860-1947.

"The role of Chinese and Indian women as immigrants and workers in colonial Malaya is examined using data from censuses, immigration records, official reports and secondary sources. The article discusses the main types of work of female immigrants and their contribution to the economic development of colonial Malaya during the late nineteenth and early twentieth centuries in an attempt to redress the neglect of female immigrants' economic role in Malaya's history. Comparisons between male and female immigrants' labor and between Chinese and Indian immigrants, are drawn to highlight the different conditions of migration and labor for the different groups of immigrants."

Asia↗
PubMed2003

Depleting fish resources, declining fishing communities, and the state revitalization project in Korea.

This paper reviews recent declines in fish resources and fishing communities in Korea, evaluates major factors of declines, and examines a subsequent community-based revitalization project. Factors leading to depleting fish resources include global regulations, technological advances in fishing, national economic development policies, land reclamation projects, and pollution. The negative economic and societal impact of depleting fish resources is addressed using demographic and income levels of the communities. In response, the state initiated revitalization projects and invested in local fishing cooperatives promoting community-based management. The result has been less than effective as it led to mismanagement of investment and created an attitude of dependence on the government for financial assistance.

Animals↗
PubMed1994

Parasites, animal production and sustainable development.

Ecologically sustainable development is aimed at reducing environmental degradation while enabling economic development with equity between the developed and developing worlds and between generations. Parasite control in livestock can both contribute to, and take advantage of, sustainable agriculture. This will tend towards less intensive, lower input, diversified crop and animal production with less risk of parasite-induced losses and greater opportunities for integrated control including the exploitation of grazing management. Chemotherapy will continue to play a part but the most serious problem is resistance in the target species. Except for a few isolated issues, currently used parasiticides are relatively minor contaminants of the food supply or the environment. Nevertheless, the compounds of the future will need to be narrow-spectrum, non-persistent and rapidly degraded, with convenience in the hands of the user reduced in importance. Environmentally friendly alternatives to chemotherapy, including genetic resistance of hosts, vaccines, and biological control, show considerable promise and must be pursued. Sustainable systems pose optimisation problems and more attention must be given to systems research, models and products to aid decisions. If governments are serious about sustainable development, greater support will be needed for longer-term patient, multi-disciplinary research.

Agriculture↗
PubMedDate not supplied

[Lactation and weaning patterns in Mexico. 1986 National Health Survey].

In the process of nutrition, breastfeeding is fundamentally important, due to the nutritional and immunological value of the mother's milk. Within its beneficial effects, it is found that it improves weight and size in children. Another stage in the child's feeding that should be considered during the first year of life is the weaning that complements, at certain age of the breastfeeder, the nutrition given by breastmilk. The decrease or abandonment of breastfeeding is alarming in the developing countries, where this natural product is more available, economical and nutritious. There is evidence that within the health institutions, artificial feeding is encouraged. The National Health Survey collected basic information on sociodemographic variables risk factors, demand and use of health services. It also included questions on breastfeeding and weaning for the population under one year of age. It was found that 19.9 percent was never breastfed. Another important fact is that 42.4 percent of children received breastmilk for just three months or less. This view suggests that breastfeeding in our country is changing, due to various factors, among which we can mention the differences in life styles, education and economical development among states. The results of this study show interesting data that oblige us to consider more detailed and specific analyses in the future.

Breast Feeding↗
PubMed1995

E.H. Christopherson Lecture: lessons for the United States From the Worldwide Child Survival Revolution.

It is time to apply in the United States' principles that are emerging from a series of World Summits and United Nations Conference on Children, Environment, Population, Women, and Social Development. After years of top-down programs supported by international agencies, which have made some significant contributions in promoting activities such as childhood immunization but are having problems of sustainability, we need to focus now on integrated human development. The past tendency in international assistance to concentrate on economic development has not helped the people in greatest need. There is growing realization that what improves the quality of life most is what people do for themselves. Sustainability requires social mobilization at the local level. There are thousands of integrated, social development projects around the world that demonstrate the power of community-based, participatory approaches and we know how such local programs can be made to work under any political or economic system. What we haven't learned is how to "go to scale" in extending such projects to cover larger populations. A promising approach seems to be using successful local projects upgraded into Centers for Action Learning to promote the adaptation of science-based innovations to everyday life in a whole region of a country.

Child↗
PubMed1990

Social and demographic principles in an alternative typology of cities.

"The authors challenge some conventional notions regarding the USSR's urban hierarchy and settlement network and the basis for functional city classifications. They assign a key role to technological and social change in the overall growth and development process and downplay the role of territorial production complexes vis-a-vis large cities as major regulators of future economic development. Considerable attention is devoted to identifying stages of urban interaction (especially via migration and innovation diffusion) with the rural hinterland and of social-demographic transformations accompanying scientific and technical progress. A city typology based on stages in the 'social-demographic transition' is outlined briefly."

Demography↗
PubMed1995

Epidemiology of type II diabetes: an international perspective.

Non-insulin-dependent diabetes mellitus (NIDDM, type II diabetes) is present in nearly all of the countries of the world, and represents a significant disease burden in most developed countries. Type II diabetes is fairly common among Caucasoid populations in the United States and Europe and, more importantly, among Native Americans, Pacific Island populations, persons of Asian Indian origin, Hispanics and African Americans. Our current understanding is that type II diabetes probably results from an interaction of genetic and environmental factors. While a genetic link is most likely a precursor to type II diabetes, a number of lifestyle behaviours, including obesity, lack of physical activity, and diet, also influence the development of the disease. Lifestyle changes and westernization that accompany economic development in developing countries have been followed in the past by substantial increases in the prevalence of type II diabetes. Thus, further increases in type II diabetes might be expected in the Third World as the economic advancement of these countries continues.

Diabetes Mellitus, Type 2↗
PubMed2003

[Dietary changes in Mexico].

Although the Mexican population has traditionally been malnourished, the prevalence of obesity in children and adults has increased by almost 50 % in the last 10 years. Recent studies show substantial changes in the nutritional status of Mexicans, especially in the pediatric population. Among the factors associated with the development of obesity are overeating, sedentariness, and genetics. The apparent economic development in Mexico, as well as the influence of dietary patterns from other countries, have contributed to modifying lifestyle. Despite measures taken by the health system, iron- and zinc-deficiency anemia continue to be prevalent. The present review aims to describe the changes that have taken place in Mexico in the last few decades leading to a generation of short and obese children, as well as to determine the associated factors in order to promote healthier eating patterns among the Mexican population.

Body Composition↗
PubMed2001

Infectious diseases: considerations for the 21st century.

The discipline of infectious diseases will assume added prominence in the 21st century in both developed and developing nations. To an unprecedented extent, issues related to infectious diseases in the context of global health are on the agendas of world leaders, health policymakers, and philanthropies. This attention has focused both on scientific challenges such as vaccine development and on the deleterious effects of infectious diseases on economic development and political stability. Interest in global health has led to increasing levels of financial support, which, combined with recent technological advances, provide extraordinary opportunities for infectious disease research in the 21st century. The sequencing of human and microbial genomes and advances in functional genomics will underpin significant progress in many areas, including understanding human predisposition and susceptibility to disease, microbial pathogenesis, and the development new diagnostics, vaccines, and therapies. Increasingly, infectious disease research will be linked to the development of the medical infrastructure and training needed in developing countries to translate scientific advances into operational reality.

Bioterrorism↗
PubMed1999

Demographic and socio-economic factors with implications for the control of lymphatic filariasis in Kwale District, Kenya.

OBJECTIVE: To examine demographic and socio-economic factors with regard to control of lymphatic filariasis. DESIGN: A cross sectional data collection approach using a questionnaire. SETTING: Three adjacent villages, namely Lutsangani, Dzivani and Gandini in Kwale district. This was the study site for a larger KEMRI-JICA lymphatic filariasis control project. Findings from the larger project showed filariasis prevalence rates of 22.6%, 12.1% and 11.9% in the three villages respectively. SUBJECTS: All 891 household-heads in the three villages. MAIN OUTCOME MEASURES: Relationship between selected factors (age, sex, education, employment status, availability of latrine and permanent roofing for the main dwelling) and current use of protection against mosquito bites. RESULTS: Use of mosquito-bed nets, mosquito repellents and insecticides was found in 13.8% of the households. Education and employment status of the household-heads were positively associated with protection against man-vector contact (p < 0.001). Non-availability of latrines and lack of permanent roofing (tiles or corrugated iron sheets) for the main dwellings in 80% and 95% households, respectively, were additional clear indicators of low socio-economic development. CONCLUSION: Given the inter-village variations in the prevalence of the filariasis, wide scale diagnosis for treatment control approach could be prohibitively expensive. Effective control of filariasis in this and similar communities may be by mass treatment with either diethylcarbamazine (DEC) or ivermectin combined with albendazole.

Adolescent↗
PubMed2005

An inaugural conference on occupational health in The Gambia: exploring the world through international occupational health programs.

This conference on workplace safety was a success for both the Gambians who attended and the Americans involved in planning, implementing, and funding the conference. The Americans were delighted to bring about some understanding of worker safety to a country that has struggled with labor issues for centuries. The dialogue reflected the concern that stakeholders in both countries have for labor issues, but there is a tremendous need for ongoing partnership with industrialized countries to bring these ideas and strategies to fruition. The Gambia has received some assistance in the area of economic development, but not in improving workplace safety. A wide range of economic support activities have been initiated by the ILO in The Gambia during the past 20 years. This has included providing guidance with international labor standards, assistance to the development of labor and related services, support to employer and worker organizations, vocational training, job creation and employment policy, and small enterprise development. Many challenges lie ahead for The Gambia in improving workplace safety. Serious concerns remain related to minimum safeguards in the workplace. For example, the Labor Act specifies safety equipment that an employer must provide for employees working in designated occupations, but these are rarely offered (Culp et al., 2003). Workers are plentiful and jobs are not, so workers tend to take any employment they can without regard to working conditions. The government has not formally revoked employers who have contributed to worker deaths. Industrial inspections are conducted, although there is little consequence for violations. The cycle of poverty, younger workers, and lack of education also contribute to many worker safety issues. Farm workers cannot read instructions on pesticide containers and industrial employees cannot understand workplace hazard communications. While the Gambian constitution mandates free compulsory primary education, the current state of educational opportunities is so dismal for poor families that many will not go beyond primary school and will enter the work force without technical skills. Teachers are overworked. While some young people could develop small business enterprises related to tourism and woodcarving, the vast majority continue a downward spiral into poverty (McGrath & King, 1999).

Developing Countries↗
PubMed2006

The contribution of health to the economy in the European Union.

Despite increasing recognition of the link between health and economic development in low-income countries, the relationship has to date received scant attention in rich countries. We argue that this lack of attention is not justifiable. While the economic argument for investing in health in rich countries may differ in detail from that in low-income countries, there is considerable and convincing evidence that significant economic benefits can be achieved by improving health not only in poor, but also in rich countries. Better health increases labour supply and productivity and historically, health has been a major contributor to economic growth. In spite of remaining evidence gaps economic policy-makers also in developed countries should consider investing in health as one (of few) ways by which to achieve their economic objectives.

Developed Countries↗