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PubMed1981

The effect of crises on differential mortality by sex in Bangladesh.

"Male mortality is known to be lower than female mortality in South Asia in...normal times. But it has also been observed that during the crisis periods, this ordering is reversed. The experience of the 1974 famine of Bangladesh, as analysed in this study, confirms this reversal of relative mortality rates. But the usual explanations offered for this reversal are not borne out by the data pertaining to Bangladesh. Several other alternative explanations are explored, but cannot be confirmed due to the lack of appropriate data."

Asia↗
PubMed1990

"Ghana faces ecological disaster".

The rate of deforestation in Ghana is alarming and urgent steps need to be taken to reverse the trend, Robert D. Mann, a British tropical agriculturist, has warned. He says, "There will be further disintegration of the local climate, deterioration of soil fertility and reduced food-crop production, if the present trend of denudation by felling trees and uncontrolled bush fires is not halted and reversed." Mann, who has conducted research on "deforestation, drought and famine in Africa" was in Ghana recently to speak on the "role of the Church in West Africa in stimulating action to combat desertification". Representatives of protestant churches in Ghana, Togo, Liberia, Gambia, Nigeria, Cote d'Ivoire and Sierra Leone attended the 3-day conference which was organized by the Overseas Department of the British Methodist Church. It was to enable participants to share perspectives on the nature, scale and seriousness of the deforestation problem. Participants also exchanged experiences on village-based projects for promoting tree planting and agro-forestry, and developed strategies for the rural development programs. Robert Mann noted that Ghana was not only affected by its proximity to the Sahel, but also by its own deforestation. The situation in Ghana, once renowned for her extensive forests and woodland, has now drastically changed. By 1980/81 the area of closed forest had been reduced to 17,000 sq km from 47,9000 sq km in 1937/38. He said in 1939 the volume of wood exported from Ghana was 42,450 cubic meters but it rose to 1,471,600 cubic meters by 1987. Such activities, Mann said, put severe strain on the environment and affected both the economy and sociocultural basis of the country.

Africa↗
PubMed1995

[Fertility decline in China and family planning programs].

"The article looks in detail at the population development in China since the 1950s, highlighting some dramatic changes. In the late 1950s the country was hit by widespread famine, which resulted in increased mortality and decreased fertility. Infant mortality climbed to almost 300/1,000. During the 1960s fertility began to increase again and mortality declined. From the beginning of the 1970s fertility started to decline, dropping from about six to just over two children per woman in the late 1980s. Today, fertility is thought to be below replacement level. The main reason for this fertility decline lies in the highly efficient family planning programmes implemented in China since the 1950s and particularly since the 1970s. The decline in infant mortality and the favourable socio-economic development have also been important factors in the decline in fertility. Although fertility in China is currently at a low level, the country's population is still set to grow." (SUMMARY IN ENG)

Asia↗
PubMed2003

[Obstetric complications and risk of schizophrenia. An association appears undisputed, yet mechanisms are still unknown].

This paper reviews the literature on obstetric complications (e.g. premature births and hypoxia at birth) and the later development of schizophrenia. Some forty studies and two meta-analyses are summarised concerning methods and results. The balance of evidence today supports an association between obstetric complications at different points of time: during foetal life, delivery, as well as during neonatal life. This is supported by other studies of early life risk factors, e.g. infections, maternal stress and famine. Presuming there is a causal relationship, the results may support the view that various underlying "mechanisms" may be associated with schizophrenia. On the other hand this does not exclude a final common pathway. One candidate, among others, is the deleterious effects of hypoxia, hypoglycaemia, and hyperbilirubinaemia on the NMDA-receptors. To further understand how the factors are related, the statistical models in epidemiological research have to be improved and co-operation with other disciplines such as neuropathology and genetics is a necessity.

Female↗
PubMedDate not supplied

Agriculture and environment.

Agriculture came into existence about 15,000 years ago and passed through different stages of gathering, hunting, hoe culture, and sedentary agriculture, followed by modern agriculture. It began simultaneously in five world centers concentrating on different crops, most suited to the respective areas, and it was affected by changes in climate which determined the distribution of populations and their occupations. With the increase in population, the need for food progressively increased, necessitating introduction of modern agriculture to enhance production. The indiscriminate and faulty use of advanced technology to meet the food demand of fast-increasing populations added to its share to the destruction of the environment. The two approaches that contributed to this were horizontal expansion and vertical expansion. The former resulted in deforestation, desertification, soil erosion, land salting, and water logging, as well as the frequent occurrence of droughts and famines; the latter destroyed the soil structure and fertility through decreased microbial populations, fish culture, wildlife and bird sanctuaries, in addition to producing water and soil pollution and serious health hazards in human beings and fauna. The real culprit of this geobiologic devastation is the population growth rate, which needs to be contained at safer levels.

Agriculture↗
PubMed1992

Archaeology and the "thrifty" non insulin dependent diabetes mellitus (NIDDM) genotype.

In recent decades, non-insulin dependent diabetes mellitus (NIDDM) has become a major public health problem in several parts of the world. A complex disorder, NIDDM is associated with an increased risk of blindness, coronary heart disease, peripheral vascular disease, and kidney failure (1). The epidemiology of NIDDM is providing new insights into many aspects of this disease, including prevalence, incidence, morbidity, and mortality (2). My objective is to explain the high prevalence of a NIDDM susceptible genotype(s) in several distinct populations: American Indians, Australian Aborigines, and Pacific Islanders. The susceptible genotype may have been selected into these populations because of unusually frequent food shortages that occurred during the initial colonization of 'new worlds'. NIDDM has been shown to have a strong genetic component (3) that may include a 'thrifty' genotype(s) (4,5). The 'thrifty' genotype(s) may have once allowed founding populations to survive feast' and 'famine' conditions for several generations. With an assured food supply and a sedentary lifestyle, however, the 'thrifty' genotype(s) becomes disadvantageous, leading to obesity, increased insulin resistance, beta cell decompensation, and NIDDM (3,6).

Australia↗
PubMed1964

THE MUSHROOM CROWD: SOCIAL AND POLITICAL ASPECTS OF POPULATION PRESSURE.

The meaning of population pressure is discussed and, with the help of a formula, its five main components (people, rate of increase of people, food-producing acreage, protein nutrition and industrialization) are analyzed.Factors which have eased population pressure in the past are considered under the headings of political violence (war and genocide), natural disaster (famine and disease), and social action (increased local protein supply, emigration, industrialization and birth control).Birth control is the first prerequisite to an easing of population pressure; the effectiveness of the Japanese and the Indian programs is discussed.The crippling burden of preventable disease, shown to be a major obstacle to the development of sophisticated industries, presents a challenge to Western medical men who so far have done little to meet it.

Agaricales↗
PubMed1992

Population-based mortality assessment--Baidoa and Afgoi, Somalia, 1992.

Since 1990, Somalia has been the site of an intense civil war that has disrupted health-care services and food delivery to a substantial part of the country. A regional drought, in combination with the ongoing civil disturbances, has further resulted in widespread famine. Multiple international government- and nongovernment-aid agencies are involved in the relief effort for Somalia. However, security problems in most areas of Somalia have prevented recent, systematic population-based assessments of the health and nutritional status of local Somali populations for use in directing relief efforts. To characterize the mortality of various Somali populations and to provide data on major population centers outside of the capital (Mogadishu), CDC, in collaboration with the United Nations Children's Fund (UNICEF) and the U.S. Agency for International Development, conducted a survey (1) of urban populations in a central region of Somalia (Figure 1). This report describes two pilot assessments performed during November 20-25 and December 5-6, 1992, in the towns of Baidoa and Afgoi.

Adolescent↗
PubMedDate not supplied

A conversation with John Sulston.

Sir John Sulston was a co-winner of the Nobel Prize for Medicine in 2002. He won the prize for his discoveries concerning "genetic regulation of organ development and programmed cell death," along with his colleagues sydney Brenner and H. Robert Horvitz. Dr. Sulston was founding director of the Sanger Centre, Cambridge, England, which he headed from 1992 to 2000. From 1993 to 2000, he led the British arm of the international team selected to work on the Human Genome Project. He is co-author of the book The Common Thread: A Story of Science, Politics, Ethics, and the Human Genome, published by Joseph Henry Press in 2002.This interview was conducted on December 20, 2002, shortly after Dr. Sulston was awarded his Nobel Prize and was originally broadcast on that date on radio station WPKN-FM in Bridgeport, Connecticut. The interview was conducted by Valerie Richardson, the Managing Editor of The Yale Journal of Biology and Medicine.Dr. Sulston has been an outspoken advocate against letting the data from the Human Genome Project become property of commercial interests that would charge the world's scientific community for its use. Since leaving the Sanger Institute, he has worked with OxFam, the Oxford Campaign for Famine Relief.

Animals↗
PubMed2003

[From obesity to obesities: from concepts to practices].

In the singular, obesity is a symptom reflecting an excess of energy stores as fat mass, the only trait obese people are sharing. Long time ago we proposed to use the plural to account for the large diversity characterizing obese subjects that conceptual evolutions have put to the fore during the past three decades. Weight gain and obesity are resulting from a positive energy balance produced by the conjunction of a number of etiopathogenetic factors associated in various proportions according to patients and evolutive status. Decreasing physical activity, increasing sedentarity, quantitative and qualitative energy consumption unadapted to energy expenditure and to lipid oxidation capabilities, reinforced by psychological needs, are catching out the control of food intake, particularly since it is more efficient to defend against famine than to protect against plethora. These environmental factors, responsible for obesity pandemia, lead to obesity subjects predisposed by their genetic background, in itself extremely variable. The clinical heterogeneity of obesity is patent and a careful phenotypic analysis is a prerequisite to design the management strategy. Obesity is a chronic situation that needs a long-term treatment. The goals of treatment cannot be longer reduced to weight loss only, which in addition should be realistic, i.e. moderate. Management strategies must be conceived on a long-term basis, focused on prevention of weight regain, multifaceted and individually tailored. A number of tools are available and the state of the art is to use them appropriately to avoid being counter productive. Obesity may be viewed as an adaptive symptom in subjects poorly prepared to cope with recent environmental changes, but it is also a disease due to its prevalence, the number of weight dependent comorbidities and its socio economic costs. A specific medical approach of obesity has still to be developed.

Behavior Therapy↗
PubMedDate not supplied

[Vascular placental pathology in high-risk groups: definition and synopsis].

The vascular placental pathology (VPP) is associated with many etiologies. Some are the consequence of a maternal genetic or acquired predisposition. Others are associated with a chronic maternal disease (hypertension, lupus, obesity, diabetes, ...). Finally, some others are associated with placental implantation leading to fetal ischemia (multiple pregnancy, chorioangioma, primiparity, feto-placental hydrops) or to environmental (altitude) or nutritional factors (famine and specific alimentary depressions). We classify these factors into three categories according to the risk level (moderate, significant and elevated). While any of these factors can increase the risk of VPP, no one is sufficiently sensitive or specific in predict inevitable onset of VPP. In most cases VPP results from a combination of two (or more) risk factors. The risk factors of VPP classified as moderate include age (> or = 35 years), increased blood pressure during the second trimester of pregnancy, a new paternity, dietetic factors or environmental factors, smoking and controlled diabetes (class B, C), or inactive systemic diseases. Risk is significantly elevated among obese (BMI > or = 25), primiparous women, women with a past familial history (first degree) of preeclampsia or eclampsia, cocaine use or association of tobacco and caffeine use, increased placental mass (associated with twin pregnancy, fetal hydrops or molar pregnancy), uncontrolled diabetes, lupus, active scleroderma. Risk is considered to be high among patients with chronic hypertension, women with a past history of preeclampsia, diabetes (class D, F, R), patients with active systemic disease or with antiphospholipid antibodies or women with lupus or renal lesions and/or proteinuria as well as chronic kidney disease resulting in proteinuria, hypertension and renal insufficiency. Finally, the risk of VPP is considered to be increased in the presence of acquired thrombophilia. It remains moderate in the presence of isolated genetic thrombophilia, except in forms presenting with multiple genetic mutations or associated with an hyperhomocysteinemia. A "high-risk group" is defined among women with past history of deep venous thromboembolic events outside pregnancy, or with a past history of placental vascular pathology (intra-uterine death, placental abruptio, severe and precocious placental, intra-uterine growth retardation, early and repetitive fetal loss) and who, in addition, present with acquired thrombophilia (antiphospholipid antibodies, thrombocytemia), unique homozygous genetic thrombophilia, amultiple genetic thrombophilia or unique heterozygous genetic thrombophilia associated with hyperhomocysteinemia. Prophylactic treatment of acquired thrombophilia and of the multiple genetic forms or associated with hypercysteinemia is a logical rationale, particularly among women with a past history of placental vascular pathology, or with a past history of venous thromboembolic events. On the contrary, prophylaxis using low-molecular-weight heparin in the event of asymptomatic genetic thrombophilic mutations and for women without a past history of deep venous thromboembolism or vascular placental pathology remains controversial.

Adult↗
PubMed2003

[Obstetrical complications and further schizophrenia of the infant: a new medicolegal threat to the obstetrician?].

Schizophrenia is a multifactorial disease with complex interactions between a genetic liability, possible perinatal complications and exposure to later environmental risk factors in childhood. Maternal influenza infection, wartime-famine-related denutrition and maternal depression or exposure to repeated stress in pregnancy may have a deleterious effect on brain development and neuronal migration. Obstetrical complications which are significantly associated with schizophrenia are bleeding, diabetes, prematurity, fetal growth retardation, Rhesus incompatibility, preeclampsia and congenital malformations. Subjects with onset of schizophrenia before age 22 had more often a history of acute fetal distress (abnormal presentation at birth and complicated cesarean delivery). Obstetrical complications may have a direct negative impact on fetal brain development or may be on the causal pathway between prepartum maternal depression or psychosis, exposure to stress and impaired relation between mother and child consecutive to postnatal depression.

Birth Weight↗
PubMed2004

[Morbidity in the concentration camps of the Third Reich].

Life in the concentration camps of the Third Reich was like living on another planet. The prisoners, stripped of all rights, experienced constant humiliation, uncertain survival and endless terror. Living conditions were harsh, characterized by crowding, poor sanitation and personal hygiene, lack of proper clothing and heating. The days began early with long marches and slave labor. Sleep was short and interrupted, and fatigue was constant and severe. Above all hoovered the dark cloud of ever-present famine. The prisoners were given about a fourth of the daily calorie requirements, and the food lacked vital components such as vitamins and other essential ingredients. The psychological stress was extreme, yet morbidity and mortality were mainly due to infections, injuries and hunger. Lice, scabies and other skin diseases were common. Typhus fever was ever-present, both endemic and epidemic, with a fatal outcome. Many suffered from tuberculosis, typhoid, dysentery, pneumonia and other infections diseases. Injuries were common, caused by beating, punitive whiplashing and other forms of physical abuse, gunshot wounds and dog-bites. Skull injuries with brain contusions and hemorrhages were prevalent, as well as fractured limbs, ribs and pelvic bones. Blunt injuries to chest and abdomen often had fatal outcomes due to the perforation of viscera and peritonitis or as a result of massive hemorrhage from ruptured blood vessels. The harsh winters were marked by frozen gangrenous limbs and hypothermia. Yet, the most ominous condition was the "hunger disease" with its multiple clinical expressions which, in their extreme form, led to the emaciated "musleman" and eventual death.

Concentration Camps↗
PubMed2004

Sociocultural, environmental, and health challenges facing women and children living near the borders between Afghanistan, Iran, and Pakistan (AIP region).

BACKGROUND: For hundred of years, people in the region encompassed by the Afghanistan-Iran-Pakistan borders (AIP region) have been challenged by conflict and political and civil instability, mass displacement, human rights abuses, drought, and famine. It not surprising that health and quality of life of vulnerable groups in this region are among the worst in the world. In general, women and children, in particular girls, in the AIP region have had especially limited access to healthcare. Women and children have dramatically high rates of communicable and non-communicable disease, morbidity, and mortality and a general low life expectancy that is rapidly declining. In spite of national and international efforts to improve health status of vulnerable populations in this region, the key underlying sociocultural determinants of health and disparities (ie, gender, language, ethnicity, residential status, and socioeconomic status) have not been systematically studied, nor have their relationships to environmental challenges been examined. OBJECTIVES: We set out to summarize existing information regarding the sociocultural, environmental, and traditional determinants of health disparities among different population groups in the AIP region; identify gaps in research regarding the communities' needs in the region; and highlight factors that must be considered in the design and implementation of future health intervention studies in the region. METHODS: We reviewed current health literature, official documents, and other information (eg, reports of UN agencies) related to the social, cultural, and environmental factors that may influence the health outcomes of subpopulations living in the AIP region. We also interviewed individuals who had recently worked in this region. RESULTS: Overall, the health problems faced by this underdeveloped region can be categorized into those resulting from lack of essential supplies and services and those stemming from the existing cultural practices in the area. The low health status of the people, particularly women and children, in the AIP region is associated with not only poor hygiene and lack of water but also limited knowledge and lack of access to healthcare services. In addition, cultural, political, and socioenvironmental factors play a role, including gender inequality and differences between languages spoken locally in the region and those most often used in written health education materials. CONCLUSION: Future intervention programs designed for this region must use culturally sensitive strategies not only to provide health information and health services but also to address the underlying nonmedical determinants of health related to gender inequalities.

Adult↗
PubMed2004

[Arctic and southern freshwater pearl mussel Margaritifera margaritifera with long and short life span as a model system for testing longevity mechanisms].

The freshwater pearl mussel (Margaritifera margartifera) is one of the longest lived animals, attaining ages in excess of 150 years in polar climates. Because of its long life, the species may be useful for studying genetic and physiological mechanisms contributing to longevity. An ongoing study is comparing 6 southern populations in Spain, with maximum recorded ages of 28-40 years, to 3 Arctic populations in northwest Russia, with maximum ages of 114-190 years. Within Arctic populations, 40% of mussels live more than 100 years in rivers that are pristine. Possible evolutionary significance of northern longevity is an adaptation to severe cold and unstable environments in high gradient rivers. During winter, mussels have a near-famine existence during the Polar Night, and experience some shell damage from ice formation and flows. In summer, periodic droughts result in exposure and desiccation. In response to adversity, pearl mussels have acquired effective mechanisms for shell reparation and tissue healing and regeneration. Northern populations have low metabolic rates, reducing energy expenditure for growth under normal as well as extreme conditions. However, this species is capable of increasing metabolic rate for tissue regeneration and self-healing. The physiological adaptations to sustain longevity may provide useful clues to impedence of the aging process.

Aging↗
PubMed2004

The performance of a nitrogen-fixing SBR.

A laboratory study has successfully demonstrated that a nitrogen deficient thermomechanical pulping wastewater can be effectively treated in a sequencing batch reactor (SBR) operated under conditions of biological nitrogen fixation (the N-ViroTech process). In comparison to continuous stirred tank reactor activated sludge (CSTR-AS) configurations operated under either nitrogen fixing or nitrogen supplemented conditions, slightly lower removals of dissolved organic material were observed in the SBR. However, this was largely offset by significantly better suspended solids removal in the SBR, which contributes to the overall COD discharge. The settleability and dewaterability of sludge produced by the SBR was significantly better than that obtained from the nitrogen fixing CSTR-AS reactors, and comparable to that of a nitrogen supplemented system. Consistently low total and dissolved nitrogen discharges from the N-ViroTech systems demonstrated the advantage of this system over ones requiring nitrogen supplementation. The feast-famine regime of an SBR-type configuration has significant potential for the application of this technology in the treatment of nitrogen deficient waste streams, particularly those in which conventional single-stage systems may be susceptible to sludge bulking problems.

Bioreactors↗
PubMed2003

Food aid in emergencies and public health nutrition.

HUNGER LEAVES SCARS: The visible kind may be born by the survivors of famine. Less visible, but all the more damaging, are the long-term effects of hunger that run through families through generations. Hunger passed from mother to child represents a ruinous inheritance. It marks a cycle of hunger that transcends generations, unless the cycle is broken. Food aid provided at crucial times in the lives of women and infants represents an investment for future. Thus, in contrast to former conceptions of food aid as an exclusively life-saving vehicle, modern aims of food aid also include preventing increases in the prevalence of malnutrition and asset depletion. Mass migration and food shortages have been responsible for most deaths following civil conflicts around the world. The most visible form of migration occurs when people cross international borders. The reasons for the flight of refugees and internally displaced persons are generally same; war, civil strife, and persecution. "NUTRITIONAL GATEWAYS": Finally, the importance of timely and sustained delivery of adequate food aid adequate in quality and quantity to people in dire need during the emergency is paramount. Food aid is the most direct means for conveying nutritional benefits: the time frame is often limited, sustainability is not an issue. However, in the case of drought victims, refugees or displaced people, the nutritional situation and the actions needed are more complex. In many situations people arrive are often in very bad state. While high prevalence of malnutrition is associated with inadequate food rations, in some situation malnutrition developed primarily because of the high incidence of diarrhoeal diseases. The synergism between high malnutrition and increased incidence of communicable diseases explains much of excess mortality seen in refugee and displaced persons.

Disasters↗
PubMed2005

[Medicine in the concentration camps of the Third Reich].

Between 1942 and 1944 millions of prisoners were subjected to forced labor in concentration camps throughout the Third Reich, all the while being the victims of a systematic and "scientific" extermination policy. Though the policy was directed mainly against Jews, it was implemented against other "inferior races" as well. The prisoners, stripped of all rights, experienced constant humiliation, uncertain survival and terror. The harsh living condition, characterized by crowding, absent sanitation and poor personal hygiene led to considerable morbidity, mainly due to injuries, infectious diseases and famine, and to high mortality rates. Medical care in the camps was the responsibility of the S.S. Each camp had a chief S.S. physician accompanied by a number of assistants and orderlies. There was also a parallel system of "prisoner-physicians." There was a chief prisoner-physician in every camp, and each block was assigned a "block doctor" who was responsible for sanitation, the removal of corpses, setting up the sick- call and authorizing sick leave. Work teams were accompanied by "mobile doctors" (Streckenpfleger), who dispensed first aid for work injuries. Prisoner-physicians were also charged with disinfecting the blocks and maintaining hygienic conditions in the camp. Every camp had one or more blocks, called "Reviers", that were used for treatment and hospitalization. In the larger camps a number of blocks were designated to function as a sort of hospital (Krankenbau). At times one camp out of a group of camps would be set aside as quarantine, primarily for patients with infectious diseases. Officially, the "Revier" was the responsibility of an S.S. physicians', assisted by a chief prisoner-physician, his assistants and, at times, nurses. But in actuality the Reviers were managed by prisoners (Capos) who did not have medical training but were authorized to make decisions in medical matters such as operations and, on occasion, even performed them. The Reviers suffered from shortage of everything: beds, manpower, diagnostic and therapeutic means, sterile supplies and drugs for anaesthesia. Crowding was the rule, and each cot was occupied simultaneously by several patients regardless of their condition or the nature of their disease. Life-saving procedures could not be performed and surgery, if done, was usually without anaesthesia. Mortality was high, and the Revier was commonly perceived by the prisoners as a place of death, not of healing. Occasionally there were visits, or inspections, by the S.S. physicians. The main purpose of those visits was "selection". Patients with no chance of recovery were sent to their death and the others were returned to work in spite of their condition. The prisoner-physicians made every effort to prevent this "selection" in various ways. They were often punished or even executed for their efforts.

Concentration Camps↗