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At least 847 records · Page 47Linked to original sources
PubMed1998

Indication for isolated hyperthermic liver perfusion: a surgeon's view.

Isolated hyperthermic liver perfusion is a transitional therapy, i.e. a therapy between evidence based, standard therapy and experimental therapy. It appears to provide distinct benefits in a number of situations but the scientific evidence is still incomplete. In our view the present indications for use of isolated hyperthermic perfusion of the liver are: to gain more knowledge; nonresectable liver metastases without proven extrahepatic growth from: uveal melanoma, colorectal carcinoma, and ovarian cancer; symptoms related to hepatic metastases from endocrine tumors. A multicenter study aimed at gaining more knowledge is recommended.

Chemotherapy, Cancer, Regional Perfusion↗
PubMed2004

Arctic research at three levels.

This paper is a posthumous publication of a Steven McNabb's presentation to the 1993 annual meeting of the American Anthropological Association. In it he described how the Social Transitions in the North research project involved explicit cross-cultural contact or participation at three levels: between scientists and public agencies; between scientists and study populations; and between research teams themselves. He explored a few of the entanglements and opportunities that arise in those interactions. Dr. McNabb urged northern researchers to avoid embracing rigid standards, for they will result in more entanglements and fewer opportunities. On the otherhand, if researchers are open-minded, they will be able to treat each dilemma as an opportunity that will make for better science.

Alaska↗
PubMed2002

Africa: the new family planning frontier.

Sub-Saharan Africa will be the family planning frontier of the twenty-first century. Fertility levels and population growth rates are still high, and family planning programs suited to the region are still being developed. Nevertheless, by the end of the twentieth century, fertility transition was under way in Southern Africa and a few countries elsewhere. Successful regional family planning in the twenty-first century will depend upon stronger political leadership, the development of family planning programs that meet the needs of all segments of society and not only currently married women, assistance to the market, and a recognition of the central importance of hormonal methods, especially injectables. Problems include stagnation in economic growth and in child mortality decline, as well as the persistence of the AIDS epidemic.

Africa South of the Sahara↗
PubMed1988

A longitudinal study of functional change and mortality in the United States.

Studies of functional impairments in the U.S. elderly population have tended to rely on prevalence estimates from nationally representative health and institutional surveys. These prevalence estimates generally show higher rates of disability for females than males. Unfortunately, prevalence estimates can be misleading when one attempts to assess the risks of certain types of health event transitions for individuals. This study directly examined the individual transitions both into and out of functionally impaired states using longitudinal data from the 1982 and 1984 National Long Term Care Surveys (NLTCS). The data show that, even at very high levels of impairment, there are significant numbers of community residents who apparently manifest long-term improvement in functioning. The longitudinal data also show that the risks of becoming disabled are roughly the same for males and females. This suggests that sex differences in the national prevalence of disabilities arise from the greater longevity of females at any given level of age and functional impairment.

Activities of Daily Living↗
PubMed2004

Diverging destinies: how children are faring under the second demographic transition.

In this article, I argue that the trends associated with the second demographic transition are following two trajectories and leading to greater disparities in children's resources. Whereas children who were born to the most-educated women are gaining resources, in terms of parents' time and money, those who were born to the least-educated women are losing resources. The forces behind these changes include feminism, new birth control technologies, changes in labor market opportunities, and welfare-state policies. I contend that Americans should be concerned about the growing disparity in parental resources and that the government can do more to close the gap between rich and poor children.

Adult↗
PubMed1989

Dietary fiber and health. Council on Scientific Affairs.

During the last 18 years, considerable research has been conducted on the role of dietary fiber in health and disease. Interest was stimulated by epidemiologic studies that associated a low intake of dietary fiber with the incidence of colon cancer, heart disease, diabetes, and other diseases and disorders. Dietary fiber is not a single substance. There are significant differences in the physiological effects of the various components of dietary fiber. A Recommended Dietary Allowance for dietary fiber has not been established. However, an adequate amount of dietary fiber can be obtained by choosing several servings daily from a variety of fiber-rich foods such as whole-grain breads and cereals, fruits, vegetables, legumes, and nuts.

Adult↗
PubMed2004

The essence of living parental liver donation--donors' lived experiences of donation to their children.

The use of living parental liver donors will continue and probably increase because of lack of cadaveric livers for paediatric transplantation and the excellent graft survival of parental livers. Therefore, it is important for the health care professionals involved in living parental liver donation to understand the experience of being a liver donor. The aim of this study was to investigate the expressed deeper feelings of parents who donated a part of their liver to their own child. The study took the form of in-depth interviews with 11 donors. All donors were biological parents of the recipient, nine fathers and two mothers. The interpretive phenomenology method was used, and interpretive analysis was carried out in three interrelated processes in line with Benner. Data collection was guided by the researcher's preliminary understanding of the donor experience from being involved in the surgery and care of the donors as well as the paediatric recipients. However, the research question was approached from the perspective of holistic care for the donor. In this study, the essence of living parental liver donation was found to be the struggle for holistic confirmation. There were three categories leading to this central theme; the total lack of choice, facing the fear of death and the transition from health to illness. There was total agreement among the respondents that there is no choice when it comes to the question of donation. The findings in this study stress the importance of organizing the parental liver donation programme with as much focus on the donor as on the child. Based on the results of this study, several clinical implications are suggested for the formation of guidelines for living parental liver donation.

Adult↗
PubMedDate not supplied

Is the relationship between fertility of parents and children really weak?

The relationship between fertility of parents and children has been designated as "weak" by most investigators. This paper reviews the evidence over the past century and argues that, even allowing for problems with available data sources, the relationship was probably close to zero for pre-transitional populations. However, over time, the relationship has tended to become more substantial and is now of a similar order of magnitude in developed countries as other widely used explanatory variables. Possible mechanisms for the observed relationship are discussed, especially the roles of socialization and inherited factors. The types of data used are compared to the scientific questions posed, and the limitations of the common comparison of married-mother/married-daughter pairs are considered. Finally, some evidence from recent large-scale surveys in Britain and the United States is presented to show changes over recent periods and the relative effects of sibship size of fathers and mothers.

Adult↗
PubMedDate not supplied

Reproductive preferences and fertility trends in post-transition Thailand.

Two large national surveys in 1988 and 1933 provide new evidence on trends in family-size preferences in Thailand at a time when the Thai fertility transition is reaching its conclusion. Although the average preferred number of children has continued to decline, a resistant lower bound of two children is found for the vast majority of respondents, stemming, apparently, from a pervasive, although not inflexible, desire to have one child of each sex. Moreover, new evidence from birth-registration data indicates that the decline in the total fertility rate appears to have leveled off at about replacement level. These findings challenge the view that fertility in Thailand will continue to fall well below replacement level, and contradict recently expressed alarmist predictions of population decline in the foreseeable future.

Adolescent↗
PubMedDate not supplied

Reconciling heart disease mortality and ICD codes.

This study uses 61 years of death certificates for Bexar County, Texas, uniformly coded under ICD 9, to describe the transition in heart disease mortality from 1935-1995. We find that life expectancy for persons dying with heart diseases increased throughout this period, with clear differences in rates of increase for males and females, associated with acute ischemic heart disease. Our data point to an epidemic of AIHD in the 1950s and 1960s, which is now abating. Findings are less clear for chronic ischemic heart disease, while other major heart diseases cannot be traced with any confidence owing to changes over time in the emphasis accorded particular causes. Our findings suggest caution with respect to the socioeconomic analysis of heart disease mortality data, particularly where the instability of the coding conventions has been most acute.

Acute Disease↗
PubMed1999

Comparative epidemiology of initial drug opportunities and transitions to first use: marijuana, cocaine, hallucinogens and heroin.

The earliest stages of involvement with illicit drugs have been understudied. In a recent report, we examined initial opportunities to try marijuana and transitions from first opportunity to first use of that drug. This report extends that work by investigating early involvement with cocaine, heroin, and hallucinogens as well. We examine sex and race ethnicity differences in estimates of having a drug opportunity, and in the probability of progressing from having an opportunity to try a drug to actually using the drug. Self-report interview data collected for the National Household Surveys on Drug Abuse (NHSDA) from 1979 to 1994 were analyzed. Results showed that an estimated 51% of US residents have had an opportunity to try marijuana; comparative estimates for cocaine, hallucinogens, and heroin are 23, 14, and 5%, respectively. Among those who eventually used each drug, the vast majority made the transition from first opportunity to first use within 1 year. Males were more likely than females to have opportunities to try these drugs, but were not more likely than females to progress to actual use once an opportunity occurred. Time trends indicate recent increases from 1990 to 1994 in the estimated probability of using an illicit drug once an opportunity occurs, particularly for hallucinogens. Exploratory analyses on race ethnicity yielded some interesting leads for future research. This study sheds light on the epidemiology of the earliest stages of drug involvement in the USA. Implications for prevention efforts and for our understanding of sex differences in drug involvement are discussed.

Adolescent↗
PubMed1996

Transition from high to replacement-level fertility in a Kerala village.

This paper uses a micro-approach to examine the motivation and processes of rapid fertility decline in a Kerala village. Fertility declined in the village substantially during the 1970s and continued to decline to reach replacement level at the time of study. The proximate determinants are postponement of marriage and extensive use of contraceptives. However, the changes in these factors were the result of changing socio-economic conditions. At the time of study the singulate age at marriage was 29 years for males and 23 years for females, higher than elsewhere in India. Delayed age at marriage was a combined effect of favourable attitudes to education and economic changes. Smaller families became advantageous because of decreasing agricultural opportunities, expanded education and mortality decline. Contraceptives were available with the implementation of the family planning program. Higher use of contraceptives can be attributed to favourable conditions resulting from socio-economic changes.

Adolescent↗
PubMed2002

Prevalence and risk factors for overweight and obesity in children from Seychelles, a country in rapid transition: the importance of early growth.

OBJECTIVES: To establish the prevalence of overweight and obesity and related risk factors in children from Seychelles (Indian Ocean), a country in rapid economic and epidemiological transition. DESIGN: Cross-sectional study with retrospective access to early life data. SUBJECTS: All children from all schools of Seychelles, in four selected school grades (kindergarten, fourth, seventh and tenth year of obligatory school) in 1999. A total of 5514 children aged 4.5-17.4 y were measured, corresponding to 83.5% of the eligible population. MEASUREMENTS: Overweight and obesity, using age- and sex-specific body mass index (BMI) cut-off points as defined by the International Obesity Task Force. RESULTS: Some 12.6% (95% confidence interval: 11.8-13.5%) of the children were overweight and 3.8% (3.3-4.4%) were obese. Weight gain (kg) during the first year of life was strongly associated with subsequent overweight (odds ratio 1.46, 95% confidence interval 1.27-1.67) and obesity (1.59, 1.29-1.97) in childhood, independently of birth weight. Increased maternal BMI (kg/m(2)) was also associated with overweight (1.07, 1.03-1.10) and obesity (1.09, 1.04-1.14) in the offspring. CONCLUSION: Prevalence of overweight and obesity among school children in Seychelles was as high as or higher than in some industrialized countries. If confirmed in other environments, the strong association between weight gain during the first year of life and subsequent obesity in childhood could affect the way optimal infant weight gain is defined in countries where public health priorities are changing.

Adolescent↗
PubMed2004

Overview of the Social Transition in the North project 1995- 1998.

OBJECTIVE: This paper describes the overall aims and design of the Social Transitions in the North study. The objective of the STN study was to assess how epidemiological, demographic and domestic changes have affected Northern communities. STUDY DESIGN: Sixteen communities in the Russian Far East and Alaska were compared. Survey data were collected in three phases with a response rate of 70%. METHODS: The experiences of indigenous peoples with demographic, epidemiological and domestic changes were measured using forced-choice questionnaires, focus groups, oral histories, protocol interviews, interviews with institutional informants, genealogies and analysis of secondary data. RESULTS: The principal researchers died during a boating accident before the analysis phase. Alaska researchers were asked to review the data for utility. CONCLUSIONS: The STN data was developed using rigorous cross-cultural research team. It was be used by social science researchers and others to better understand the impact of rapid changes in the Arctic.

Alaska↗
PubMed2002

Acute poisoning with psychoactive substances in the 1990-2000 period of socioeconomic transition and crisis in Plovdiv region, Bulgaria.

The "opening" of the post-totalitarian societies of Eastern Europe increased the illegal spread of psychoactive substances (PAS) in the past decade. We studied psychoactive substance acute poisoning (PAS AP)--types of toxic agents involved, incidence rates, and their changes--as indirect indicators of the characteristics, magnitude and development of the problem in Bulgaria during the 1990-2000 period of socioeconomic transition and crisis after collapse of communism. The study analyzed retrospectively the caseload of all 571 PAS acute poisonings that occurred in the territory: 417 men (73%) and 154 women (27%); mean age 24.07y (range 10-75). The number of all AP and PAS AP showed a marked increase during the last 3years of the studied period, especially in 2000. The average PAS AP incidence rate for 1998-2000 (13.50/100,000) compared to the mean value for the preceding period 1990-1997 (5.76/100,000) showed a 2.34 fold increase. Acute alcohol intoxication was 62.7%, of all PASAP; the opioid 15.2% (heroin 11.0%, other opioids 4.2%); prescribed and over the counter drugs 12.6%; inhalants 1.1%; cannabis 1.1%; and cocaine 0.7%. Amphetamine (or amphetamine-like), hallucinogens and phencyclidine (or phencyclidine-like) AP were not encountered. The average percentage of alcohol AP for 1998-2000 compared to the preceding 1990-1997 dropped from 78.12% to 44.72% (1.75 fold), while that of opioids rose from 6.59% to 26.47% (4.02 fold), and that of the other drugs group from 12.22% to 21.78% (1.78 fold increase). The new non-alcoholic PAS AP (heroin, cocaine, inhalants and cannabis AP, as indirect indicators of narcotic exposure) showed a rapid increase. The data showed they are expanding and catching up with alcohol as a new cause of substance-related problems, thus becoming one of the important health and social problems of post-totalitarian society.

Acute Disease↗
PubMed2001

"The tongue is venomous": perception, verbalisation and manipulation of mortality and fertility regimes in rural Mali.

Demographic theory frequently assumes that pre-transitional populations adopt fatalistic attitudes to fertility and mortality. Fertility decline is said to require a "pro-active" mentality incorporating a newly conceived idea of numeracy about children and a new-found awareness by individuals of where they stand in relation to demographic norms. Nonnumeric responses to questions about desired family size are interpreted as meaning that women are unable to conceptualise their ideal number of children and are unaware of their demographic environment. However, ethnographic evidence from the Malian Fulani will show how women accurately appraise their mortality and fertility regimes and how they actively seek to manipulate them via a series of ritual behaviours. It is described how women do think numerically about demographic outcomes but are reluctant to verbalise this numeracy as it is believed that it will incur supernatural risks. The implications for demographic research of the widespread belief in the danger of verbalising numbers of children are discussed.

Attitude to Health↗
PubMed2002

Nutrition transition in Morocco.

OBJECTIVE: To analyse the nutritional transition in Morocco. DESIGN: Examination of Moroccan national survey data. RESULTS: Morocco is undergoing a demographic, epidemiological and social transition. The urban population increased from 29% in 1960 to 53% in 1997. Per capita gross domestic product increased steadily from 1972 to 1999. Life expectancy at birth increased to 70 years in 1999 from 47 years in 1962. Both infant and juvenile mortalities have decreased, from 92/1000 and 69/1000 in 1982-87 to 46/1000 and 37/1000 in 1992-97, respectively. In parallel, the diet changed considerably: the intake of animal products increased while that of cereals and sugar remained relatively high, reflecting the specificity of Moroccan dietary habits. The rise in the consumption of meats and vegetables was accompanied by a steady consumption of bread, used to eat the sauce in which the meat and vegetables are cooked. Sugar is mainly used in tea, the very sweet, national drink consumed throughout the day. Under-nourishment persists among children under five (23% stunting and 10% underweight in 1997) while overweight is rising (9% in 1997 compared with 3% in 1987 for children under three). Among adults, overweight (body mass index (BMI) > 25 kg m(-2)) increased from 26% in 1984 to 36% in 1998. It is higher among women (32% in 1984 and 45% in 1998) than among males (19% in 1984 and 25% in 1998). It is also higher among urban populations (30% in 1984 and 40% in 1998) than rural populations (20% in 1984 and 29% in 1998). Obesity (BMI > 30kg m(-2)) increased from 4% in 1984 to 10% in 1998. Overweight seems to be positively associated with economic status but negatively with education level. CONCLUSION: Overweight and obesity constitute major health problems in Morocco.

Adolescent↗