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PubMed2006

Helicobacter pylori occurrence and transmission: a family affair?

About half of the world's population is estimated to be infected with Helicobacter pylori, a gastric bacterium that contributes to the development of peptic ulcer disease and gastric cancer. H. pylori is more prevalent in low-income areas of the world and social and economic development decreases the prevalence as reflected in comparisons both within and between countries. The infection is typically acquired in early childhood and once established commonly persists throughout life unless treated. Person-to-person transmission within the family appears to be the predominant mode of transmission, particularly from mothers to children and among siblings, indicating that intimate contact is important. The route of transmission is uncertain, but the gastro-oral, oral-oral and faecal-oral routes are likely possibilities. Hence, gastroenteritis may facilitate dissemination of the infection. The community and environment may play additional roles for H. pylori transmission in some (low-income) settings. Furthermore, host and bacterial factors may modify the probabilities of acquisition and persistence of the infection. The understanding of H. pylori occurrence and transmission is of practical importance if future study deems prevention of the infection desirable in some high-prevalence populations. The present paper reviews aspects of H. pylori occurrence and transmission with an emphasis on household factors.

Carrier State↗
PubMed2003

The long-run growth in obesity as a function of technological change.

This paper analyzes the forces contributing to the worldwide long-run rise in obesity and the role of public interventions in affecting its continued growth. A growth in obesity in a population must result from the growth of calorie consumption outpacing the growth of physical activity. Yet historically in developed countries, obesity has grown with modest rises in calorie consumption and with a substantial increase in both exercise and dieting. We consider the economic incentives that give rise to the long-run growth in obesity by stimulating intake of calories at the same time as discouraging the expending of calories on physical activity, whether in work or leisure. We argue that technological change provides a natural interpretation of the long-run growth in obesity, that it predicts that the effect of income on obesity changes from positive to negative with economic development, and that it implies that technological change may not continue to raise weight. We discuss the positive and normative impacts of direct and indirect public interventions to reduce obesity.

Adolescent↗
PubMed1988

[The nutritional and health status of the Latin American woman].

Latin America is a region where countries have various levels of socioeconomic development. Thus, the living standards and health status of its people differ significantly in the midst of a mosaic of social, ethnic, cultural and economic realities. Social inequalities and extreme poverty determine significant differences, not only in the magnitude of health indicators, but also in the type of pathology prevalent. People in the high socioeconomic levels are affected by nutritional diseases characterized by excessive food intake, while people from the low socioeconomic levels are affected by undernutrition and its associated pathology. Undernutrition occurs fundamentally among the age groups at higher risk in the population segments with low income, low food intake, illiteracy and poor access to the health care and preventive medicine centers. Among families exposed to undernutrition, women are usually in worse condition than men. This is due to the long working hours and the increased nutritional requirements caused by frequent gestations and prolonged lactation. It is estimated that one fourth of newborns in Latin America are affected by low birth weight, which has been associated to adolescent mothers, their excessive physical work, anemia, low maternal pregestational weight, low weight gain during gestation, and frequent maternal infections. Nutritional anemia due to iron deficiency is highly prevalent among pregnant women in Latin America. In some countries, the prevalence of folate deficiency during pregnancy appears to have increased significantly in the past 15 years and is becoming a nutritional problem that needs preferential attention. Diets generally are inadequate and, in the case of pregnant and lactating women, usually deficient in calories, protein, iron and folic acid. It is urgent that the health and nutritional status of Latin American women of low socioeconomic condition be given special attention, particularly mothers during gestation and lactation. Otherwise, women will not be able to altogether fulfill their important role in the home and within the family, nor will they successfully participate in the economic development of their countries.

Adolescent↗
PubMed1994

Recent trends and future prospects for the elderly in Scandinavia.

After World War II, and all through the 1970s, social and economic development in general, and social policy in particular, raised the standard of living for old people in Scandinavia considerably. Public provision then leveled off and declined through the 1980s, with some variation between the countries. While the aging of the population continues, the political and economic climate now favors cuts rather than expansion of public budgets. Any further development along these lines will reinforce the inequalities, and place a growing number of the elderly and their families at risk.

Aged↗
PubMed1997

Health policy development in wartime: establishing the Baito health system in Tigray, Ethiopia.

This paper documents health experiences and the public health activities of the Tigray People's Liberation Front (TPLF). The paper provides background data about Tigray and the emergence of its struggle for a democratic Ethiopia. The origins of the armed struggle are described, as well as the impact of the conflict on local health systems and health status. The health-related activities and public health strategies of the TPLF are described and critiqued in some detail, particular attention is focused on the development of the baito system, the emergent local government structures kindled by the TPLF as a means of promoting local democracy, accountability, and social and economic development. Important issues arise from this brief case-study, such as how emerging health systems operating in wartime can ensure that not only are basic curative services maintained, but preventive and public health services are developed. Documenting the experiences of Tigray helps identify constraints and possibilities for assisting health systems to adapt and cope with ongoing conflict, and raises possibilities that in their aftermath they leave something which can be built upon and further developed. It appears that promoting effective local government may be an important means of promoting primary health care.

Communicable Disease Control↗
PubMed2005

Interaction of legislation and prevalence of sexually transmitted diseases with focus on syphilis and gonorrhoea in the Czech Republic - review to year 2003.

INTRODUCTION: A large increase in syphilis prevalence was noted in the Czech Republic during the last decade. It was associated with prostitution in cities and especially in areas bordering more economically developed countries. Foreigners account for more than 50% of this increase. Absence of legislative regulations contributes to this situation. OBJECTIVE: To demonstrate the necessity of setting sexually transmitted disease (STD) fighting priority in the Czech Republic. METHODS: The authors review the development of legislation related to STDs in the context of geopolitical changes and the epidemiological situation in the Czech Republic by relating epidemiological, geopolitical and economic data. RESULTS: Venereal-diseases-related regulatory codes have existed in the Czech Republic for years; however, they became fragmented in several regulations and often do not have the status of law. It is a consequence of the transformation of the entire state health care delivery system to a private system. The treatment of foreigners, refugees and uninsured people is a major problem. CONCLUSION: It is necessary to focus on special populations, such as homeless people, immigrants and prostitutes. It is desirable to strengthen international cooperation in combating STD as well as prostitution. Relevant legislation should be introduced to correlate the existing regulations and bring them up to date.

Czech Republic↗
PubMed1998

The economic impact of biomedical research: a case study of voluntary institutions in the New York metropolitan region.

This study estimates the economic significance of biomedical research for a geographic region. Through a survey of nonprofit biomedical research institutions in the metropolitan New York region and an analysis of research budget data obtained from the area's six largest research institutions, estimates were made of the spending effect of biomedical research on the region. Biomedical research undertaken by the voluntary institutions in metropolitan New York accounted for almost $1.15 billion per year in direct spending in 1991. When the indirect and induced ripple effects of this spending on the regional economy were considered, the total annual spending impact was over $2.3 billion. Sponsored biomedical research directly generated 19,816 jobs per year in the host institutions. The indirect and induced job creation in the region amounted to an additional 12,773 jobs per year for a total of almost 32,600 regional jobs per year. As economic development becomes more competitive locally, regionally, and internationally, the biomedical sciences that have always been intrinsically valued gain extrinsic value. Therefore, techniques for estimating their economic impact are becoming increasingly important.

Budgets↗
PubMed2003

Population aging and implications for epidemic cardiovascular disease in Sub-Saharan Africa.

Within the clinical and public health communities, it is often unnoticed that the developing world is experiencing an aging population with its attendant increase in the burden of chronic, noncommunicable diseases. From July 1999 to July 2000, 77% of the world's net gain in elderly persons occurred in developing countries. In Sub-Saharan Africa alone, the number of persons aged 65 years and older is expected to increase by 50% in 2015, from 19.3 million to 28.9 million. This demographic change has profound implications for developing countries that already shoulder a huge burden of communicable diseases, especially the HIV/AIDS epidemic, and continue to be challenged by basic infrastructure needs and economic development. In the 30-year period from 2000 to 2030, the population of elderly persons is projected to double in many Sub-Saharan African countries including the Democratic Republic of Congo, Mozambique, Cameroon, and Ghana. The scale and magnitude of these demographic changes are unprecedented. Since advancing age is the most powerful independent predictor of cardiovascular morbidity and mortality, the impact of these demographic changes on heart disease and stroke will be substantial. Aggressive efforts in promoting healthy aging and the prevention of cardiovascular risk factors will be crucial in preventing an impending cardiovascular epidemic in these countries.

Africa South of the Sahara↗
PubMed2006

No scalpel vasectomy advocacy and community mobilisation--a personal experience.

The so called myths and taboos among the people of India are obstactes controlling population explosion and thereby the nation is being handicapped with economic development. To propagate awareness and information, the NSV Resource Center took up organising mega camps for the acceptance of NSV as the method of family planning and male participation. The awareness material has been developed to bring forth total sociocultural transformation through development of intense desire, strong determination, effective management and inclusion of a zeal of perpetual efforts both among the promoters and acceptors. The information modules have been developed to suit the requirements of various vehicles through which the message has to be spread. Awareness messages are generated through the inputs from sociocultural, economic, ethical, hygienic and administrative acumen. The materials prepared are disseminated through display hoardings, wall writings, distribution of pamphlets, audiovisual clips, face to face counselling, etc. Communication technology serves mobilising and educating people, especially rural populace. Some steps are suggested to reach remotest villages which are elaborated. Counselling is an essential part of motivation to the client. During the last 5 years a significant surge has been noticed in terms of access to new communication technologies. This may be employed to successfully implement the family planning programme.

Awareness↗
PubMed1989

The WHO multicentre trial of the vasopressor effects of combined oral contraceptives: 1. Comparisons with IUD. Task Force on Oral Contraceptives. WHO Special Programme of Research, Development and Research Training in Human Reproduction.

Changes in blood pressure were measured at three-monthly intervals over one year in a prospective study of 704 women using an oral contraceptive (OC) containing levonorgestrel 250 ug with ethinyl estradiol 50 ug and 703 women using an intrauterine device (IUD). The study was conducted in 11 centres in seven developing and three developed countries. Women using OC developed systolic blood pressures which were 3.6-5.0 mmHg higher than those using IUDs; their diastolic pressures became 1.9-2.7 mm higher. The OC-induced change was not affected by climate, age, a family history of hypertension, stroke or heart disease or by a history of hypertension in pregnancy. The life-table rate of hypertension (BP 140/90 or more) in the first year of OC treatment was 0.6 +/- 0.4 in the developing countries and 1.1 +/- 0.8 in the developed ones, per 100 woman-years of use. The vasopressor response to OC varied widely between centres but was not obviously related to the economic development of the country.

Adolescent↗
PubMed1994

Environment and development of respiratory allergy. II. Indoors.

Even if it is difficult to obtain correct epidemiological evidence, there is a body of evidence which suggests that the frequency of allergic respiratory diseases is increasing. The majority of atopic patients, in particular in childhood and adolescence, develop immunoglobulin E (IgE) antibodies with clinical symptoms to aeroallergens, such as those derived from house dust mites, pollens and pets. Since, in the economically-developed countries individuals spend most of their time indoors (home, school and workplace), indoor pollutants (tobacco smoke etc.) and allergens (house dust mite, cats, etc.) are the most important source of exposure. Indoor allergens are associated with a wide variety of particles in a broad size range, only some of which are microscopically identifiable, culturable, or detectable with existing immunoassay. Evaluation of indoor allergens requires both air and source sampling, and several different analytical techniques. It is likely that the increased prevalence of allergy and asthma may be caused in the indoor environment by the synergistic action of air pollution (in particular derived from tobacco smoking) with allergic sensitization. Passive smoking in infancy has also been involved in the airways allergic sensitization to common aeroallergens.

Air Pollution, Indoor↗
PubMedDate not supplied

A new market instrument for sustainable economic and environmental development.

The regenerative capacity of ecosystems provides a regulatory basis for sustainable economic growth and development. A natural valuation of an ecosystem's services will arise in a market for developmental rights in the ecosystem using a unit of tradable 'right': E-Scrip. The amount of e-scrip needed for a development may be set by Environmental Assessment. The capacity of the ecosystem to regenerate with developmental pressure may be represented by an independent trader or Factor Proxy for the Environment who provides e-scrip to the market.

Conservation of Natural Resources↗
PubMed2006

Routes to better health for children in four developing countries.

Despite the availability of effective, affordable interventions for the most common causes of death, more than ten million children in developing countries die each year. This article describes the circumstances of four countries whose reductions in child mortality exceeded what might be expected from their poor economic circumstances, and it asks whether they followed common routes to improved health for children. The findings suggest that contextual factors, such as the degree of economic development, good governance, and strong health care systems, matter less than do targeted health intervention, foreign aid, and technical assistance. In general, these findings contradict prevailing U.S. foreign policy regarding the circumstances in which progress toward health goals can be made.

Child↗
PubMed1977

The international transfer of medical technology--an analysis and a proposal for effective monitoring.

The international transfer of medical technology to the developing countries occurs at four levels--medical education, research, and missions; multinational corporate transactions; technical assistance projects sponsored by the World Health Organization; and bilateral foreign aid programs. In this article, a proposal is made for effective monitoring of international medical technology transfer through political and legal means, including a specific code of conduct for corporations engaged in medical technology transfer. The development of "intermediate health technologies" along the lines suggested by E. F. Schumacher, and the advantages of such an innovation in terms of population issues and economic development are also discussed.

Communicable Disease Control↗
PubMed1993

[Using prenatal care in the Tunisian context: barriers and motivation factors].

Several barriers to and motivators of antenatal care are analysed in the context of a developing country. The authors found that socio-cultural factors are as important as organizational factors in motivating women to seek antenatal care. While social and economic development may improve the quality of life in the long term, it is important to respond now to the needs of pregnant women in order to encourage them to use such services. A comprehensive analysis of certain organizational factors would be useful in achieving this goal.

Adolescent↗
PubMed2005

Socioeconomic status and obesity in adult populations of developing countries: a review.

A landmark review of studies published prior to 1989 on socioeconomic status (SES) and obesity supported the view that obesity in the developing world would be essentially a disease of the socioeconomic elite. The present review, on studies conducted in adult populations from developing countries, published between 1989 and 2003, shows a different scenario for the relationship between SES and obesity. Although more studies are necessary to clarify the exact nature of this relationship, particularly among men, three main conclusions emerge from the studies reviewed: 1. Obesity in the developing world can no longer be considered solely a disease of groups with higher SES. 2. The burden of obesity in each developing country tends to shift towards the groups with lower SES as the country's gross national product (GNP) increases. 3. The shift of obesity towards women with low SES apparently occurs at an earlier stage of economic development than it does for men. The crossover to higher rates of obesity among women of low SES is found at a GNP per capita of about US$ 2500, the mid-point value for lower-middle-income economies. The results of this review reinforce the urgent need to: include obesity prevention as a relevant topic on the public health agenda in developing countries; improve the access of all social classes in these countries to reliable information on the determinants and consequences of obesity; and design and implement consistent public actions on the physical, economic, and sociocultural environment that make healthier choices concerning diet and physical activity feasible for all. A significant step in this direction was taken with the approval of the Global Strategy on Diet, Physical Activity and Health by the World Health Assembly in May 2004.

Adult↗