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PubMed2001

Seroprevalence of Schistosoma mansoni in Puerto Ricans with inflammatory bowel disease.

BACKGROUND: The etiology of Inflammatory Bowel Diseases, Crohn's disease (CD) and ulcerative colitis (UC), is unknown. These diseases have a higher incidence in industrialized countries and their pathogenesis involves an over-reaction of the immune system. A genetic factor is believed to predispose to the development of chronic inflammation in response to an unidentified stimulus. Exposure to infections in childhood may modulate future immune responses. Parasitosis, particularly Schistosomiasis, stimulate Th2 immune responses. It has been hypothesized that the absence of these parasitic infections, as seen in economically developed countries, favors a Th1 response that may result in the clinical appearance of Crohn's disease later in life. OBJECTIVE: To determine the prevalence of Schistosoma mansoni antibodies in Puerto Ricans with Inflammatory Bowel Disease and controls. METHODS: Serum from 92 Puerto Ricans with IBD and 106 controls was screened for S. mansoni adult microsomal antigens (MAMA) using the FAST:ELISA assay. Those positive were confirmed with an enzyme-linked immunoelectrotransfer blot test. RESULTS: Seven serum samples (3 UC and 4 controls) were positive for S. mansoni antibodies. There was no significant difference between groups in gender, municipality of origin or seroprevalence of Schistosomiasis. The control group was slightly older than the IBD group. CONCLUSIONS: Our study did not demonstrate an inverse relation between Schistosomiasis and IBD. However, the decreasing prevalence of Schistosomiasis in the general population of Puerto Rico may account for this result.

Adult↗
PubMed2002

[Health care services and regional development, a medicometric approach].

Health care services and regional development, a medicometric approach. If regional development is defined in terms of job creation and increased quality of life, health services can be seen as an investment contributing to employment and local structural changes. Spendings to increase health services, especially in peripherical regions, increase the level of economic development. Through case studies in Switzerland we open four perspectives for the future and propose a global view of health care systems in a regional context.

Delivery of Health Care↗
PubMedDate not supplied

Considerations of HAV vaccine in India.

Currently available evidence indicates that most parts of India still quality to be hyper-endemic regions and hence recommendations for vaccinations developed for low endemicity regions are not applicable. There are however, some pockets which showed evidence of distinct epidemiologic shift. There is need to identify geographic regions like Kerala which have potential for epidemic outbreaks through cyclic sero-epidemiological surveys. With economic development and consequent improvements in the levels of sanitation and quality of water supplies, more such areas will be identified. Efforts to improve sanitation and personal hygiene will remain as the most important and efficient intervention to retard the transmission of HAV. Unless a critical improvement in the living standards of our population is achieved, aim of eradicating HAV infection from the community is not realistic. Presently, the cost of three doses of HAV is exorbitant and the focus of HAV vaccination will have to be restricted to individual protection who are likely to remain unexposed till adulthood and can afford to pay for it. HAV Infection below 5 years is mostly asymptomatic. The most efficient use of resources will therefore be to offer HAV vaccine to high risk individuals beyond this age after screening for antibodies against HAV.

Adult↗
PubMed1975

Progress in the control of coccidiosis with anticoccidials and planned immunization.

New anticoccidials continue to be introduced to the poultry industry on an average of about one every 2 years. Revised requirements have increased costs of discovery, development, and approval by the Food and Drug Administration to several million dollars for each product. Gross sales of anticoccidials are now estimated to be in excess of $30,000,000 annually. Anticoccidials are almost universally used in starter rations for meat-type birds being raised under floor-pen management. Protection is more important with these fast-growing birds than with egg-producing types where immunity and cage layer management modify demands for anticoccidials. Coccidiosis mortality has generally been eliminated by all 25 approved anticoccidials if properly used. Selection of specific anticoccidials is based on the ability of the anticoccidial to: (1) improve weights and (2) feed conversion, and (3) to suppress development of lesions. Costs of the product may influence decisions on which one to use. With some anticoccidials the rapid emergence of drug resistant strains has been the biggest problem. "Switching" among the 13 classes of anticoccidials and the so-called "shuttle program" are common methods used to avoid development of resistance. Preventive medication will probably continue to constitute the major method of coccidiosis control with meat-type poultry if attempts to develop economic cage-type management do not supplant current litter and floor-pen management. Immunity acquired through incidental or planned immunization is more important in control of coccidiosis with layer and breeder flocks raised in floor-pens. Some progress in development of avirulent immunogenic strains of different species of coccidia has been reported and further research efforts in this direction should be encouraged.

Administration, Oral↗
PubMed2002

Dams, environment and regional development--harnessing the "elixir of life: water" for overall development.

Water--the Elixir of Life--has the potential to sustain human life and also to develop it further, and that is why various international instruments have aptly recognized its role in sustainable development. This paper reviews the global and Indian water scenario before presenting the case of Gujarat State, where perennial water scarcity has raised serious threats to the existence of millions of people and cattle and has led to environmental degradation and constrained economic development. More than 13,000 villages out of 18,028 villages of the State are facing scarcity in terms of crop failure this year. Drinking water supply is maintained by transporting water by road tankers, "water special" trains and even by ships via a sea route. Lack of access to safe and clean water for domestic use has a detrimental effect on the social fabric, and even incidences of migration and water riots are recorded. The paper discusses the efficacy of available options including rain water harvesting. The efforts of the State to harness the untapped waters of Narmada for the survival of millions and sustainable development of western India, are discussed adjudging socioeconomic and environmental impacts. The paper concludes that assured water supply is essentially critical for overall development.

Agriculture↗
PubMed1997

[Mortality due to suicide in Spain: associated socioeconomic and environmental factors].

OBJECTIVE: Describe the cumulative incidence of suicide mortality and self-inflicted injuries in Spain during the period 1987-1991 and identify associated socioeconomic and meteorological factors. DESIGN: Ecological study. SITE: Fifty Spanish provinces excluding Ceuta and Melilla. PATIENTS: Spanish population during the study period. MAIN MEASUREMENTS AND RESULTS: For each province, the cumulative incidence of mortality from suicide and self-inflicted injuries were calculated by gender and age groups. The associations between suicide mortality and 31 socioeconomical and meteorological variables were evaluated using multiple linear regression. The incidence of suicide deaths was stable during the study period. The most important negative associations identified were with variables indicating economical development and the positive associations with the variable measuring specific general mortality. No significant differences between genders were found. For both genders, the model with the highest coefficient of determination corresponded to the group of adults aged. CONCLUSIONS: In Spain, social and economical factors are associated with the frequency of deaths from suicide and self-inflicted injuries in both genders and specially in the adult age.

Adolescent↗
PubMed1997

Integration of Environmental Assessment into the Regional Development Planning Process of the Galilee

/ The Galilee region on the northern edge of Israel constitutes more than 15% of the state's territory, supplies more than half of its drinking water needs, and is an important recreational resource and destination for Israelis. One of the main objectives of the plan for the Galilee was to devise a regional physical and economic development strategy for the years 1992-2007 that would arrest the trend of emigration of its residents, attract newly arrived immigrants to the region, and at the same time protect natural resources and environmental quality. This paper is limited to discussion of the environmental aspects of the plan. It analyzes spatial concepts for distribution of projected population growth, evaluates environmental impacts of alternative plans, and proposes a decision-making framework and tools for minimizing natural resources loss from development at the local level. Assessment of potential environmental impacts generated quantitative data of natural resources areas. Application of the data in the plan evaluation stage showed that the alternative that concentrated most of the new development in central Galilee was the second-best choice environmentally, but was preferred as the best choice for overall qualities. The planning study offers an alternative environmental impact assessment (EIA) process to the one presently used in Israel by incorporating environmental considerations at the initial plan-making stage and not at the plan-approval stage. It demonstrated that in order to be effective, environmental assessment and land-use planning should be seen as one effort that is integrated from the start and in each stage of the plan-making process.KEY WORDS: Environmental assessment; Development planning; Galilee

Journal Article↗
PubMed2006

Trends in the incidence of cancer in Qidong, China, 1978-2002.

A population-based cancer registry was established in Qidong, Jiangsu Province, China, in 1972, and the trends in incidence rates of the major cancer sites have been analyzed for a 25-year period, 1978-2002. Five-year age-specific rates, crude incidence rates, world age-standardized rates (ASR), percent change (PC) and annual percent change (APC) were calculated using annual data on population size, and estimates of its age structure. The indices of histological verification of diagnosis, death certificate only and proportion of mortality to incidence were employed for assessing the registration quality. A total of 51,933 incident cases of cancer were registered in Qidong from years 1978 to 2002, with a male-to-female sex ratio of 1.9:1. Crude incidence increased markedly over the 25-year period (PC and APC of +55.6% and +2.1%, respectively), but ASR showed a slight decrease (-0.4% in males, and -0.3% in females), indicating that the major part of this is due to population ageing. The leading cancer sites in rank were liver (average ASR = 50.8 per 100,000), stomach (26.7), lung (22.7), colon-rectum (8.9), oesophagus (7.4) and breast (5.4). Cancers of liver, lung, colon-rectum and female breast all showed increases in incidence during the study period, with APCs (ASR) of +0.1%, +1.7% and +1.4% for males, and +0.2%, +0.9%, +1.9% and +1.1% for females, while the cancers of stomach (APC: -3.2% in male, and --2.4% in female) and cervix (APC: -4.7%) showed notable declines. Examination of age-specific rates showed declining trends in the younger generations for liver cancer, but increases for cervix cancer. The results underline the increasing importance of cancer as a cause of mortality and morbidity in a population that is ageing and undergoing profound changes in socioeconomic development and lifestyle. The cancers of high lethality that have been common in the Chinese population (liver, stomach, oesophagus) are showing some evidence of decline, at least in younger generations, but they remain major problems. At the same time, the cancers associated with economically "developed" societies -- lung, colon-rectum and female breast -- are showing increases. The population-based cancer registry is an indispensable tool for providing data for planning and evaluation of programmes for cancer control in all societies.

Adolescent↗
PubMed2003

Cervical cancer, a disease of poverty: mortality differences between urban and rural areas in Mexico.

OBJECTIVE: To examine cervical cancer mortality rates in Mexican urban and rural communities, and their association with poverty-related factors, during 1990-2000. MATERIAL AND METHODS: We analyzed data from national databases to obtain mortality trends and regional variations using a Poisson regression model based on location (urban-rural). RESULTS: During 1990-2000 a total of 48,761 cervical cancer (CC) deaths were reported in Mexico (1990 = 4,280 deaths/year; 2000 = 4,620 deaths/year). On average, 12 women died every 24 hours, with 0.76% yearly annual growth in CC deaths. Women living in rural areas had 3.07 higher CC mortality risks compared to women with urban residence. Comparison of state CC mortality rates (reference = Mexico City) found higher risk in states with lower socio-economic development (Chiapas, relative risk [RR] = 10.99; Nayarit, RR = 10.5). Predominantly rural states had higher CC mortality rates compared to Mexico City (lowest rural population). CONCLUSIONS: CC mortality is associated with poverty-related factors, including lack of formal education, unemployment, low socio-economic level, rural residence and insufficient access to healthcare. This indicates the need for eradication of regional differences in cancer detection. This paper is available too at: http://www.insp.mx/salud/index.html.

Adult↗
PubMedDate not supplied

Applying economic principles to health care.

Applying economic thinking to an understanding of resource use in patient care is challenging given the complexities of delivering health care in a hospital. Health-care markets lack the characteristics needed to determine a "market" price that reflects the economic value of resources used. However, resource allocation in a hospital can be analyzed by using production theory to determine efficient resource use. The information provided by hospital epidemiologists is critical to understanding health-care production processes used by a hospital and developing economic incentives to promote antibiotic effectiveness and infection control.

Anti-Bacterial Agents↗
PubMedDate not supplied

Perinatal outcome and the social contract--interrelationships between health and humanity.

Rates of infant mortality and prematurity or low birth weight serve as indirect measures of the health of a nation. This paper presents current population data documenting the still serious problem of perinatal outcome in the United States as well as in other economically developed countries. International comparisons suggest that nations with the greatest inequality of income and social opportunity also have the most adverse perinatal, child, and adult health outcomes. Furthermore, the data assert that these effects are independent of average national wealth or gross national economic productivity. Health status differs by social class and race, even among the most affluent sectors of the population. All social classes, even the wealthiest, suffer the health consequences of social inequalities. An explanatory sociopsychologic theory of causality is proposed.

Adult↗
PubMed1998

Perinatal outcome and the social contract: interrelationships between health and society.

Rates of infant mortality and prematurity or low birthweight serve as indirect measures of the health of a nation. This paper presents current population data documenting the still serious problem of perinatal outcome in the USA as well as in other economically developed countries. International comparisons suggest that nations which have the greatest inequality of income and social opportunity also have the most adverse perinatal, child and adult health outcomes. Furthermore, the data assert that these effects are independent of average national wealth or gross national economic productivity. Health status differs by social class and race, even among the most affluent sectors of the population. All social classes, even the wealthiest, suffer the health consequences of social inequalities. An explanatory socio-psychological theory of causality is proposed.

Adult↗
PubMed1999

[Unemployment during pregnancy: direct or indirect risk factor of prematurity and fetus hypotrophy?].

The question as to whether in a transitional phase in the political and socio-economic development in Poland, an increased threat of unemployment may also produce health effects manifested by an elevated risk for prematurity and fetus hypotrophy is one of important challenges. If the answer is positive then this issue should have much stronger impact on political and economic decisions. The data obtained from numerous studies carried out in countries of western Europe and the United States shows that the job performance during pregnancy under conditions free from occupational exposure and arduousness does not directly augment the risk of detrimental effect to the health of pregnant woman or her fetus. Just on the contrary, it was found that job performance during pregnancy, and strictly speaking steady employment during this period may somewhat become a 'protective factor'. In Poland, the highest rate of unemployment is observed among women in the 18-24 age group, that is at the age most suitable for procreation. Nowadays it is common that the decision on child-bearing is postponed until the economic status of the woman or her family comes to be more stable. On the other hand, in the population of women looking for a job but determined to set up a family prematurity is quite common that results only in part from an excessive effect of risk factors for this pathology very typical of this social group, like smoking, single parenthood, early or late child-bearing age. After adjusting these factors, the risk of prematurity decreased considerably but it was still high. It is thought that stress and the sense of threat and uncertainty is mostly responsible for this phenomenon. An increased risk of fetus hypotrophy among unemployed women after considering all confounding factors, was not observed.

Adolescent↗
PubMedDate not supplied

[Health care delivered to Portuguese children. The past, present and new challenges].

The socio-economic development of a country as well as the state of its health, its communications network, cultural level and health care organisation together affect what is known as the health indicators. Portugal belongs to the group of UNICEF countries with the best indicators in what concerns infant mortality and death below the age of five. It is still, however, 25th and 28th respectively at world level. The authors review some of the factors which have most contributed towards the progress of the indicators over the last twenty years, namely, the role played by general practitioners, the creation of health centers, the development of a maternal-infant assistance programme and the activity of Central and District Hospitals. They analyse the recent maternal-infant programme and discuss the main short and mid-term problems in the perinatal and paediatric age groups. The socio-economic changes seen in Portuguese society, together with sociological changes and those observed in the field of pathology, call for a new approach in the organisation of care which includes the need for a new dialogue between the different health structures of a society, namely, through maintaining the functional coordinating maternal-infant units, the creation of the same units for paediatrics, new efforts by the general paediatrician, the community paediatrician and the sub-specialised paediatrician together with the general practitioners within a specific action programme of a Health Unit.

Child↗
PubMed1989

Beverage alcohol spending in Singapore: a potential development constraint?

World Health Organization sponsored studies identify Singapore as a low-level-drinking country where beverage alcohol consumption is not growing at a rapid pace. However, data for Singapore do show that from 1978 through 1986, consumer spending on beverage alcohol was on the rise, although not alarmingly. Growing spending on beverage alcohol could signal a challenge to Singapore's continuing economic development when viewed in the context of the country's emerging labor shortage and its development strategy. Beverage alcohol could become a problem due to the upward trend in spending on drinking, the emergence of a labor shortage, and the need for the largest possible pool of highly skilled workers to sustain Singapore's growth and development. Government might, therefore, look into spending on alcohol as diligently as it focuses on the consumption of tobacco and narcotics.

Alcoholic Beverages↗
PubMed1998

Body mass index as indicator of standard of living in developing countries.

OBJECTIVE: To assess the suitability of the body mass index (BMI) as an indicator of standard of living in developing countries. DESIGN, SETTING AND SUBJECTS: The analysis is based on data collected in the first two rounds of the Ghana Living Standards Survey, held in 1987/88 (GLSS-I) and 1988/89 (GLSS-II). The dataset provides information on a wide range of socio-economic variables, at the individual, the household and the community level, including the height and weight data of approximately 9000 adults in the 20-65 y age bracket. METHOD: Bivariate analysis was used to assess, at the individual level and at the level of population groups, the relationships between adult Body Mass Index and selected household characteristics such as income and expenditure, years of schooling of head of household, access to services, quality of housing, and nutritional status of children. Through multiple regression, indicative estimates have been derived of the effects of these variables on adult BMI. For comparison, the same relationships were investigated for weight and height. RESULTS AND CONCLUSION: At the individual level, BMI shows a significantly positive relation with the various socio-economic indicators of living standard, though the correlation coefficients indicate a poor fit. However, at the level of population groups, The relationship between BMI and other characteristics of socio-economic development is strong with a correlation coefficient of 0.86 between mean BMI and mean per capita expenditures of 12 population groups in Ghana, presumed to be at different levels of standard of living. The relationships between weight and the various socioeconomic characteristics were comparable to those for BMI, while height was poorly correlated with the selected household variables. Result suggest that in low-income countries, information on adult BMI (mean and distribution) can be used for assessing differences in standards of living between population groups or for monitoring changes over time.

Adult↗
PubMed1995

[Clinical experimentation with HIV vaccines: scientific and ethical dilemmas].

Developing a vaccine against HIV is one of the greatest challenges the scientific community faces today. Several vaccine candidates have undergone preliminary safety and immunogenicity studies in humans. Research teams are ready to test these vaccines in the field, yet the scientific community is divided as to whether efficacy trial should begin. This paper addresses the complex scientific and ethical issues raised by clinical trials. Considering the pressure to act rapidly to solve the crisis, scientists need to hold to the fundamental principles that guide decisions in biomedical research: respect for persons, beneficence and justice. Because these studies need to enroll a large number of subjects, prospective vaccines will need to be tested in developing, as well as industrial countries. The international community needs to work to ensure that the populations that accept the risk of the research receive the full benefit of that research and, that the vaccine proven successful, be made accessible and affordable to people in less economically developed situation.

AIDS Vaccines↗