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We must tackle population problems.

Thank you Mr. Chairman, for the opportunity to speak out not only as a Japanese parliamentarian, but also as a member of GLOBE International, Global Legislators Organization for a Balanced Environment, consisting of legislators from the US Congress, EC Parliament, USSR Assembly and Japanese Diet who have joined together to compare, improve and coordinate our respective legislative activities in an effort to effectively address the complex issues surrounding environment and development. Mr. Chairman, world population--which reached 5.4 billion in mid-1991--is growing exponentially. According to 1 UNFPA report 3 people are born every second, a total of 250,000 people every day or 95-100 million people every year. At this rate, world population will reach 6.4 billion by year 2001, and if this rate continues to go unchecked, world population will reach 14-15 billion by the end of the 21st century. GLOBE is highly aware of the relationship between rapidly growing human populations, environmental degradation and sustainable development. We urge UNCED negotiators to address population growth rates and the integrally linked concerns of resource consumption levels, particularly in the industrialized world, in their search for solutions to the conflict between environment and development. Negotiators should also seriously consider ways in which to broaden educational and economic opportunities for women to ease population growth rates, and to alleviate poverty and stresses on the environment that result from population pressures. Social and economic factors must be integrated into population planning. It is saddening to note that almost 40,000 children die every day due to malnutrition, lack of fresh water and access to resources. Over 100 million children do not receive a primary education. Mr. Chairman, worldwide demand for a range of family planning services is increasing faster than supply. Recent studies indicate that if quality family planning information, training and services were made readily available by government and other groups, population rates would drop to manageable levels. Widespread access to family planning services is essential to population stabilization. The health of mothers, children and general quality of life is also improved through the implementation of family planning programs. At the present time many women cannot make use of the limited available services because of cultural constraints, lack of status and self-confidence. Unless complementary efforts are made to expand economic and educational opportunities for women, family planning and other reproductive health services will not reach their full potential for stabilizing population. Although family planning is an individual decision, and implementation of population programs is a sovereign matter in each country, I would urge developed countries to help their neighbors in developing countries who are in need of support for family planning and health services. Investment in family planning programs is 1 of the best ways to contribute to environmental protection and improvement. A greater portion of our foreign aid monies should be allocated for direct population assistance programs that will reach people at the grassroots level. To achieve this, a cooperative working relationship with local nongovernmental organization (NGOs) is essential. The members of GLOBE hope to facilitate cooperation between NGOs and governments so that we might stabilize human population.

Conservation of Natural Resources↗

The role of professional education in building capacity for health promotion in the global South: a case study from Norway.

The capacity to train public health professionals is far from sufficient to meet urgent global needs. Foreign aid programs hold much promise to deal with this challenge. A case study from Norway illustrates the possibilities. Since the early 1960s, Norwegian universities have offered English-taught masters and doctoral degree programs, with sufficient financial support that all Third World students have the resources to complete training, regardless of their personal financial circumstances. This facet of the program is its main distinguishing factor, compared to many educational opportunities that are available in other countries. Since the first visiting students were awarded degrees in 1968, almost 10,000 students have participated at more than 25 Norwegian institutions, including many offering public health training. Many eligible applicants have been turned away due to lack of resources, indicating a level of interest that cannot be met with existing resources. Similar programs in more countries could help alleviate the need.

Education, Graduate↗

A clinical and educational telemedicine link between Bulgaria and Greece.

During its transition to a free economy, Bulgaria benefited from foreign aid provided by Greece. One of the projects was the clinical and educational telemedicine link between the Medical University of Varna in Bulgaria and the Faculty of Medicine of Aristotle University of Thessaloniki in Greece. This began in 1997. In terms of the educational activities, the Bulgarian side of the network supports (a) electronic design and publishing activities, (b) web hosting and mail server activities and (c) satellite communications. In addition it supports an electronic classroom equipped with personal workstations, multimedia projectors and videoconference facilities. Communications are via the ISDN network. In terms of its telemedicine activities, the network provides remote medical assistance to "language handicapped" travellers and to migrant workers in both countries. The main clinical experience is remote consultations in immunology. This admittedly limited experience demonstrates that telemedicine can be used to provide assistance to remote colleagues. In cases where the patient cannot communicate with the attending physician, the use of telemedicine can greatly improve the quality of care available to travellers and migrant workers.

Bulgaria↗

[Healthcare: a growing role in international politics].

Since the end of the cold war the tone of international relations has clearly changed. Whereas relations were once defined strictly in terms of more or less armed confrontation, economic and social issues now play a growing role. Healthcare policies in Africa have long been influenced by the policies of countries sponsoring bilateral and even multilateral foreign aid programs. However the last ten years have witnessed an increasing interaction between international policy and healthcare policy. The two main reasons for this trend involve 1) access to drug treatment and the WTO and 2) the extension and impact of the AIDS epidemic. The problem of access to drug treatment for poor populations (fundamental right) has led to the emergence of an increasingly strong and effective civil society. Because of its social and economic effects as well as its geopolitical and security implications, AIDS has become a major factor in international relations. With regard to both these issues the place and role of the USA is demonstrative of the interaction between healthcare and international relations.

Acquired Immunodeficiency Syndrome↗

Primary prevention of type-2 diabetes in developing countries.

Although diabetes is now a worldwide epidemic, the rate of increase in its prevalence in developing countries is alarming. By the year 2025, more than three-quarters of all persons with diabetes will reside in developing countries. India and China are leading this surge in diabetes, and sub-Saharan Africa is currently at a lower prevalence rate. However, the estimated increase is substantial among African descendants in the Americas, West Indies and throughout the diaspora. There are compelling reasons why aggressive efforts must be directed toward primary prevention of diabetes in developing countries. Once diabetes develops, the cost of caring for patients is prohibitive. Poorly managed diabetes leads to several complications (e.g., end-stage renal failure, blindness, amputation and heart disease) that many developing countries are ill equipped to tackle. In landmark trials, lifestyle modification approaches are more efficacious than expensive medications in the prevention of diabetes. This is fortunate because lifestyle modification can be implemented locally, whereas medications often need to be imported at high cost. The first task is the education of policymakers on the urgent need for timely action to prevent the looming epidemic of diabetes. Once governments become convinced of its critical value, the translation of diabetes prevention through dietary modification and increased physical activity would require careful planning, extensive piloting and creativity in the allocation of scant resources. External support, foreign aid, debt forgiveness and other forms of creative financing will almost certainly be needed to implement widespread diabetes prevention programs in developing countries.

Developing Countries↗

[Transcultural aspects of family therapy].

The transcultural view is evident throughout all of Positive Family-Therapy. It helps us to understand the individual conflicts and can also be important in dealing with such social issues as the treatment of illegal aliens and refugees, foreign aid for the Third World countries, problems in dealing with members of other cultural systems, interracial and transcultural marriages, prejudices, alternative life-styles societies and political problems. 4 ways of dealing with conflict and the 5-stage Positive Family-Therapy are therapeutic strategies in which therapy and self-help are intertwined.

Austria↗

The Fifth World Food Survey: an assessment of food supplies and malnutrition.

The methodology and findings of the United Nations Food and Agriculture Organization's Fifth World Food Survey are reviewed. Data compiled from national food balance sheets indicate that per capita energy supplies increased by 14% during the past two decades. The number of undernourished is estimated for the periods 1969 to 1971 and 1979 to 1981 on the basis of a distribution of population food intakes and two alternative estimates of minimal energy requirements. The survey findings indicate that the proportion of undernourished in the developing market economies decreased, although an estimated 335 million to 494 million people fall in this category. In the least developed countries, the proportion of undernourished increased during this period. Elimination of poverty, the fundamental cause of malnutrition, through increased economic and agricultural development, is regarded as the only long-term solution to malnutrition. Short-term solutions are also needed to address interim needs and the diverse environmental, social, and cultural factors implicated in the causation of malnutrition. Short-term solutions include nutrition programs, complementary health measures, food subsidies, population programs, and programs aimed at improving the status of women. Projected future food needs in developing countries also indicate the need for increased international food trade and expanded foreign aid.

Developing Countries↗

[Inhaled foreign bodies: first aid].

In the last 30 years 1,484,576 patients with traumatic lesions of different kind of seriousness were observed and managed. By mean of retrospective investigation, the authors selected and statistically analysed a sample of 95 patients treated for accidental tracheobronchial foreign bodies inhalation: authors' aim was to punctually determinate--step by step--diagnosis and treatment procedure in a "time-saving" frame. Inhalation of foreign bodies is a very dangerous event, particularly in children. In authors' experience, in 60% of cases they were children under 3 years; in 25% of cases children under 10; in 10% patients from 10 to 60 and in 4.5% over 60. As regards the gender of the patients, the male/female ratio has been 2 to 1 in favour of male. Since 85% of the study population was represented by children under 10, its clear that male children in this range of age has a greater statistical risk for accidental tracheobronchial foreign bodies inhalation.

Adolescent↗

Corneal foreign bodies--first aid, treatment, and outcomes. Skills review for an occupational health setting.

Eye injuries from foreign body incidents remain prevalent in the workplace setting. Often the professional nurse provides the first line of treatment. The informal class presented at the authors' facility offered a comprehensive, organized presentation of a common injury encountered in the practice of occupational health nursing. Strenghts of the presentation included handouts demonstrating eye eversion technique and a flip chart summarizing the content to be placed in each medical station as quick reference. One challenge involved presenting the information to all nurses. The site encompasses four locations and some nurses function as the only staff in the plant for a given shift. With the support of administration and some creative scheduling, 10 of 17 nurses attended one of three classes offered in one morning, and the remaining 7 were able to view the class on videotape. Videotaping the presentation also provided material for future orientation, as well as an opportunity for review. Overall analysis found this a worthwhile offering relevant to practice. A brief formal written evaluation indicated the objectives for the class were achieved and elicited subjects for future topics. Informal chart reviews to check for documentation of visual acuity testing and eversion of the upper lid for foreign body injuries is another outcome measure currently in progress. In addition, a performance improvement project could be accomplished easily by retrospective chart review of assessment and treatment documentation, and tracking of revisits and referrals. Knowledge of current standards in the assessment, first aid, and treatment of eye injuries is every occupational health nurse's responsibility. However, prevention of foreign body injuries is far superior to any treatment modality available. As highly visible leaders within the occupational setting, nurses can be advocates and role models for safe work practices. Occupational health nurses may promote safe eye practices by actively seeking collaboration with safety departments to continuously monitor and improve eye injury and outcome statistics and use of protective eye-wear. By consistently wearing proper safety eyewear, such as approved goggles or prescription safety glasses with side sheilds, during each and every venture into the work area, occupational health nurses provide a strong role model and have the opportunity to educate employees and encourage safe work practices. It is important to encourage shared responsibility and awareness between workers and management for prevention of foreign body incidents and prompt, accurate treatment when necessary to promote optimal outcome.

Cornea↗

The cost of overseas aid.

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Foreign Professional Personnel↗

[HIV infections among Turkish citizens who have lived in foreign countries].

AIDS or HIV infection, since 1981 when the first description was made because of showing epidemic characteristics, present increasing in number of patients, go along with high mortality, the disease become an event not only medically but also for any parts of the society. There is a danger of AIDS in risky groups and also danger of spreading by those persons. Among the 10985 Turkish citizens who came Turkey from foreign countries to fulfill military duty, antibody research against HIV was made and one positive anti-HIV case was observed.

Blotting, Western↗