Conference report. "This plan can change the world".
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There is evidence from developed countries that genetic disease is the major cause of childhood blindness. Little data are available from most developing and newly industrialised countries concerning the relative importance of hereditary diseases as a cause of childhood blindness. Children in schools for the blind in 13 countries of Africa, Latin America and Asia were examined between 1990 and 1994 using a standardised method The anatomical site of abnormality and underlying aetiology were analysed for children with a corrected acuity in the better eye of less than 6/60 (severe visual impairment and blindness, svi/BL). In these countries II-39% of svi/BL was attributed to genetic disease. Genetic diseases were responsible for a higher proportion of childhood visual loss in countries with higher levels of socio-economic development. An autosomal recessive mode of inheritance was reported in 22-52% of children with genetic disease. Retinal dystrophies were the commonest form of genetic eye disease (49-80%) in all countries apart from Thailand and the Philippines where cataract was the commonest (43.9%). The role of consanguinity, and opportunities for further research are discussed.
A survey has been carried out on anthropometric nutritional status and food habits of students of the secondary schools of a little town of Umbria that is now in an economic development. The anthropometric data (body weight and height, skinfolds, diameters, muscle and fat areas and body mass index) show that in the girls the body fat mass is higher than in boys and american girls of the same age. The boys of professional men are fatter than the boys of workmen. The survey of food habits (using the method of frequency of occurrence for three days) shows that milk, eggs, legumes and cheese are not frequently consumed, while meat (particularly beef and veal), alcoholic beverages, animal fats and sucrose occur rather frequently in the diet. The excess of body fat mass and the biological and economic errors in the diet of these children need to be corrected with a nutrition education program. It is well recognized that both diet and physical activity play an important role in the prevention of metabolic degenerative disease and this prevention has to be started as early as possible.
The cattle industry in Canada has changed greatly over the past several decades. Size of the national dairy herd has reduced steadily but this reduction has been more than offset by an increase in the beef herd. As the dairy herd has decreased, the role of the Holstein has increased. The genetic improvement of the Canadian Holstein, based on selection procedures emphasizing progeny performance and mediated through increasing use of artificial insemination, has earned the breed a strong international reputation. This is reflected by the increasing international demand for semen. The strongest growth of the national beef herd occurred during a period of brisk import activity. Several of the new nonBritish breeds are now well established. Their advent on the Canadian scene rekindled interest in crossbreeding and systematic crossbreeding programs designed to make controlled use of heterozygosity are in the process of development. The new breeds of major importance at this time combine rapid growth rate with desirable carcass characteristics, specifically lean content. This, coupled with the carcass grade standards inaugurated in 1972, has resulted in improved efficiency of lean meat production. Importation activity has waned and a review of the production credentials of breeds not yet in Canada suggests little likelihood that they will contribute meaningfully to Canadian production. The numerous beef breeds now in Canada are presently undergoing a process of applied evaluation and relatively few of them seem destined to make a lasting contribution. The future of the cattle industry will be determined largely by economic developments. However, the ability of the ruminant to utilize food materials that do not compete directly with human demands should ensure an enduring future.
A short account is given of present views on urinary schistosomiasis or bilharziasis. The incidence of infections is increasing in endemic areas of Africa and the near east, as a consequence of irrigation programs and hydroelectric power development. Urinary schistosomiasis is a disease of children and young adults. The serious consequences, obstructive uropathy due to more or less irreversible ureteral lesions, and cancer of the bladder, less directly related to the infection, appear but later in life. Diagnosis is still based on parasitology and serology but ultrasonography has proven to be an important means to evaluate the extent of lesions of the urinary tract, especially in developing countries. Praziquantel was a major development in the medical treatment and cures easily the infection. Some irreversible consequences have however to be treated surgically. Schistosomiasis is still an important cause of morbidity and mortality in medically backward endemic countries. The control of the disease aims at reducing morbidity and mortality, consequences of the infection, rather than to avoid infection itself. It is based on mass treatment of school age children, together with focal molluscacides at places where people have contacts with water. Vaccination will be available in the near future and will be a welcome addition to other control measures, but will not be able to interrupt transmission on its own. Only economic development will solve in the long term this social African problem.
I very much agree with Marge Berer that feminists must recognize that there needs to be a population policy, worldwide and country by country, that encourages lower birth rates and that it is essential to start talking about population policies that respect and promote women's moral agency. Indeed I think it would be fair to say that the failure to respect and promote women's moral agency is the major reason why government-sponsored population policies have failed in the past. Male population planners habitually think of mass population as objects, rather than subjects, of population policy. This is why they think so readily of "incentives" or even more coercive methods. Birth control is thought of as a "war" to be imposed on the population, not as an integral part of the self-development of the people's own capacity to organize and become decisionmakers. If this is true in relation to the male population, it is even more so in relation to women. Population policy continues the basic male approach to women as bodies under their control, not as self-actualizing subjects. Until population policies take as their starting point women's human development as persons and moral agents in their own right, such policies both will be abusive to women and also will not "work." However, Marge Berer's remarks about oppressive, dehumanizing governments as incapable of promoting any other form of population policy give one pause. If this is the case, then neither national governments nor most international agencies linked to Western hegemonic neocolonialism can be the authentic promoters of feminist population policy. There must be a global effort to build parallel women's health organizations that work on the grassroots level with women, especially poor women, to empower these women themselves to become the leaders in educational and economic development of the women in their communities. Only in and through this larger context can such women both learn how to use and become empowered to use methods of birth control.
The role of socioeconomic and other cultural factors as determinants of fertility change has been widely discussed, with some scholars emphasising an inverse relation between socioeconomic development and fertility, others suggesting that no such relation necessarily exists, and yet others indicating that by using data from various sources it is possible to "prove" that a given country's crude birth rate has declined, remained unchanged or increased. Demographic data are presented on age-sex structure, completed and total fertility rates, and age specific fertility rates by age cohorts of women, from several small, anthropological population units of West Bengal, India and Upper Khumbu, Nepal, exposed to various physical and cultural environmental stresses. The data show that fertility has declined in most of the populations/subpopulations studied and that the decline may, deductively, be attributed to economic development via greater family planning practices.
A United Nations University study investigated the activities of four major United Nations agencies that focussed on helping developing countries gain advanced capabilities in biotechnology. Relevant program and project documents were scrutinized at agency headquarters and managers were interviewed. Then, projects underway in three case countries (Egypt, Thailand, and Venezuela) were examined. The resulting information was used to assess whether United Nations projects were fulfilling these countries' needs and (or) advancing their capabilities in biotechnology. The minute, United Nations originated assistance available was directed solely at increasing capabilities in research and thus benefited bioscientists and their institutes. However, as virtually no linkage exists between the research establishment and the industrial--marketing sector, results from indigenous research does not reach industrialists or health workers. Consequently, biotechnology is neither advancing economic development in the case countries nor helping solve national problems. This situation is likely to persist because corrective systemic changes will be difficult to implement. Major implications of these findings are discussed, particularly as they bear on the United Nations system.
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Researchers from Japan, China and Singapore have initiated a collaborative project, with the aim of comparing adolescent quality of life (QOL) internationally. This study presents the primary results of the investigation conducted in Beijing, China, and Kobe, Japan. The 70-item Quality of Life Questionnaire for Adolescents (QOLQA) was developed and evaluated in Japan and China. In total, 1114 Japanese and 613 Chinese junior high school students, aged 12-15 years, completed the questionnaire. Chinese students scored significantly higher than the Japanese students in overall QOL scores and in most domains. For both groups, subjects had highest score in the independence domain and lowest in psychological domain. In terms of overall QOL score, Chinese male students ranked first, followed by Chinese girls, Japanese boys, and Japanese girls. In the Japanese group, a continuing decrease of QOL scores with age was observed without exception, but no such tendency was present in their Chinese counterparts. No parallel relationship was observed between the higher level of economic development and better quality of life. The results also suggest that mental health promotion should be a priority in improving overall quality of life of adolescents both in Japan and China.
Health disparity by socioeconomic status has recently become an important public health concern. Socioeconomic status may affect health status through several pathways including lifestyle choices. The authors tested the link between socioeconomic status and lifestyle in China (in 1993) and in the United States (in 1994-1996), countries with high contrasts in development, to understand health discrepancy issues cross-nationally. Healthfulness of lifestyle was measured using the Lifestyle Index, a summary score that integrates four key lifestyle factors: diet, physical activity, smoking, and alcohol consumption. Income and education were used as indicators of socioeconomic status. In China, as socioeconomic status improved, lifestyle was less healthy (relative odds for the highest socioeconomic status group = 0.19, 95% confidence interval: 0.10, 0.35). Conversely, in the United States, higher socioeconomic status was related to a healthier lifestyle (relative odds for the highest socioeconomic status group = 3.81, 95% confidence interval: 2.94, 4.94). The contrasting relation between socioeconomic status and lifestyle depicts different phases of the lifestyle transition (changes in lifestyles accompanying economic development). The differences may in part explain why nutrition-related noncommunicable diseases are more prevalent in the developing world among people with a high socioeconomic status, whereas often the opposite is found in developed societies. Public health programs may benefit by advising each socioeconomic status group separately, while considering the country's level of development.