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PubMed1996

Notes on the socio-economic and cultural factors influencing the transmission of HIV in Botswana.

Botswana currently has one of the highest recorded incidences of HIV infection in Africa although AIDS was only first publicly recognized in 1985. By this time other countries in the region such as Malawi, Zambia and Uganda were already showing signs of epidemic levels of HIV. The rapid transmission of HIV in Botswana has been due to three main factors; the position of women in society, particularly their lack of power in negotiating sexual relationships: cultural attitudes to fertility; and social migration patterns. These three factors along with other, arguably more minor, ones have been shaped and mediated within the specific context of Botswana's rapid socio-economic development and cultural milieu. This has resulted in a constellation of factors unique to Botswana which accounts for the current high seroprevalence rate in the country.

Botswana↗

PubMed1987

Assisting the deficient resident in oral and maxillofacial surgery.

There are innumerable pitfalls in the intense learning process of residency training that may result in a deficient resident. These pitfalls run the gamut of human experience; physical, intellectual, psychological, social, and economic. Developing problems in any of these areas will affect the resident's clinical performance and his subsequent abilities as an oral surgeon. Helping the deficient resident requires the proper diagnosis of the underlying problem and a precise method of addressing the problem before the resident has missed his professional milestones. Ensuring the continuum of the learning process is the best means of overcoming deficiencies. As in any disorder, the best cure is prevention.

Attitude of Health Personnel↗

PubMed1984

International migration, non-traded goods and economic welfare in the source country: a comment.

"Labor emigration redistributes income in a two factor, two good economy where one good is internationally non-traded. Labor's nominal wage rises as nominal capital payments fall. Recent research has shown that the prices of non-traded goods rise, causing society's welfare to decline. Here the induced change in the real income of each factor is considered separately. There is an ambiguity with regard to the real income of non-emigrating labor. If labor spends a relatively small fraction of income on the non-traded goods, its real income may rise, even though society suffers the loss of welfare."

Costs and Cost Analysis↗

PubMed1987

Childhood burns in Zaria, Nigeria.

From 1971 to 1980, 429 children with burn injuries were admitted to the Ahmadu Bello University Hospital, Zaria. These were major burns in 275 patients, moderate in 82 and minor in 72. Fourteen of the patients were neonates, 102 infants, 228 were 5 years old or younger and 85 were older. Socioeconomic factors contributing to the injuries included the use of firewood for cooking at ground-level and for warming the house and body during the cold season; loose indigenous garments; thatch-roofed huts and the post-partum rituals of mud-bed heating and hot baths. Flame burns exceeded scalds with a seasonal frequency which peaked during the harmattan. In the absence of a 'burn's unit', burned children were nursed on the general ward together with other sick children by the same nursing personnel supervised by general surgeons. Complications included wound infection, respiratory distress, measles, malnutrition and tetanus. One-fifth of the patients absconded. Overall mortality was 13 per cent but 29 per cent of the neonates died. Preventive strategy should include public information, nursery school supervision, economic development and architectural improvements.

Adolescent↗

PubMed1988

Burns in adults in Zaria, Nigeria.

From 1971 to 1981, 245 adults with burn injuries were admitted to the Ahmadu Bello University Hospital, Zaria. The burns were major in 197 patients, moderate in 28 and minor in 20. Socioeconomic factors contributing to the injuries included the use of wood fires for cooking, for warming the body and the dwelling during the cool harmattan season, loose indigenous garments, thatch-roofed huts, petrol hoarding and epileptic seizures. Flame burns exceeded scalds with a high seasonal frequency in both men and women during the harmattan. Scalds occurred predominantly among the women, puerperal hot baths being a major cause. The overall mortality rate of 22 per cent is excessive. General economic development, architectural improvements, proper handling of petrol and kerosene, modification or abandonment of the puerperal ritual of hot baths, the maintenance of chronic epileptics on anticonvulsants and a programme of universal active immunization against tetanus would contribute to the prevention of burns and complications in adults and decrease the mortality rate.

Adolescent↗

PubMed1979

Patterns of retarded fetal growth.

The measurement of weight, length and head circumference at birth was used to document the size and shape of infants born at term in a population where mothers are relatively short and underweight. Different patterns of intrauterine growth are proposed to explain the variation in the infant's appearance at birth. Most of the small-for-gestational-age infants were proportionately stunted. This pattern of fetal growth is probably characteristic of infants born to undernourished mothers in economically developing communities, and reflects prolonged intrauterine growth retardation.

Adult↗

PubMed1984

Kat and its use: an historical perspective.

Of the many Old World plants or plant products which have potential for abuse, kat has probably been the least publicized in so-called more economically developed countries. Because kat has rather localized used and because, unlike opium and hashish it has no documented history or well-developed tradition dating from remote antiquity, few outside the confined areas of use even know about it. While kat has been, and still is, used in traditional medicine, it cannot boast of any great potential for development as a drug for use in Western societies. In short, the incentives for detailed, serious investigation until recently have been lacking. Even so, there is a considerable, albeit scattered, body of literature which might help provide renewed insights in approaching what is seen by some as an increasingly serious kat problem. A multidisciplinary historical overview of the use, abuse and sociology of this important plant is presented. Special emphasis is given to European early knowledge of, and evolution of attitudes towards kat use. Alleged past use and development of contemporary use patterns, effects, legal aspects, and chemical composition is covered from an historical perspective as well.

Africa↗

PubMed1996

The role of molecular techniques in the understanding of emerging infections.

Emerging infections are defined as infections that are newly identified or recognized, or those whose incidence in humans has significantly increased over the past 20 years. The interaction of several factors contributes to the emergence of infectious disease, including changes in human behavior, technological advances, economic development, increased international travel, microbial adaptation and lapses in public health measures. Biomedical research has allowed us to identify and classify previously uncultured pathogens, characterize microbial virulence factors, create new diagnostic tests and develop vaccines. Here, we highlight a few emerging infections and illustrate the role that molecular medicine has played in furthering our understanding of these diseases.

Bartonella Infections↗

PubMed2007

Relationship between quality of life and child traffic fatalities.

Traffic injuries are the leading cause of morbidity and mortality of children around the world. Economic development and quality of life are main components of public health. Using canonical correlation analysis, this study examined the relationship between quality of life and traffic fatality among children. Data were collected from 19 countries by using World Health Organization and OECD statistics. The results indicated that there is a strong relationship between quality of life and children traffic fatality. Growing quality of life has become protective against child traffic accident mortality. Increasing in gross national income per capita, life expectancy at birth number of years, road motor vehicles per thousand population, and share of persons of working age (15-64 years) in employment also increases children traffic safety.

Accidents, Traffic↗

PubMed2005

The National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention: a new administrative structure for schistosomiasis control.

Since more than 5 decades, the overall responsibility for the national programme on schistosomiasis control in China resides at the government level, i.e. Ministry of Health. Day-to-day activities are carried out by independent provincial parasitic institutes situated in the endemic areas. Along with the general economic development and the steady progress in the medical sciences, successful developments in control and research of the parasitic diseases in the country were achieved. This necessitated a corresponding reorganization of the administrative structures which has taken place at several levels. In January 2002, the Chinese Centre for Disease Control and Prevention was reorganized and the Institute of Parasitic Diseases in Shanghai became part of this new organization under the name of the National Institute of Parasitic Diseases to better reflect its new role. By assigning all administrative tasks regarding research and control of parasitic diseases under the umbrella of one administrative central laboratory, the new task force for epidemiological surveys and direction of parasitic control programmes is well suited to respond to the daunting challenges of the future. The new institution has only existed for a few years but has already become a well-functioning force with a broad contact net of national and international experts on research and control of parasitic diseases.

Academies and Institutes↗

PubMed2005

Socio-economic factors and health care system characteristics related to cancer survival in the elderly. A population-based analysis in 16 European countries (ELDCARE project).

The ELDCARE study aims to investigate, at the ecological level, the relationships between socio-economic variables and cancer survival in patients aged 65 years and over. Survival data for patients diagnosed during the period 1985-1989 and followed up to 1994 were provided by 43 European Cancer Registries in 16 countries participating in the EUROCARE 2 project. Relative survival was computed by Hakulinen's methods. Data on socio-economic factors were collected by national statistics offices for the years around 1991. Pearson's correlation was used to study the relationships between cancer survival and socio-economic factors. We selected four groups of variables. The first group included macro-economic variables (such as Gross Domestic Product, GDP; Total Health Expenditure, THE); the second, the main characteristics of national health care systems; the third, demographic factors; and the fourth, variables on labour market organisation. The countries with the largest proportions of elderly populations, in Northern and Western Europe, spent more on health than the less affluent countries of Eastern Europe. GDP was strongly related to THE but a very high variability in Computed Tomography Scanners (CTS) among countries with similar THE was observed. Indeed, those countries with THE around US 1500 dollars per capita had survival rates for breast cancer ranging from 67 to 82%. Cancer survival in elderly patients in Europe was most strongly related to GDP and THE, especially for good prognosis cancers. Survival was strongly correlated with health care technologies, particularly CTS, but not with health employment. Survival was positively correlated with proportion of married elderly people (and negatively with widowed elderly), suggesting a role played by social support in influencing the prognosis of elderly patients. These results highlight how health outcomes in the elderly are a complex phenomenon, not determined only by GDP and THE, but affected by social organisation and life habits as well as economic development conditions.

Age Factors↗

PubMedDate not supplied

Patentability of life and ethics.

Patent law has relied in part on ethical considerations since its inception in Europe. Such considerations have been introduced more recently in the United States. Whereas the EU Directive on the protection on the occasion of the Human Genome Project of biotechnological inventions was intended to foster economic development in Europe, its implementation is outweighted by controversy about patenting life and commercialization of science. The confusion created must be cleared at the international level through harmonization of patent office policies preventing abusive commercial practices in the absence of inventiveness.

Biotechnology↗

PubMed2006

Prevalence of type 2 diabetes mellitus of Chinese populations in Mainland China, Hong Kong, and Taiwan.

This article reviews and describes trends and differences in prevalence of type 2 diabetes mellitus of Chinese populations in Mainland China, Hong Kong and Taiwan based on literatures published in the MEDLINE Advanced database (January 1966-October 2005) in both Chinese and English languages. Chinese populations in Hong Kong and Taiwan have significant higher prevalence rates of diabetes than their Mainland counterparts, with odds ratios 1.5 (95% confidence intervals: 1.4, 1.7) and 2.0 (95% confidence intervals: 1.8, 2.2), respectively in 1995-2003 adjusted for age and diagnostic criteria. Using stratified diagnostic criteria; the odds ratios in Hong Kong and Taiwan were consistently higher than Mainland China for the periods of 1985-1994 and 1995-2003. A large proportion, i.e. 68.6% (95% confidence intervals: 67.4%, 69.7%) of diabetic patients remains undiagnosed in Mainland China as compared to 52.6% (95% confidence intervals: 49.8%, 55.5%) undiagnosed in Hong Kong and Taiwan. The prevalence rates of diabetes and impaired glucose tolerance of the Chinese populations rise in older age groups. In tandem with economic development and change toward lifestyle that is lack of physical activity and rich in high-fat diet, prevalence of diabetes of the Chinese populations are on the rise. If the undiagnosed individuals left uncontrolled, they are subject to higher risks of developing diabetes and its complications. These will increase the burdens of diabetes medically and financially.

Asian People↗

PubMed2006

Does the level of infant mortality affect the rate of decline? Time series data from 21 countries.

Some scholars have suggested that an inverse care law holds for infant mortality--that infant mortality reductions are more rapid in regions with lower infant mortality. This theory has not been subjected to proper quantitative analysis. This paper examines time series data on infant mortality from 21 countries to test whether percentage reductions in infant mortality are larger when infant mortality is lower. We apply the Dickey-Fuller generalized least squares (DFGLS) unit root test to infant mortality rate (IMR) time series data from 21 mostly European nations for 1870-1988 to test the statistical significance of beta in a regression analysis of Deltaln IMR(t)=alpha+beta ln IMR(t-1)+epsilon(t). Evidence that beta is significant and negative would support the claim that infant mortality declines more rapidly when substantial mortality reductions have already been achieved. With the preferred specification, the DFGLS unit root test rejected the inverse benefit hypothesis in all countries except the Netherlands at the 5% and 10% cutoffs and Australia at the 10% cutoff. The rejection of the inverse benefit hypothesis was robust to alternative specifications of the lag structure of IMR and to transformations of IMR other than logarithmic. Based on late 19th and 20th century data from countries in Europe and Latin America, there is scarce evidence that percentage reductions in infant mortality are generally smaller in higher mortality countries. These findings suggest that large percentage reductions in infant mortality are possible for countries at any stage in economic development and are reflective of durable advances in human knowledge, social institutions and physical capital.

History, 19th Century↗

PubMed2005

Nutrition and primary prevention of breast cancer: foods, nutrients and breast cancer risk.

Worldwide, each year approximately one million women are newly diagnosed with breast cancer (BC), in Germany 65 new cases per 100,000 inhabitants are registered, yearly. The fact that incidence has been rising in parallel with economic development indicates that environmental factors might play a role in the causation of BC. Migrational data have pointed to nutrition as one of the more relevant external factors involved. Preventive dietary advice often includes a reduction of alcohol, red meat and animal fat and increasing the intake of vegetables, fruit and fibre and lately, phyto-estrogens from various sources. Clearly, the scientific basis for these recommendations appears sparse. The available prospective data from epidemiological studies and interventional trials do not support the overall hypothesis that higher fat-intakes are a relevant risk factor for BC development, more important seems the relative distribution of various fatty acids. A non-vegetarian eating habit (consumption of animal products) per se does not elevate BC risk, while consumption of broiled or deep fried meats cannot be ruled out as a risk factor in genetically susceptible individuals. It appears prudent to abstain from regular and increased alcohol consumption. This should be particularly true for pubescent girls, in whom glandular breast tissue is particularly vulnerable. In general, if alcohol is consumed on a regular basis, a sufficient supply of fresh vegetables and fruit is essential. While there is no overall protective effect of a high fruit and vegetable consumption speculation remains over possible beneficial effects of certain subcategories, especially brassica vegetables like broccoli, cauliflower and cabbage. In essence, regional differences in BC incidence are probably partially attributable to life long dietary habits. There is no need to adopt a foreign dietary plan in order to protect oneself against BC. Traditional western diets also have their beneficial ingredients that should be regular constituents in our meals. Lignans from traditionally made sourdough rye bread, linseed/flaxseed and berries are local sources of potentially canceroprotective phyto-estrogens. Furthermore, indole-3-carbinol rich cabbage species might contribute to BC protection by diet. Nevertheless, clear cut recommendations for or against single nutrients or secondary plant metabolites are not yet possible, lacking sufficient data on individual bioavailability, safety and long term outcome. BC prevention by dietary means therefore relies on an individually tailored mixed diet, rich in basic foods and traditional manufacturing and cooking methods.

Alcohol Drinking↗

PubMed2004

Over one hundred years of trace metal fluxes in the sediments of the Pearl River Estuary, South China.

The rapid economic development in the Pearl River Delta (PRD) region in South China in the last three decades has had a significant impact on the local environment. Estuarine sediment is a major sink for contaminants and nutrients in the surrounding ecosystem. The accumulation of trace metals in sediments may cause serious environmental problems in the aquatic system. Thirty sediment cores were collected in the Pearl River Estuary (PRE) in 2000 for a study on trace metal pollution in this region. Heavy metal concentrations and Pb isotopic compositions in the four 210Pb-dated sediment cores were determined to assess the fluxes in metal deposits over the last one hundred years. The concentrations of Cu, Pb and Zn in the surface sediment layers were generally elevated when compared with the sub-surface layers. There has been a significant increase in inputs of Cu, Pb and Zn in the PRE since the 1970s. The results also showed that different sampling locations in the estuary received slightly different types of inputs. Pb isotopic composition data indicated that the increased Pb in the recent sediments was of anthropogenic origin. The results of trace metal influxes showed that about 30% of total Pb and 15% of total Zn in the sediments in the 1990s were from anthropogenic sources. The combination of trace metal analysis, Pb isotopic composition and 210Pb dating in an estuary can provide vital information on the long-term accumulation of metals in sediments.

China↗

PubMed2006

Ground-level ozone in China: distribution and effects on crop yields.

Rapid economic development and an increasing demand for food in China have drawn attention to the role of ozone at pollution levels on crop yields. Some assessments of ozone effects on crop yields have been carried out in China. Determination of ozone distribution by geographical location and resulting crop loss estimations have been made by Chinese investigators and others from abroad. It is evident that surface level ozone levels in China exceed critical levels for occurrence of crop losses. Current levels of information from ozone dose/response studies are limited. Given the size of China, existing ozone monitoring sites are too few to provide enough data to scale ozone distribution to a national level. There are large uncertainties in the database for ozone effects on crop loss and for ozone distribution. Considerable research needs to be done to allow accurate estimation of crop losses caused by ozone in China.

China↗

PubMed2005

Medicine, landscapes, symbols: "The country Doctor" by Honoré de Balzac.

This paper considers examples from research that has interpreted literary works including representations of topographical landscapes, in order to examine the geographical and social perspectives of the author, and of the society in which the author was living and working. We focus especially on the use of representations of therapeutic landscapes in literature to convey the author's perceptions of the aspects of social and physical environments that contribute to human well-being. The novel entitled The country Doctor (Le Médecin de campagne) by Honore de Balzac, first published in 1833, is the particular focus of this paper and we consider this book in the context of the historical period when it was written and other novels of the period which also portray doctors and medicine in varying ways. We present an interpretation of Balzac's novel which focuses on four themes arising from the discussion in the introduction of this paper: the symbolic use of ideas of 'therapeutic landscapes' to represent the 'heroic' role of the doctor; the link between landscapes and ideas of medicine and health, corresponding to the Hippocratic heritage; the representation, through images of salubrious landscapes, of planning and economic development and the role of the leader; the significance of the contrast between the 'therapeutic' rural world and the unhealthy urban settings found in Paris. We conclude that The country Doctor is interesting because of the ways that it reflects the three aspects of landscape (physical, social and symbolic) that Gesler (1998. In: Kearns, R., Gesler W. (Eds.), Putting Health into Place: Landscape, Identity and Well-Being. Syracuse University Press, Syracuse, NY, pp. 17-35 (Chapter 2)) has identified as central 'therapeutic' qualities. Not only does the book reflect a conceptual model of what a therapeutic landscape might be, but it also uses this landscape symbolically as an allegory for spiritual progress and redemption, and for medical and social advance. The novel represents a period of transition from traditional social values and prescientific medical theory towards modernization of society associated with the growing domination of medical science, which continued into the 20th century.

Books↗