Ethical, legal, and social implications of genomic medicine.
Explore the source record for details and available documents.
Genetic Privacy↗
SEARCH · Search PubMed
Results for “Government Programs”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Thabo Mbeki and the AIDS 'jury'.
This paper examines the debate regarding efforts by the South African government to control the spread of HIV infections, with particular reference to events surrounding the 13th International AIDS conference. We posit that the reaction of the medical, pharmaceutical, and media sectors to the stance by the President Mbeki on HIV control amounts to an over-simplification of a very complex issue. Empathy and sincere partnership are required to address South Africa's worsening AIDS situation.
Acquired Immunodeficiency Syndrome↗
DYNAMIC PROGRAMMING APPLIED TO CONTROL PROCESSES GOVERNED BY GENERAL FUNCTIONAL EQUATIONS.
Explore the source record for details and available documents.
Journal Article↗
Nuclear import of proinflammatory transcription factors is required for massive liver apoptosis induced by bacterial lipopolysaccharide.
Stimulation of macrophages with lipopolysaccharide (LPS) leads to the production of cytokines that elicit massive liver apoptosis. We investigated the in vivo role of stress-responsive transcription factors (SRTFs) in this process focusing on the precipitating events that are sensitive to a cell-permeant peptide inhibitor of SRTF nuclear import (cSN50). In the absence of cSN50, mice challenged with LPS displayed very early bursts of inflammatory cytokines/chemokines, tumor necrosis factor alpha (1 h), interleukin 6 (2 h), interleukin 1 beta (2 h), and monocyte chemoattractant protein 1 (2 h). Activation of both initiator caspases 8 and 9 and effector caspase 3 was noted 4 h later when full-blown DNA fragmentation and chromatin condensation were first observed (6 h). At this time an increase of pro-apoptotic Bax gene expression was observed. It was preceded by a decrease of anti-apoptotic Bcl2 and BclX(L) gene transcripts. Massive apoptosis was accompanied by microvascular injury manifested by hemorrhagic necrosis and a precipitous drop in blood platelets observed at 6 h. An increase in fibrinogen/fibrin degradation products and a rise in plasminogen activator inhibitor 1 occurred between 4 and 6 h. Inhibition of SRTFs nuclear import with the cSN50 peptide abrogated all these changes and increased survival from 7 to 71%. Thus, the nuclear import of SRTFs induced by LPS is a prerequisite for activation of the genetic program that governs cytokines/chemokines production, liver apoptosis, microvascular injury, and death. These results should facilitate the rational design of drugs that protect the liver from inflammation-driven apoptosis.
Active Transport, Cell Nucleus↗
AKAP12alpha, an atypical serum response factor-dependent target gene.
We recently identified three AKAP12 isoforms that are differentially regulated by distinct promoters. During a screen to identify molecular determinants distinguishing the activities of these promoters, we found a potential binding site for the serum response factor (SRF) in the promoter of the ubiquitously expressed AKAP12alpha isoform. SRF is an evolutionarily conserved transcription factor that governs disparate programs of gene expression linked to cellular growth and differentiation. Using a combination of reporter assays and RNA interference, we demonstrate that SRF is required for AKAP12alpha expression. SRF regulates the activity of the AKAP12alpha promoter through two conserved CArG boxes that bind SRF with different affinities. Unlike other SRF-dependent genes, AKAP12alpha is not regulated by growth or differentiation stimuli. Molecular analysis of the AKAP12alpha SRF-binding sites, or CArG boxes, indicates that sequences flanking these sites are the determinants of sensitivity to SRF-activating signals. Specifically, the AKAP12alpha CArG boxes are shielded from growth stimulation by the absence of a binding site for Ets transcription factors. Similarly, sensitivity to the differentiation-associated co-factor, myocardin, was also determined by responsive flanking sequence; however, unlike growth stimuli, sensitivity to myocardin was found to also be dependent on a consensus CArG box. Collectively, our data demonstrate that AKAP12alpha belongs to a novel class of atypical SRF-dependent target genes. Furthermore, we provide new insight into the role of flanking sequences in determining sensitivity to SRF-myocardin activity.
A Kinase Anchor Proteins↗
Schoolchildren's diets and participation in school feeding programmes in Jamaica.
OBJECTIVES: To describe food consumption during the school day of rural Jamaican children and participation in two government school feeding programmes. To determine factors which were related to these. DESIGN: Cross sectional. SETTING: 16 primary schools in rural Jamaica. SUBJECTS: 415 children in grades 2 and 5 (ages 7 and 10 years). RESULTS: Consumption of sweets, sweet drinks and snacks was high. Mean intakes at lunch were: energy 1537 kJ (SD 756), protein 10.4 g (SD 7.6) and iron 1.5 mg (SD 1.2). The mean energy intake was 17-20% of the daily requirement for this age group. Two types of school feeding programmes were available in the schools, one provided a cooked meal and the other a bun and milk. Median availability of school meals (as a percentage of children enrolled in the schools) over three terms was 24.6% (range 0-85.4%). Twenty per cent of the children participated in one or other programme. Poorer children were more likely to participate in the bun and milk programme (odds ratio 2.1, 95% CI 1.3-3.5) but children with more money to purchase food participated in the more costly cooked meal programme (odds ratio 2.4, 95% CI 1.3-4.6). CONCLUSIONS: Energy intakes at lunch in Jamaican children were somewhat below optimal levels and the reliance on sweets and snacks is an area of concern. Programme characteristics such as meal cost, may affect access to school feeding by poor children.
Analysis of Variance↗
A review of the MAFF Optimal Nutrition Status research programme: folate, iron and copper.
OBJECTIVE: The objective was to conduct a critical appraisal of research conducted within one of the UK government's research programmes, Optimal Nutrition Status, and to place the findings of this work in the context of the international research effort, to assist policy makers and advisers. Nine nutrients are addressed within the programme; the findings for three of these are reported here: folate/folic acid, iron and copper. DESIGN: To conduct the review, the researchers had access to all unpublished progress reports, submitted to officials, arising from the projects. The overall assessment criterion was whether the information generated by the research programme could be regarded as reliable experimental data of direct relevance to setting optimal dietary requirements for the particular micronutrients. However, findings were also assessed against specific scientific criteria concerning understanding of the bioavailability, interactions, development of functional markers and inter-individual variations in metabolism, for each of the nutrients scrutinised. RESULTS: The results of the review indicated that many important questions are indeed being addressed by the UK government's research programme, and that the work is contributing to the overall research effort being conducted world-wide on this important subject. CONCLUSIONS: Many major questions still need to be addressed before it will be possible to identify optimal intakes for various sub-populations. These priorities are summarised in the paper.
Copper↗
Relative efficiency of government and non-government organisations in implementing a nutrition intervention programme--a case study from Bangladesh.
OBJECTIVE: The Bangladesh Integrated Nutrition Programme (BINP) experimented with two models of delivery: the first model uses the Government of Bangladesh's (GOB) own management structure and the second uses the non-government organisations (NGOs) working in the local community. This study compares the relative efficiency of GOB and NGO management in the provision of nutrition services. DESIGN: A detailed costing survey was carried out to estimate the cost of delivering nutrition services from the Community Nutrition Centres (CNCs). The number of individuals enrolled, the number actually participating in the programme and person-days of service delivered were used as effectiveness measures. SETTING: Thirty-five CNCs were randomly selected from five BINP areas, of which 21 were in GOB-run areas and 14 in NGO-run areas. RESULTS: The cost of providing nutrition services per enrolee was US dollars 24.43 for GOB-run CNCs and US dollars 29.78 for NGO-run CNCs. CONCLUSIONS: Contrary to the widely held view, the analysis implies that the NGO facilities are not more efficient in the delivery of nutrition services when cost per person-days of service delivered is considered. The food cost component of BINP is so high that, irrespective of the delivery mode, policy makers should examine carefully the components of BINP in order to find the most cost-effective mix of services.
Adult↗
Salt iodisation and public health campaigns to eradicate iodine deficiency disorders in Armenia.
BACKGROUND: Iodine deficiency disorders (IDD) are endemic in the mountain regions of Armenia. Universal salt iodisation has been chosen as the control measure. OBJECTIVES: (1). To measure the prevalence of iodine deficiency in the Armenian population; (2). to evaluate household use of iodised salt; and (3). to monitor iodised salt promotion strategies. DESIGN: Cross-sectional study on a nationally representative sample of 2627 households, including 3390 children under five and 2649 women of fertile age. Cluster sampling design on four population strata: residents, refugees, rural and urban. RESULTS: Thyroid was palpable in one-third of the women, 6% of them having a visible goitre. Median of urinary iodine excretion in children was 139.5 microg l-1. One-third of the children showed low urinary iodine concentration. Iodised salt was consumed in 66% of the households. The national IDD control programme included modernisation of the Yerevan Salt Factory, legislative regulation of the iodine content of the salt, and public information by the media. CONCLUSIONS: Armenia was still an endemic zone for goitre in 1997. The iodine status of children under five in 1997 was not considered alarming even though 33% of them had low values of urinary iodine. After four years of intervention strategies, the use of iodised salt has increased by 17%. Further efforts should be made to control salt imports and to monitor IDD indicators in vulnerable groups.
Adolescent↗
Evaluation of malaria surveillance in Trinidad (1988-1998).
Explore the source record for details and available documents.
Evaluation Studies as Topic↗
Major change in the use of antibiotics following a national programme: Swedish Strategic Programme for the Rational Use of Antimicrobial Agents and Surveillance of Resistance (STRAMA).
In order to reduce inappropriate use of antibiotics and to counteract the increase in antimicrobial resistance in community-acquired and nosocomial infections, a national project was initiated in Sweden in 1994: the Swedish Strategic Programme for the Rational Use of Antimicrobial Agents and Surveillance of Resistance. In the first years the project focused on inappropriate prescribing of antibiotics to children with respiratory tract infections and on the surveillance of resistance in pneumococci. Statistics on antibiotic sales on a national and county level and for different age-groups were studied. Between 1993 and 1997 antibiotic prescribing was reduced by 22%, from 16.3 to 13.0 defined daily doses (DDD) per 1000 inhabitants/d. The reduction was most pronounced for children, 0-6-y-old, from 15.7 to 9.7 DDD/1000 children/d. Macrolides and amoxicillin/co-amoxyclav decreased most. There were large variations in antibiotic sales in different counties, and a decrease was also noted in counties starting from a low level. In the county with the highest sales in 1993, antibiotic prescribing to children was reduced by 40%. The national frequency of penicillin-non-susceptible pneumococci (MIC > or =0.1 mg/l) has not increased during the 1990s and the increasing incidence in southern Sweden seems to have been curtailed. During the period that the project has been running, a major change in the use of antibiotics, especially for pre-school children, has been achieved.
Child↗
Changing the way people think about health-enhancing physical activity: do mass media campaigns have a role?
Mass media campaigns are conducted to influence community norms around health behaviours, including physical activity. Campaigns can reach large populations at relatively low cost, to influence awareness, knowledge and beliefs through to intention and behaviour change. We reviewed 15 campaigns with an explicit focus on physical activity, and explored impacts upon a range of proximal and distal variables. Campaigns achieved high recall, with a median of 70% of the target group aware of the campaign. Increases in knowledge or attitudes to physical activity were found among half the campaigns that reported this measure. Few campaigns reported other proximal variables, such as saliency, beliefs, self-efficacy or behavioural intention. Increases in physical activity were reported among motivated sub-groups of volunteers, but few campaigns reported population increases in activity. Campaigns increase awareness of the issue of physical activity but may not have a population-level effect on behaviour. Campaigns should focus more on influencing proximal variables, such as social norms, to bring about long-term behaviour change. This should be seen as part of a broader strategy, including policy and environmental change. Evaluation designs that measure the full range of variables are preferred to an over-concentration on behaviour alone.
Exercise↗
Pesticide monitoring programme of the Ministry of Health of Brazil.
The structure of the recently introduced Brazilian government programme for monitoring pesticide residues in six major agricultural products is described. Residues found from the analysis of samples of tomatoes and strawberries are discussed in detail. The much greater frequency of detection of pesticide residues, many of which are not approved for use in Brazil, in produce being sold on the domestic market, as opposed to that produced for export, is of major concern. It is perceived that this new monitoring programme will become permanent and be used to underpin enforcement actions that will need to be taken to reduce the numbers of incidents of illegal residues occurring, particularly in fresh fruits and vegetables.
Brazil↗
Medical device evaluation in the United Kingdom: past, present and future.
The evaluation of medical devices in the UK has been through many changes since the early hospital equipment assessments in the 1960s. The range of medical devices evaluated has increased and the evaluation reports published have changed, but the evaluation programme continues to be a respected service for the NHS and social care. This review documents the history of the Device Evaluation Service, from its beginnings to the present day, and looks forward to its future. Following an independent strategic review and the Healthcare Industries Task Force (HITF) recommendations, the Device Evaluation Service is now entering a new and exciting developmental phase.
Equipment Failure Analysis↗
Strategy and actions for achieving productive aging in Japan.
The objective of this study was to develop basic strategies for determining the ideal form of corporate management that meets the needs of an aging work force, specifically with the intent to develop a method of calculating functional age, one of the determining factors of such strategies. A literature search was made of annual reports of research conducted jointly by the Association of Employment for Senior Citizens and Japanese corporations. We tested the physical, physiological, and psychomotor functions of 271 male workers ranging in age from 20 to 59, and we used the results to examine the means of creating a formula to calculate functional age. Many of the measures adopted by Japanese corporations to deal with aging involve job redesign. This category accounts for 58.5% of such measures in all research fields. Night vision, standing trunk flexion, timed vital capacity, systolic blood pressure, and jumping reaction time each have an important influence on functional age calculation.
Aging↗
Mainstreaming HIV/AIDS in development sectors: Have we learnt the lessons from gender mainstreaming?
Drawing on an international literature review, two international workshops and primary qualitative research in Uganda this paper reviews experiences of mainstreaming HIV/AIDS in development sectors (such as education, health and agriculture) in developing countries. The extent to which HIV/AIDS mainstreaming strategies and associated challenges are similar to or different from those of mainstreaming gender in the health sector is also explored. The paper details the rationale for HIV/AIDS mainstreaming through illustrating the wide reaching effects of the pandemic. Despite the increasing interest in mainstreaming HIV/AIDS there is little clarity on what it actually means in theory or practice. This paper presents a working definition of HIV/AIDS mainstreaming. It is argued that all too often processes of 'mainstreaming' emerge as too narrow and reductionist to be effective. The paper then considers four key challenges for mainstreaming HIV/AIDS and explores how and to what extent they have also been faced in gender mainstreaming and what can be learnt from these experiences. These are: (1) the limited evidence base upon which to build mainstreaming strategies in different country contexts; (2) the role of donors in mainstreaming and implications for sustainability; (3) who should take responsibility for mainstreaming; and (4) how to develop capacity for mainstreaming. The conclusion argues for more joined up thinking and sustainable approaches to mainstreaming both HIV/AIDS and gender.
Female↗
From scrubland to vintage wine: Australia's response to substance-related problems in the last 40 years.
Over the last 40 years Australia's response to substance-related problems compared with most western nations has been outstandingly good. Since the 1960s concerns about problems of substance use have expanded from a focus on alcohol to include tobacco and a wide range of other licit as well as illicit psychoactive substances. During this period there have been major advances in our knowledge and understanding of substance-related problems and effective methods of prevention, intervention and treatment. In parallel has been the development of a large number of non-government, government and professional organizations concerned with problems of substance use. These groups, individually and collectively, have contributed to the development of policies, plans, resources and programmes to prevent and minimize substance-related harm. Although significant progress in these endeavours took place between 1960 and 1986, there has been accelerated growth since and largely as a result of the establishment of the National Campaign Against Drug Abuse in 1986 and the ensuing National Drug Strategy and the Illicit Drug Strategy. However, much of this more recent success was possible because of the existence of the organizations, networks and infrastructures established in the earlier period and the Nation's general health, social and educational programmes. These initiatives have been associated with reductions in alcohol and tobacco use and related problems and evidence of reductions in some problem areas associated with illicit drug use. Despite these gains, there have been areas of failure and missed opportunities. Finally, it is critical to ensure that past achievements and opportunities for continued successful initiatives are not undermined by identifiable impediments and risks that could imperil the philosophy, goals, infrastructure and programmes that form the basis for Australia's success to date.
Adolescent↗
Community-based rehabilitation: the generalized model.
This article presents an overview of a generalized approach to rehabilitation services which have come to be known as community-based rehabilitation (CBR). The various administrative and government organizations that may be involved in the delivery of rehabilitation services are identified. Specific attention is given to the various forms of medical referral systems that might exist. In general, rehabilitation services are provided at the community level but more difficult cases, which require more sophisticated approaches, are referred to institutions more closely allied to a central government. This referral system also gives the disabled person access to more specialized personnel and services. The sources of information in this article consist of fundamental and formative primary references from documentation provided by the World Health Organization (WHO). These sources provide a valuable set of historical documents detailing the idealized concept of CBR.
Child↗