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PubMed2001

Reclaimed municipal wastewater--a potential water resource in China.

Due to water resource shortage and socio-economic development within twenty years, China faces serious problems of water supply and water pollution. Several criteria and suitable reclamation processes related to water reuse have been created in China, which are helpful to improve the situation of water scarcity. In the future, reclaimed municipal wastewater reuse will mainly be developed for urban and industrial use. Potential supply quantity of reclaimed water, quality of reclaimed water, and reclamation cost are favorable to potential reuses. Based on further public environmental education, on a relevant development of national and local standards for reclaimed water quality, and on an increase of sanitary rate, more and more planned reclaimed water reuse projects would be expected in China.

Agriculture↗
PubMed1975

Family planning in Bali.

Despite low per capita income and little evidence of economic development, the response to the government-sponsored family planning program in Bali has been remarkably favorable. After five years of government involvement, a total of 29 percent of eligible women are estimated to be using program methods, including 25 percent who have accepted IUDs, and 4 percent more are estimated to be using nonprogram methods. This level of performance is higher than in most other developing areas of the world. A number of the factors that might help to explain the success of the program in Bali are identified, and the future prospects for continued success are assessed.

Adolescent↗
PubMed2001

Recommendations for using fluoride to prevent and control dental caries in the United States. Centers for Disease Control and Prevention.

Widespread use of fluoride has been a major factor in the decline in the prevalence and severity of dental caries (i.e., tooth decay) in the United States and other economically developed countries. When used appropriately, fluoride is both safe and effective in preventing and controlling dental caries. All U.S. residents are likely exposed to some degree to fluoride, which is available from multiple sources. Both health-care professionals and the public have sought guidance on selecting the best way to provide and receive fluoride. During the late 1990s, CDC convened a work group to develop recommendations for using fluoride to prevent and control dental caries in the United States. This report includes these recommendations, as well as a) critical analysis of the scientific evidence regarding the efficacy and effectiveness of fluoride modalities in preventing and controlling dental caries, b) ordinal grading of the quality of the evidence, and c) assessment of the strength of each recommendation. Because frequent exposure to small amounts of fluoride each day will best reduce the risk for dental caries in all age groups, the work group recommends that all persons drink water with an optimal fluoride concentration and brush their teeth twice daily with fluoride toothpaste. For persons at high risk for dental caries, additional fluoride measures might be needed. Measured use of fluoride modalities is particularly appropriate during the time of anterior tooth enamel development (i.e., age <6 years). The recommendations in this report guide dental and other health-care providers, public health officials, policy makers, and the public in the use of fluoride to achieve maximum protection against dental caries while using resources efficiently and reducing the likelihood of enamel fluorosis. The recommendations address public health and professional practice, self-care, consumer product industries and health agencies, and further research. Adoption of these recommendations could further reduce dental caries in the United States and save public and private resources.

Dental Caries↗
PubMed2001

Southeast Asian perspectives on nutrition needs for the new millennium.

Over the last three decades, there has been significant changes in the lifestyles of commmunities, including food habits, and food purchasing and consumption patterns in the Southeast Asian region. As a result, there is a definite change in the food and nutrition issues in the region. Nutritional deficiencies in many of these countries are slowly being decreased in magnitude. On the other hand, the significant proportions of the population are now faced with the other facet of the malnutrition problem, namely diet-related chronic diseases. However, because of the different stages of socio-economic development, the extent of each of these extremes of the malnutrition problems varies considerably between the different countries in Southeast Asia. Nutrition needs in the new millennium would necessarily differ somewhat among these countries while at the same time, there would be a considerable amount of similarities. This presentation highlights several macro issues that countries in the region may focus on in the near future. Various intervention programmes have been undertaken by authorities to tackle the co-existence of twin faces of malnutrition in many developing countries. It would be desirable to have a blue print of such programmes and activities in the National Plans of Action for Nutrition (NPANs) . The NPAN should be more than a framework or a descriptive document. It should be a tool for action, an operational plan that sets out priorities; identifies projects and activities, with details of implementation such as what, how and when; designates responsibilities and accountability for the activities; identifies resource requirements and their source; and sets out the plan for monitoring and evaluation. One of the main obstacles in the formulation and effective implementation of intervention programmes in developing countries is the lack of comprehensive data on the extent of the problems in many cases and the causes of such problems specificy to the communities concerned. It is thus imperative to identify appropriate research priorities and conduct relevant studies. It is also important to have basic baseline data collected at regular intervals such as nutritional status of communities and dietary intake. To conduct all these activities, it is vital to ensure adequate funding, preferably through establishing a dedicated fund for research. There should be closer collaboration between countries in the region in all nutrition activities to enable sharing of resources, experiences and learn from the mistakes of others. One existing mechanism is through the ASEAN structure. The other existing mechanisms are through WHO and FAO. One other mechanism is through the International Life Sciences Institute (ILSI) Southeast Asian Branch. Closely related to this need for networking is the need for continuing harmonization of approaches to nutrition activities in the region. Current efforts in harmonisation include RDA, nutritional status assessment methodologies and dietary guidelines. Other areas of harmonisation in the near future include nutrition labelling and claims.

Asia, Southeastern↗
PubMed1975

The demography of the Kuwaiti population of Kuwait.

Kuwait has experienced a dramatic rise in national income since 1945, and its material standard of living is as high as that of any country in the world. The national population (Kuwaitis) is a stable and almost closed population comprising 45 percent of the total population of the state. The Kuwaitis, readily separable from the immigrant population, both de facto and de jure, have a very low level of mortality but retain their traditionally high level of fertility. It is suggested that this largely unaltered pattern of fertility is a function of the peculiar form of economic development to which Kuwait has been subjected and of the strongly pro-natalist pressures associated with Arabic Islam.

Adolescent↗
PubMed2001

[Receptivity of the Tunisian to malaria after its eradication: analysis of the situation for adequacy of the surveillance].

In Tunisia, there has been no local transmission of malaria since 1979. Although the disease has been eradicated, its re-emergence is not considered impossible. An epidemiological evaluation has been conducted in order to evaluate the current level of receptivity. A. labranchiae and A. sergenti, the former vectors of malaria in the country, are still present and the anopheline population in the country is increasing following the building of dams and manmade lakes. It is hoped that Tunisian vectors are refractory to sub-Saharan strains of malaria parasites. According to the data collected regarding malaria history, climate, geography and socio-economic development, we assume that the receptivity level of the country is low and the risk of re-emergence of local foci is small.

Aedes↗
PubMed2001

Social context, stressors, and disparities in women's health.

OBJECTIVE: to describe stressors experienced by women living in an economically disenfranchised urban community and test the relationships between those stressors and women's self-reported health status. METHODS: We used a stress process framework to examine the implications of economic divestment and race-based residential segregation on the lives and health of women raising children in Detroit. We conducted qualitative analysis of in-depth interviews with 48 community residents and surveyed 679 women raising children in this community. Regression models controlling for age, education, and income examined the relationships of each of these stressors to symptoms of depression and general health status. RESULTS: Stressors described by women in the in-depth interviews included financial, work, family, safety, police and other municipal services, and disrespect or unfair treatment. Financial, police, and safety stress and unfair treatment were significantly associated with symptoms of depression; financial and family stress were significantly associated with self-reported general health status. CONCLUSION: Our results support the hypothesis that life stressors associated with economic divestment contribute to the disproportionate burden of disease experienced by African-American women residing in urban communities. Efforts to address racial and socioeconomic disparities in women's health should include policies that support economic development and municipal infrastructure as fundamental to the maintenance of health.

Adult↗
PubMedDate not supplied

An approach towards public health and foodborne human listeriosis--the Austrian Listeria monitoring.

The Institute for Milk Hygiene, Milk Technology and Food Science has launched a Listeria monitoring for Austrian cheese factories in 1988 which is nowadays a valuable tool to control the safety of cheese production. It is a means to qualify the proper hygienic conditions in the participating cheese plants. Proper hygiene protects cheese plants from getting contaminated by L. monocytogenes. The preventive elimination of foodborne pathogens facilitates a thriving economical development of the domestic cheese industry as contamination by L. monocytogenes may lead to a stop of delivery, product recall and other costly measures. This report comprehensively describes the principle of the monitoring including a description of the microbiological and molecular tools. It summarizes data on the detection frequency of Listeria contamination with respect to the different matrices under investigation. Furthermore an overview is given on the course of 17 contamination periods in 10 cheese plants and the outcome of the decontamination endeavours is described. Apart from epidemiological investigations, this report summarizes data regarding molecular species confirmation in the genus Listeria as the species assignment was comparatively examined by both conventional microbiology and molecular tools. Genotyping by Pulsed Field Gel Electrophoresis was applied in three plants which were confronted with a long term contamination period. The data presented in this paper rely on results which were collected through a decade of investigation (1990-2000).

Animals↗
PubMed2001

[History of the onset and spread of sleeping sickness in Bipindi (southern Cameroon), from 1896 to today].

The aim of this article is to provide historical background on the onset and spread of sleeping sickness in the Bipindi area of southern Cameroon, from the first suspected cases in 1896 until today. Two recent events have created the need for historical perspective on this topic. In December 1994, an OCEAC mission led by Francis Louis discovered 7 cases in the area between the Lolodorf and Bipindi districts. The epicentre was the village of Bidjouka. Five years later, mass screening of all residents in the Bipindi district revealed a total of 44 cases. Although no previous medical studies are available, historical research indicates that the disease has always present in Bipindi area in a less prevalent and virulent form than in neighboring regions along the Nyong River. Bipindi is located about 140 kilometers northeast of Campo, an area on the border between Cameroon and Equatorial Guinea where sleeping sickness has been a low-grade health problem since the 1880s. Many Cameroonian refugees forced to live in Campo during a war that ended in February 1916 returned with the trypanosome and subsequently contaminated people who stayed in Bipindi. Transmission of sleeping sickness in Bipindi can also be attributed to economic development since the end of the nineteenth century. Numerous plantations have been installed in the area. Migration and trade with the Gulf of Guinea have expanded greatly, especially involving areas on the border between Cameroon and Equatorial Guinea. This study is based on written documentations obtained from the National Archives in Yaoundé (Cameroon) and the "Colegio Claret" Library, in Luba (Republic of Equatorial Guinea) and on firsthand reports from reliable sources in the Bipindi area.

Agriculture↗
PubMed1998

Childhood injury prevention in Hong Kong Hong Kong Childhood Injury Prevention Research Group.

Injury is a major health problem in Hong Kong children. During the past two decades, injury and poisoning have surpassed infectious diseases as the leading cause of childhood mortality in Hong Kong. These two are also the leading cause of childhood disability. In 1995, injury and poisoning caused approximately 2% of the deaths among children aged 0 to 1 years, 26% of the deaths among children aged 1 to 4 years, and 36% of all deaths of children aged 4 to 14 years. Road traffic accidents, drowning and submersion, and accidental falls accounted for 30%, 20%, and 20%, respectively, of all deaths from unintentional injury in children younger than 15 years of age. Exact morbidity figures for injury and poisoning are not available but injuries are known to account for approximately 30% of paediatric attendances at the accident and emergency departments of regional hospitals, 20% of all hospitalisations among children, and 65% of surgical or orthopaedic admissions. It has been estimated that approximately 2.9% of children will be admitted to hospital for an injury at least once before their fourth birthday. Hong Kong is a small, highly urbanised, and densely populated place that has undergone tremendous socio-economic development in the past three decades. The pattern of injuries has changed and shows some special characteristics. Information on the extent of the problem, the type of injury, and contributing factors are scarce. Preventive measures are reactive in nature, piecemeal, and usually not subject to evaluation. It is recommended that childhood injury prevention be accorded a high priority, child safety be given prime consideration in all policies involving children, and more research be conducted.

Journal Article↗
PubMed2001

[Malarial vectors in French Guiana: study in an epidemic focus near Cayenne (1989-1998)].

Malaria has long constituted a major public health problem for French Guyana, limiting its demographic and economic development. From 1949 to 1960, due to chemoprophylaxis and DDT spraying in houses, the number of malaria cases decreased markedly. After 1975, important migratory movements contributed to increasing the incidence of malaria. In 1989, numerous cases were observed when some 500 immigrants settled in a formerly uninhabited area, known as Cabassou BP 134. It is located 7 km (S-E) from the main city of Cayenne and bordered by secondary forest and swamps. The entomological study initiated in 1990 included weekly biting-landing catches (3 hours) on human bait in houses from dusk onwards as well as locating breeding places around the settlement to collect larvae by dipping. Anopheles specimens were identified and the females dissected to detect infections by Plasmodium and also to determine the rate of parous specimens. Control measures included deltamethrin (15 mg/m2) and DDT (2 g/m2) spraying, every four months, of interior walls and thermal fogging of naled around the houses. Cold ULV aerosol of fenitrothion (500 ml/ha) was also used to treat the swamp borders. In April 1990, a health education programme was begun and in June, 288 impregnated bednets (deltamethrin 15 mg/m2) were treated. From 1990 to 1998, 1,588 (498 larvae + 1090 adults) Anopheles (Nyssorhynchus) were collected: An. aquasalis 797 (311 L + 486 A). An. braziliensis 139 (87 L + 52 A). An. darlingi 652 (100 L + 552 A). No infected female was found among the 710 dissected. The number of malaria cases decreased abruptly in the fall of 1990 when An. darlingi disappeared and only one case due to P. vivax was detected between 1995 and 1998. An. darlingi (parous rate = 72%) appears to be the main if not the sole vector of malaria in this locality. As in the past, a focus of malaria appears when immigrants from endemic countries settle in a formerly uninhabited place where An. darlingi are breeding.

Animals↗
PubMed2002

[How beds for tuberculosis be provided and utilized?].

In 1951 when TB Control Law was legislated, and the government of Japan started intensive TB programme mainly consisting of mass health examination, BCG vaccination and distribution of appropriate treatment for TB cases, there were about 100,000 beds for TB, similar to the number of then TB deaths, and many TB patients died before admission to sanatoria. Urgent measures were taken to increase beds for TB with a target of 250,000, 2.5 times of then TB death. The target was achieved in 1957. Thereafter, the number of beds for TB as well as the occupancy rate had decreased with the decline of TB, and then policy on beds for TB could be summarized as follows: (1) top priority was given to increase the number of beds for TB, (2) general hospitals were improved with the progress of medical science and economic development, while no improvement was done on TB beds with the assumption that the need for TB beds will soon disappear, (3) minimum unit of TB beds was a TB ward with generally 40 to 50 beds, (4) an idea to provide TB bed in a general hospital came out only since 1992 as a small model project, (5) it was intended to segregate infectious TB patients from the community, however, no consideration was made about super-infection among patients themselves and the infection to health care workers, (6) admission of TB cases to a general bed and admission of non-TB cases to a TB ward was not legally permitted, (7) cost for TB treatment was set on a low level. Recent data indicate that the occupancy rate of TB beds was 43.5%, and the average stay in TB beds is still slightly over 100 days, and observing by prefectures, marked differences were seen. Taking into account changes in the pattern on TB patients such as aging and the increase of cases with serious complications and most health care workers in TB wards are not yet infected with TB, it is needed to divide TB beds into two types, one for new cases and the other for chronic cases. Beds for new cases should be provided in principle as a single room in a general hospital with good ventilation system, and DOT should be started in a hospital. Stay in this type of bed should not exceed 2 months, and higher medical fee should be provided. Beds for chronic cases could be provided in a TB ward. MDRTB cases are admitted in bed for chronic cases, however, preferably in a single room, and if active intervention such as chest surgery is tried in a few sophisticated hospital, medical fee for acute bed should be applied. Now, we have to change our mind from old concept of beds in TB ward to a TB bed in a single room with good ventilation.

Health Facility Planning↗
PubMed2002

Association of changes in the pattern of urinary calculi in Taiwanese with diet habit change between 1956 and 1999.

OBJECTIVE: Due to rapid economic development over the past four decades, urinary stone components may have changed in Taiwan. We studied the changes in urinary stone components over time and the possible association with dietary changes during the same period. MATERIALS AND METHODS: From 1956 to 1999, 9,715 urinary calculi were collected at a single institution and analyzed using polarizing microscopy. Dietary information was obtained from an official national report. Linear regression was used to analyze the possible correlation between the change in stone components with daily consumption of animal protein, vegetable protein, and lipid. RESULTS: Eleven distinct components were identified. Calcium oxalate (Jensen type I stone; found in sterile, acidic urine) was found most frequently (87.3%), and its incidence increased gradually with time. However, the incidence of Jensen type III stone (caused by metabolic abnormality) gradually decreased from 1956 to 1999. The male to female ratio among subjects was 2.3:1, and the modal age was in the forties. Female patients were more likely to suffer from type II stones (found in infected, alkaline urine), whereas type I and III stones were more prevalent in males. Among the dietary components, consumption of animal and vegetable proteins and lipid increased significantly during the same period, and appeared to be coincident with the increased incidence of type I stones during the study period. CONCLUSIONS: Patterns of urinary tract stones in Taiwan have progressively changed in the past four decades and are now similar to those in western populations. The incidence of type I stones has increased during the past four decades, which may reflect the Westernization of dietary habits in Taiwanese during the same period.

Adult↗
PubMed2002

[Obesity and osteoporosis: effect of weight variation on bone mass].

Obesity and osteoporosis are both chronic conditions with multi-factor aetiologies and a considerable associated level of morbidity and mortality. They are endemic in economically developed countries. Various epidemiological studies have indicated an overweight condition to have a protective effect on the occurrence of osteoporotic fractures, but the data available on the effects of weight loss on the conservation of bone mass are scant and fragmented. The present review attempts to give a critical assessment of the published trials that have analyzed the evolution of bone mass during the administration of low calorie diets to obese females, as well as to identify those aspects that would deserve special attention in the planning of future research in this field.

Body Weight↗
PubMed1999

[Analysis on the dietary lipid pattern in different areas of China].

Based on the "Total Diet Study" conducted in 1990, food samples from urban and rural inhabitants in the four regions of China(North I, North II, South I and South II) were analyzed separately. The results showed that, except the status in South II, the amount of fat and cholesterol intake existed obvious differences between urban and rural inhabitants in the same region. The dietary fat and cholesterol intake of rural inhabitants in North II region was obvious inadequate. Dietary fat intake of urban inhabitants was high and the cholesterol intake was higher than the level of 300 mg per capita. The results showed that the ratio of polyunsaturated fatty acids was relatively low but the ratio of monounsaturated fatty acids was relatively high for dietary fat in two southern regions. It might be beneficial to increase plant oil which contains high amount of polyunsaturated fatty acids for the inhabitants in southern regions. From these results, we concluded that the dietary lipids intake of Chinese inhabitants was generally appropriate. Considering the great difference in economic development and dietetic culture, the dietary suggestions should be different regions to regions.

Cholesterol↗
PubMed2002

Health beliefs and practices in rural El Salvador: an ethnographic study.

OBJECTIVE: To investigate the health practices and lifeways of rural villagers in a remote area of El Salvador who had been displaced by the recent civil war. The purpose of the study was to explore their view on health and experiences of loss during the war. DESIGN: Ethnography (Spradley, 1980, 1999; Agar, 1996). METHOD: The participants included any resident of three rural Salvadoran villages who were 18 years of age and over. Participants included nine families, with a total of twelve participants. Data collection included participant observation, audiotaped interviews, demographic information, and field notes. One of the Spanish-speaking key informants acted as the interpreter. The content of all data was analyzed for recurrent themes. FINDINGS: All nine families were displaced to refugee camps in Honduras during the civil war. Two cultural themes that emerged from the data were: 1) War: "We lost everything; we had to leave running," and 2) Health: "It's in God's hands." CONCLUSIONS: It is a challenge to encourage culture-specific care that acknowledges Salvadoran herbal remedies, strength of spirit, and a belief that a Supreme Being controls their lives. The health practices of the participants were shaped by their experiences of suffering from loss of family members during the war, displacement from their homes, and lack of potable water and environmental sanitation. IMPLICATIONS: To make a positive impact and effect change on health services in these rural areas, efforts should be directed toward democratic and community-based social and economic development within the context of the cultural system. Recent earthquakes (2001) have intensified the need for improvement in environmental factors including potable water.

Activities of Daily Living↗