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[The significance of secondary prevention of cancer in China].

During past twenty years (1973-1992), the cancer mortality was increasing significantly in China. For cancer prevention and control nationwide, the primary prevention is important. Pity is that it usually takes longer time to decrease cancer mortality and liable to benefit younger generation. In practice, the secondary prevention, which put emphasis on the massive screening, early detection and early treatment, would decrease the cancer mortality as well as cancer incidences in relatively short time. Therefore, it would contribute much to the local social and economic development and improve the health insurance. In the high risk areas of cancers, such as cervical, esophageal, gastric, liver and nasopharyngeal cancers, the secondary prevention could be carried out as more effective strategy for cancer prevention in China.

China↗

Epidemiology and prevention of blood pressure-related renal disease.

AIM: To examine the relationship between blood pressure and end-stage renal disease. METHOD: Review of recent reports on blood pressure in relation to renal function. BACKGROUND: The incidence and prevalence of treated end-stage renal disease are increasing progressively in economically developed countries. To combat this problem, the treatment of established end-stage renal disease must be complemented by strategies to treat and prevent risk factors for the development of renal failure. RESULTS: Severe hypertension and malignant hypertension are well accepted as risk factors for renal insufficiency. Recent reports suggest a strong relationship between blood pressure and renal function, throughout the entire range of blood pressure. Most blood pressure-related renal disease can probably be attributed to mild hypertension or a high normal blood pressure. CONCLUSIONS: Additional clinical trials are needed to assess the value of different antihypertensive drugs and different levels of blood pressure control in preserving renal function in subjects at risk of blood pressure-related renal disease. Primary prevention of hypertension may be an important complement to the treatment of established hypertension in reducing the burden of renal disease in the community.

Humans↗

[Gender inequity in the access to health care in Chile].

BACKGROUND: In the last two decades, Chile has experienced advances in economical development and global health indicators. However, gender inequities persist in particular related to access to health services and financing of health insurance. AIM: To examine gender inequities in the access to health care in Chile. MATERIAL AND METHODS: An analysis of data obtained from a serial national survey applied to assess social policies (CASEN) carried out by the Ministry of Planning. During the survey 45,379 and 48,107 dwellings were interviewed in 1994 and in 1998, respectively. RESULTS: Women use health services 1.5 times more often, their salaries are 30% lower in all socioeconomic strata. Besides, in the private health sector, women pay higher insurance premiums than men. Men of less than two years of age have 2.5 times more preventive consultations than girls. This difference, although of lesser magnitude, is also observed in people over 60 years. Women of high income quintiles and users of private health insurance have a better access to preventive consultations but not to specialized care. CONCLUSIONS: An improvement in equitable access of women to health care and financing is recommended. Also, monitoring systems to survey these indicators for women should improve their efficiency.

Adolescent↗

Urban garbage disposal and management in China.

This paper, probing into the present situation of urban domestic garbage by analyzing its growing trend, compositional change and regional difference, reveals the problems existing in its disposal and management in China. Meanwhile, a questionnaire was conducted in five big cities around China for surveying urban residents' attitudes towards garbage disposal and management policies and measures. Results showed the output of urban domestic garbage in Chinese cities is ever increasing, and the recoverable materials and energy in garbage composition are also increasing. The population growth, economic development, and increase of residents' expenditure level are the main factors influencing the growing output and changing composition of the garbage. Information acquired from the questionnaire showed that majority of the urban residents are in favor of the garbage reduction policies and managerial measures and are willing to collaborate with municipal government in battling against garbage. Based on the analysis and questionnaire, some policymaking-oriented suggestions such as operating the garbage disposal from a social welfare service to a sector of profit-gaining enterprises, transferring the garbage management from passive end control to active source control, promoting the classified garbage collection in cities around China, and charging garbage fees for its cleanup and disposal, have also been put forward in the paper.

China↗

Effect of land-use and land-cover change on nutrients in soil in Bashang area, China.

The Bashang area is a water-source area and ecological barrier zone for Beijing and Tianjin. The area is located at 200 km from Beijing and Tianjin and is a typical agriculture-pasture-interlacing zone, in which the eco-environment is vulnerable and hence it is sensitive to environmental change. The area is relatively lagged in social and economic development, where the traditional cultivation mode is predominated in agriculture and animal husbandry, but the disturbance by human activity is relatively small. Therefore, in order to reveal the interrelation between eco-environmental change in the area and environmental change in Beijing and Tianjin area, it is fairly necessary to study the effect of land-use and land-cover change on nutrients in soil in this area. According to the actual situation of changed land use for the limited time period, five series of changed land plots were selected and 4 samples were collected from each series for the study. The samples were collected from different soil-forming levels at the same site in different time. Analysis of the collected samples indicates that in the process of change of land use and land cover, the nutrients in soil, such as organic matter, total N, total P, total K, and available N, P, K, and B, Mo, Mn, Zn, Cu, and Fe, have regularly changed. When the land had changed from grassland and non-irrigated farmland into woodland, and from non-irrigated farmland into irrigated field, the nutrients in soil totally increased. But there exists some exception, i.e. quick-acting N, P, K, and some microelements have appeared to be inconsistent with the mentioned above regularity in some cases.

Agriculture↗

[Analysis of different aspects of the health systems in Tunisia].

The health care system in Tunisia is composed of two sectors, public and private. Given the social and economic development level of the country, it can be said that the hospitals, health centers and workforce devoted to health are not severely limited. However, these structures are under-equipped and finance management is not relevant. The establishment of a National Health Service would render all the system more efficient.

Delivery of Health Care↗

[Selection of DSP points in second stage and their presentation].

The principal of selecting DSP points is discussed. Because social and economic development is not balance, developing level of health business and health situation of population are obvious varies in different areas of China. In order to ensure that health information from surveillance population can be used to infer health situation of national population, the feature of geographic, administrative areas and various health situation in different areas are considered. The principals of selecting DSP are: 1. To assure well-balance of geographic distribution of DSP. 2. To assure well-balance of distribution of DSP in different kind of areas, according to above 9 index, GNP, illiterate rate, birth rate, infant death rate, rough death rate, ratio of 0-14 years people to total people, ratio of about 65 years people to total people, ratio of labor in industry to total people, and ratio of labor in agriculture to total people. The way of select DSP is: Multistage stratified random sampling (PPS). Meanwhile in order to avoid systematic error, about 15% points which are no qualified were changed. Therefore whether data from DSP can be represented health level of population of whole nation has been tested. The conclusion is that the data from DSP can indeed do so.

Birth Rate↗

[Hodgkin's disease in childhood].

Only in these latest years has been possible to consider Hodgkin disease (HD) as a neoplastic syndrome, thank of immunohistochemistry and cytogenetic techniques which have confirmed the monoclonal origin of typical cellular marker of disease: the Reed-Sternberg cell (R-S cell). Interesting associations have been observed between children suffering from HD and the positivity of EBV antigen above all in the socio-economically developed countries. The histopathologic classification of HD is divided in four sub-types, with different incidence in the pediatric age: the nodular sclerosis and the mixed cellularity are more rap-presented than the lymphocyte predominance and mostly the lymphocyte depletion. Histopathologic classification is essential for the prognosis and a correct therapeutic approach to disease. The management of HD is based on chemotherapy and radiotherapy associated; the results of treatment are more and more encouraging with a global survival over 95%. Sequelae of treatment are reduced in modern therapeutic trials: in particularly injury to somatic growth, cardiopulmonary system, gonadal and thyroid functionality is reduced by using low dose and involved fields for the early stage patients. The most important sequela in children treated for HD is the risk to developed a second malignant neoplasm; in particularly acute nonlymphocytic leukemia and non Hodgkin's lymphoma. In patients treated with radiotherapy alone increase the risk to develop solid tumors like sarcomas and carcinomas, which can appears several years after diagnosis.

Child↗

Objectives underlying future patterns of work of national committees on vital and health statistics.

As a basis for considering the forms and patterns of national committees on vital and health statistics in the future, the author first discusses the six main objectives of national systems of those statistics. Turning then to the aims of the national committees themselves, he observes that such is the variety of statistcal needs in different countries in view of their different stages of economic development that the work of the national committees at present inevitably differs greatly from country to country and must continue to do so as development continues. However, the common purpose of the committees is to help in developing, or in strengthening, the statistical structure of each country. Any activity or objective of a national committee that furthers one or more of the country's objectives can be regarded as worthwhile and legitimate.

Health Services Needs and Demand↗

Present status of malaria control in Asia.

The author summarizes the information given by 13 governments-Afghanistan, Burma, Ceylon, China, India, Indonesia, Malaya, Netherlands New Guinea, Philippines, Portuguese India, Sarawak, Thailand, and Viet Nam-on their existing and proposed malaria-control programmes in response to a questionnaire prepared by WHO for discussion at the First Asian Malaria Conference, which was held in Bangkok in September 1953.Although in late 1953 nearly 46.5 million of the 271 million people living in malarious regions were protected against the disease, more than 224 million others were still unprotected.It is noted that residual-insecticide spraying-the basis of most campaigns-has significantly reduced spleen- and parasite-rates; that the minor opposition to spraying initially encountered in some places quickly disappeared as the benefits became apparent; that malaria control has resulted in general improvements in public health and has promoted socio-economic development; that anopheline resistance to the insecticides used has not been observed; that ten governments voiced the need for indoctrination of public officials concerning malaria control; and that there is a trend among governments to make financial provision for long-term malaria-control schemes.

Afghanistan↗

[Sociodemographic profile of the population seeking medical and hospital care in the region of the State of São Paulo, Brazil, 1988].

A descriptive, retrospective study of the socio-economic profile of the population seeking health services in a Northeastern region of the State of S. Paulo was carried out and the results compared with those of previous studies. A total of 126,297 patients discharged from 25 general hospitals of the region in 1988 were studied according to sex, age group, residence, source of financing and hospital indicators. The results of this study show that the distribution of the demand according to sex and age is similar to that known from the relevant literature. These results suggest that the regionalization of assistance, in spite of planning and of pertinent legislation, is unsatisfactory, strongly influenced by the presence of large urban centers and socio-economic development. Various sources of financing are used together with a considerable increase of private health insurance and a diminishing participation of governmental institutions over the years. The region studied presents a high rate hospitalization as well as rate of hospital bed utilization.

Adolescent↗

[A study of the mentally ill in institutions for homeless people in Tokyo].

Homeless problems associated with poverty may be considered almost resolved in Japan because of the post World War II economic development, but in large cities such as Tokyo the homeless are still being produced, a reflection of a variety of social problems. This study is based on an analysis of admission records of an institution for the homeless which was established in 1952 in Tokyo. Subjects are 2,122 single persons who were admitted between 1952 and 1985. Among these, 136 are mentally ill persons, who are the main subjects of analysis in this study. Results show that, which after 1970 the number of the mentally ill significantly increased, many of those people dropped out of the institution mostly because they were originally admitted directly from discharge from hospitals because there was no other place to go except the institutions, and also because the institution, originally meant to house street people who had been detained, did not offer appropriate programs for the mentally ill. A solution to these problems requires that roles of institutions for the homeless and subjects admitted be reconsidered. Institution staff should enrich programs designed for the homeless mentally ill and help them organize their social network and live in the community.

Adult↗

Age of entry into marriage and the date of the initiation of voluntary birth control.

It is widely known that modern economic development has been accompanied by the initiation and spread of effective limitation of fertility, and that generally the populations which experienced development at a late date also had a belated reduction in childbearing. Here a surprising relation is found between (and within) broad regions: the areas in which traditional age of entry into marriage was late were the areas in which marital fertility was reduced first.

Adolescent↗

Regional food diversity and human health.

Regions are significant for the way we understand and strategize food for health and economic development. They generally represent various food cultures and opportunities for food exchange based on proximity, historical linkages and complementarities. The example of North and West Africa represents an intersection of some of the most original of human eating experiences out of Africa and the enrichment of these by Arab traders, through the exchange of products, ideas, observations, beliefs and technologies. All of these will have encouraged diversity in food intake. However food diversity and, with it, biodiversity may not always have been recognized as important, and, therefore, secured and protected. Ultimately, food diversity cannot be sustained unless the food chain and the technologies to support it are environmentally appropriate. Cooking, without renewable energy sources, is a critical example. Additionally, human settlement has always required an adequate, a dependable and a safe water supply, although this same settlement tends to compromise these water characteristics. Water is a major factor in food diversity, whether as a source of aquatic food, or the basis of food production and preparation. The extent to which food diversity for human health is required will depend on the food component (essential nutrient and phytochemical) density of the foods represented. For example, fish, fresh lean meat, eggs and seed foods (grains, pulses, nuts) will reduce the requirement. Regional food diversity can support food diversity at the community level--where otherwise it might be fragile--by shared learning experiences, and by trade. Diversity can also be captured and enshrined in recipes with composite ingredients and by traditional emblematic foods--like soups and pies; and it provides the basis for food culture and cuisine. The evidence for food diversity (or variety) as a major factor in health has grown substantially over the last few years--as integrative indices of health like "maternal nutrition" and "successful pregnancy" (for example, through the inclusion of a variety of food sources of folate, increasing the bioavailability of iron, and the sustainable intakes of quality food protein and essential fatty acids); "adult mortality rates"; other "specific disease incidences" (like cancer, cardiovascular disease, diabetes and bone health) for "risk factors for disease" (like hypertension and abdominal fatness); and for "wellbeing" (palatable, enjoying and neurologically relevant food stuffs). Thus, there is an ongoing need to promote and maintain food diversity at the regional level and between communities.

Feeding Behavior↗

[Accumulation of heavy metals in the sediments of Shenzhen Bay, south China].

Heavy metals concentrations in marine sediment cores of Shenzhen Bay were measured, and the profile distribution characteristic of heavy metals was discussed. Combined with the 210 Pb dating results, the contamination history of heavy metals was studied in high resolution records, and the metal accumulation processes were also analyzed. The results indicated that the concentrations of heavy metals was relatively low compared with other area in the world, but the elements of Pb, Cu and Zn were obviously contaminated by anthropogenic impact. The rapid economical development of Shenzhen in the last 20 years and Hong Kong in 1960-1970s contributed much on accumulation of heavy metals in the sediments.

Geologic Sediments↗