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PubMed2003

Bioreactors for tissue engineering--a new role for perfusionists?

Tissue engineering is an exciting new area of medicine with rapid growth and expansion over the last decade. It has the potential to have a profound impact on the practice of medicine and influence the economic development in the industry of biotechnology. In almost every specialty of medicine, the ability to generate replacement cells and develop tissues will change the focus from artificial organs and transplantation to growing replacement organs from the patient's own stem cells. Once these organs are at a size that requires perfusion to maintain oxygen and nutrient delivery, then automated perfusion systems termed "bioreactors" will be necessary to sustain the organ until harvesting. The design of these "bioreactors" will have a crucial role in the maintenance of cellular function throughout the growth period. The perfusion schemes necessary to determine the optimal conditions have not been well elucidated and will undergo extensive research over the next decade. The key to progress in this endeavor will development of long-term perfusion techniques and identifying the ideal pressures, flow rates, type of flow (pulsatile/nonpulsatile), and perfusate solution. Perfusionists are considered experts in the field of whole body perfusion, and it is possible that they can participate in the development and operation of these "bioreactors." Additional education of perfusionists in the area of tissue engineering is necessary in order for them to become integral parts of this exciting new area of medicine.

Allied Health Personnel↗
PubMed2003

End of life care. Perspectives from families and caregivers.

In industrialized countries, there is growing attention to improving the quality of healthcare provided to patients with terminal or chronic illnesses as they near the end of their lives. Many patients in wealthy nations reportedly die in severe pain, but little has been documented about pain or suffering at the end of life in less economically developed nations. This qualitative study explores end of life concerns in the Caribbean among health professionals and people who had lost a loved one. It found that many patients with terminal illnesses chose to die in their homes where they could be cared for by family and/or friends, but that these patients endured much pain and their caregivers also suffered. In the absence of national or institutional policy on pain relief or end of life care, most of these patients and their caregivers seek spiritual comfort. This paper illustrates the need for health professionals and policy makers to do more to relieve suffering at the end of life.

Attitude of Health Personnel↗
PubMed1992

[Incidence of typhoid fever in our environment. Analysis in Guipúzcoa].

Based in 184 cases of Typhoid Fever bacteriologically demonstrated in the past 14 years (greater than 90% of all cases registered in the whole province), we have observed that, with the exception of some epidemic outbreaks, the disease has been constantly present during all these years, with a higher incidence between August and November. Salmonella typhi infected primarily young adults, its distribution being similar to the one among the general population. 49% of cases were males. The estimated incidence rate of the disease during this period was 2-3 per 100,000 population. A seroepidemiological study among healthy women with ages between 20 and 40 years showed a seroprevalence of anti-H:d antibodies greater than or equal to 1/40 of 1%. Although the epidemiological situation of Typhoid fever in our environment is not as bad as it has been referred in reports and textbooks, an effort is needed to situate the problem at the appropriate level, given our geographical situation and our economical development.

Adolescent↗
PubMed2004

[Connections between health/mental illness process comprehension and care technologies].

The history of humanity has registered conventions about illness and treatment, in a dialectics that is mediated by material and objective conditions, where health practices can be identified. In the field of mental health, conceptions of psychic sickening and therapeutics can be identified in different periods of political and economic development and in the organization of human society, since the origin of times to the contemporary period. This article proposes a connection between health/mental illness process comprehension and treatments, referring to the historical contexts in which they were/are registered and searches for the meaning of practices and their current social meaning.

Health↗
PubMed2004

[A virtual water analysis for agricultural production and food security].

Water resource demand is increasing with the population growth and economic development. Water resource problem for agriculture and food security have become one of the global focal points because of water resource scarcity. The concept of virtual water is useful to analyze and impair this problem. In this paper, virtual water implication was described, and international study progress about it was briefly reviewed. Furthermore, China's agricultural water scarcity and food security were analyzed. According to the grain import prediction and agricultural production conditions of China, the virtual water equivalents of China in 2010 and 2020 were evaluated, which were 88 x 10(9) m3 in 2010 and 95 x 10(9) m3 in 2020. With the function of virtual water to agricultural water stress, virtual water strategy was suggested to relieve agricultural production pressure from water resource and meet growing food demand as well as to promote water resource sustainability in China.

Agriculture↗
PubMed2004

Nutrition-related disease and death in Zhejiang Province?

In Zhejiang province economic development and changes in nutrition appear to have increased both life expectancy and nutrition-related chronic disease morbidity. Life expectancy is longer in urban populations than in rural and in both urban and rural females. From 1997 to 2002 urban females had an average life expectancy of 81.4 years. In 2002 the estimated incidence of ischaemic heart disease was higher in rural males and females whereas diabetes mellitus was higher in urban males and females. From 1990 to 2002 lung cancer had large increases in all groups, cancers of the oesophagus and stomach increased in rural males and females, and cancer of the large intestine increased 40 per cent in urban males. In 2002 deaths from cerebrovascular disease were much higher in rural males and females. Apart from differences in lifestyle factors between urban and rural, access to medical resources may also be relevant to the differences within the province in chronic disease rates and in life expectancy.

Adult↗
PubMed2004

Prevalence and determinants of overweight and obesity in Thai adults: results of the Second National Health Examination Survey.

To describe the prevalence of overweight and obesity and examine their relationship with socio-demographic factors in Thai adults. Using data from a cross-sectional survey, the National Health Examination Survey II (NHESII), the authors examined the prevalence of overweight (BMI > or = 25 kg/m2) and obesity (BMI > or = 30 kg/m2) in 3,220 Thai adults aged 20-59 yr. Univariate analyses and Logistic regression models were used to examine the association of overweight and obesity with socio-demographic and behavioral risk factors. The overall age-adjusted prevalence of overweight and obesity were 28.3% and 6.8% respectively, with a higher prevalence for women than for men (overweight: 33.9% vs 19.2% and obesity: 8.8% vs 3.5%). The prevalence of overweight and obesity was greater among older compared to younger people and among residents of urban (34.8% and 9.9%) compared to rural areas (26.4% and 5.9%). The prevalence of overweight and obesity varied by region in line with the level of economic development--Bangkok, Central, North, South and North-East. By using logistic regression analysis, overweight was associated with a number of characteristics as follows: age (per ten years increase) with adjusted Odds Ratio (OR) of 1.3; women 1.4; married 2.2; being a current smoker 0.4, and living in Bangkok and the central region 1.6 (compare to North-East). There was no clear difference in prevalence of overweight and obesity among education levels and type of occupation after controlling for other covariates. In conclusion, women of middle age, married, and living in Bangkok and the Central region, are at greater risk of overweight and obesity. Without effective lifestyle modification programs to curb these physiologic risk factors at population level, it is likely that related disease burden will ensue. Public health surveillance and intervention to modify the risk factors of excessive weight should be implemented.

Adolescent↗
PubMed2004

[Health of aged people living with siblings who are professional nurses in China from the view point of lifestyle and health condition].

PURPOSE: Since 1978 in China, rapid economic development has taken place and the nation's quality of life has improved through the introduction of reform-opening policies. Such change has caused new health problems, partially due to aging of the population, with increase in lifestyle-related diseases and environmental pollution, and also expansion of regional variation. In this study, diseases undergoing treatment (relevance) and lifestyles of the elderly living with siblings who are professional nurses were evaluated. METHOD: We conducted a study in 23 provinces to discern characteristics and factors related to lifestyle and situations of patients undergoing treatment. We analyzed 1,548 senior citizens (response rate: 82.1%) over 65 years old living with a sibling who is a professional nurse. The professional nurse provided the replying to the questions. RESULTS: 1. A total of 457 out of 597 males (76.5%) and 725 out of 951 females (76.2%) had diseases under treatment. Males over 75 years old suffered from arteriosclerosis, cerebrovascular diseases, and heart disease. Females over 75 years old suffered from arteriosclerosis, respiratory diseases, and eye diseases. 2. In both males and females over 75 years old (older elderly) there were no significant differences in the Health Practice Index (HPI) from persons under 75 (younger elderly). Older elderly were more likely to snack often. Among males and females, 5 of 8 health-practices, such as a napping and physical exercise, differed. Females were less likely to smoke and drink alcohol. 3. In both males and females, non-diseased participants had a higher HPI than that of diseased participants. This tendency was the same in both younger and older elderly. 4. Cluster analyses of patterns of diseases revealed that the 23 provinces could be classified into 4 areas. The HPI in areas with a low proportion of diseased subjects was significantly higher than that in areas with a high proportion of diseased. One of the areas' HPI appeared to be noticeably lower than that of the other 3 and the number of participants with low physical exercise was higher in this case. CONCLUSION: Our data indicate that individuals having a high HPI appear less likely to develop lifestyle-related diseases. In 4 areas divided by the cluster analysis of patterns of diseases, there were significant differences in HPI, smoking and physical exercise.

Activities of Daily Living↗
PubMed2004

Environmental impacts of two kind of ponds for shrimp production at Northwest Mexico.

Aquaculture offers a major opportunity for the economic development of Baja California Sur (BCS), Mexico. The severely limited freshwater supply and the geographic isolation of the state place limits on other productive activities. Despite the aridity, the natural vegetation of BCS is diverse and structurally complex with a high percentage (20%) of endemic species. In this work we compare the environmental impacts produced by two kinds of aquaculture systems: coastal ponds vs. inland ponds. Construction and operation of coastal ponds does not require destruction of the natural vegetation and, as is true for inland ponds. Coastal ponds are also compatible with conservation of mangroves, sea grasses and sensitive habitats for fish and mollusks. To reduce the negative impacts of aquaculture and to protect the vegetation of Baja California Sur, we recommend the use of coastal ponds for shrimp production.

Animals↗
PubMed2004

The malaria gap.

Although the correlation between malaria and poverty is apparent, the nature of the linkages in terms of directions and mechanisms of causation is less so, and different methodologic approaches provide widely divergent perspectives concerning the impact of the disease. Certain macroeconomic studies find that in highly endemic countries, malaria may be responsible for reducing economic growth by more than one percentage point a year. Microeconomic studies, which aggregate the cost per case, find a considerably smaller impact, generally less than one percent of annual per capita gross domestic product. The large gap between these estimates suggests economic externalities associated with malaria that make the burden much greater than the sum of the costs of individual cases. Both the magnitude of the burden and the channels through which malaria affects reduces income are important for policymakers. We explore this gap, examining diverse mechanisms through which malaria can affect long-term economic development.

Africa↗
PubMed2001

Doctor-patient relationships in global society. Informed consent in dentistry.

The concept for initiation of treatment only after the explicit consent of the patient, based on preliminary information, is the most important element determining the relationship between patient and doctor nowadays. The application of this concept in dentistry and its inclusion in the professional documents regulating these relationships needs more comprehensive and modern conditions-relevant analysis of ethical, legal and professional aspects of the problem. The purpose of the study was to define the modern view of informed consent and its application in dentistry in different social environment. The general and specific features of the evolution of the problem and the social practice in Bulgaria, The European Community and Northern America are discussed in the context of the global tendency for free movement of patients and mutual recognition of professional qualification. The results suggest that despite the different degree of social and economical development in different countries the interest in the problem grows significantly and harmonization of legislation for health protection is based on the new social decree in the construction of doctor-patient relationships. It is expected that the comparative studies in this field will promote the improvement of dentists' training and improvement of scientific and expert exchange in solving problems of patents' rights and professional ethics.

Dentist-Patient Relations↗
PubMed2004

China's public health-care system: facing the challenges.

The severe acute respiratory syndrome (SARS) crisis in China revealed not only the failures of the Chinese health-care system but also some fundamental structural deficiencies. A decentralized and fragmented health system, such as the one found in China, is not well-suited to making a rapid and coordinated response to public health emergencies. The commercial orientation of the health sector on the supply-side and lack of health insurance coverage on the demand-side further exacerbate the problems of the under-provision of public services, such as health surveillance and preventive care. For the past 25 years, the Chinese Government has kept economic development at the top of the policy agenda at the expense of public health, especially in terms of access to health care for the 800 million people living in rural areas. A significant increase in government investment in the public health infrastructure, though long overdue, is not sufficient to solve the problems of the health-care system. China needs to reorganize its public health system by strengthening both the vertical and horizontal connections between its various public health organizations. China's recent policy of establishing a matching-fund financed rural health insurance system presents an exciting opportunity to improve people's access to health care.

Capitalism↗
PubMed2004

[PAHs in airborne particles from Tianjin in winter season].

Total suspended particles (TSP) samples from 13 stations in Tianjin were collected and analyzed for polycyclic aromatic hydrocarbons (PAHs) during 2002 winter. There was significant difference in total PAH concentration among 13 samples. TSP samples from the east Economic Development Area and mid-north districts had the highest contents of PAHs, while Dagang Oil Field had the lowest PAH content. The urban area, south district, and Jixian county had the moderate contents of PAHs. Based on the measured concentration of the PAHs, BaP equivalent (BaPeq) were derived based on Toxicity Equivalent Factors (TEFs) of the PAHs. The total BaPeq values were similar among the samples. The contribution of PAHs with five or six rings contributed 90% of the total toxicity, while they accounted for only 50% of the total concentration.

Air Pollutants↗
PubMed2004

Body mass status of school children and adolescents in Kuala Lumpur, Malaysia.

Lifestyle and disease patterns in Malaysia have changed following rapid economic development. It is important to find out how these changes have affected the nutritional status and health behaviour of the population, especially school children and adolescents. Therefore a survey on school children's and adolescents' health behaviours and perception in Kuala Lumpur was initiated. This paper only reports the observed body mass status of the school children. A total of 3620 school children were selected in this survey using the method of multi-stage sampling. The students were surveyed using pre-tested questionnaires while weight and height were measured by the research team in the field. Using the cut-off of BMI-for-age >or= 95th percentile and <5th percentile for overweight and underweight respectively, there were a total of 7.3% of overweight students and 14.8% of underweight students. When analysed by gender; 7.5% of boys and 7.1% girls were overweight, while 16.2% of the boys and 13.3% of the girls were underweight. The youngest age group (11 years old) had the highest prevalence of underweight as well as overweight. With increasing age, the prevalence of underweight and overweight decreased and more children were in the normal weight range. The overall prevalence of overweight among the three ethnic groups was similar. However the prevalence of underweight was highest among the Indian students (24.9%), followed by Malays (18.9%) and Chinese (9.5%) (P <0.001). The results showed that both the problems of under- and over-nutrition co-exist in the capital city of Malaysia. The promotion of healthy eating and physical activities is required to address the problems of under- and over-nutrition in order to build up a strong and healthy nation in the future.

Adolescent↗
PubMed2004

[Landscape spatial changes in Shenzhen and their driving factors].

Based on GIS technology, the MSS image in 1978 and the TM images in 1986, 1990, 1995 and 1999 were used to study the landscape spatial changes in Shenzhen during the past two decades. The results showed that the regional landscape in Shenzhen changed dramatically, from a typical agricultural landscape to a rapidly urbanizing landscape. The percentage of cultivated land decreased from 31.06% to 2.67%, while that of built-up area increased from 0.33% to 22.52%. The landscape diversity index showed a tendency of increase in 1978-1995, followed by a decrease in 1999. The index of landscape contagion decreased firstly and then increased, and the landscape fragmentation index increased from 0.0042 to 0.0073. Modified fractal dimension index showed the same tendency as landscape contagion index. Human activity was the main driving factor for landscape change. The change of geometry shape of landscape patches was driven by the economic interests of individual economic cells, and that of spatial configuration of landscape components was associated with the allocation of industries. The diversity of the whole landscape was mainly associated with the natural and ecological conditions such as topography and landform, while its change was strongly affected by the whole level of social and economic development.

China↗
PubMed2004

Prevalence of self-reported myocardial infarction in a Greek sample: findings from a population-based study in an urban area (medical express 2002).

During the 1970s and 1980s, Greece was known as a country with low prevalence and incidence of coronary heart disease, compared to Western populations. However, during the past decades, the Greek population has experienced marked but uneven socio-economic development, as well as change in lifestyle habits. We assessed the prevalence of self-reported myocardial infarction (MI) in a sample of the general population, aged 20-94 years. The overall prevalence of self-reported MI was 4.1% (6.3% in men and 1.9% in women). The age-adjusted prevalence was found to be 3.6%, showing a threefold increase compared to 1980s. Age, gender (male), low educational level, obesity/overweight, hypercholesterolemia, diabetes, hypertension, smoking and origin were strongly associated with prevalence of MI. Our findings indicate that the prevalence of MI increased dramatically during the past years, reflecting the change in lifestyle habits that have gradually given way to "Western"-type diets and a more sedentary lifestyle. Therefore, the need for urgent intervention is considered essential in order to prevent a further increase of disease burden.

Adult↗
PubMed2004

Novel approach to cancer care prioritizes routine management of the 'sixth sign'.

Recognizing that issues surrounding pain, palliation, and behavioral health are often related in cancer patients, a group of specialists at Emory University has decided to work together under the umbrella of a new Quality of Life program. The aim of the program is to make sure that all cancer patients are routinely evaluated for depression, anxiety, pain, and other symptoms that can undermine treatment objectives, and to deliver individualized support in a timely fashion. While the mission of the program has nothing to do with economics, developers maintain there are financial benefits that go along with providing this kind of comprehensive care.

Cancer Care Facilities↗
PubMed2004

[The origins and foundations of social inequalities in health].

France presents the paradox of being the country where the health system has been ranked first in the world for its overall performance and where the inequalities of mortality among men are the highest in Western Europe. This reality is little known, in part because it is little studied. The authors show how the issue of health inequalities has been recently re-discovered by researchers and scientific institutions. They attempt to explain the reasons of the delay in comparison with neighbour countries, referring to its historical background. They explore how health inequalities, long considered as natural, have progressively been seen as social. The problem of definition and qualification is therefore of the utmost importance. Two conditions are necessary to speak of inequalities and not mere differences: the domain has to be socially valued (life or wellbeing, for instance) and the disparities must be hierarchical (social classes, occupational categories, etc.). Finally, the authors recall that the social inequalities in health are the result of structural inequalities which concerns all the fields of social activities and conditions and which reflects the level of social justice in a country at a specific moment of its history and economic development.

Europe↗