RESUMO
PIP: According to research conducted in Chile, the Dominican Republic, Egypt, Finland, Singapore, Thailand, and the US, the levonorgestrel contraceptive implant Norplant offers up to 7 years of effective protection from pregnancy. The research involved two independent studies of 1210 women aged 18-40 in the seven countries using soft-tubing as well as hard-tubing Norplant implants. Overall, results indicated that cumulative 7-year pregnancy rates among Norplant users are comparable to rates among women who have been surgically sterilized. Moreover, among women ages 18-33 the 7-year Norplant pregnancy rates are comparable to the median rates of tubal sterilization methods for women of the same age and duration of use. For women ages 34 and older, without regard to weight at admission, the 7-year effectiveness of soft-tubing Norplant equals or surpasses that of tubal sterilization.^ieng
Assuntos
Anticoncepção , Estudos de Avaliação como Assunto , Levanogestrel , Segurança , África , África do Norte , América , Ásia , Sudeste Asiático , Região do Caribe , Chile , Anticoncepcionais , Anticoncepcionais Femininos , Países Desenvolvidos , Países em Desenvolvimento , República Dominicana , Egito , Europa (Continente) , Serviços de Planejamento Familiar , Finlândia , Saúde , América Latina , Oriente Médio , América do Norte , Saúde Pública , Países Escandinavos e Nórdicos , Singapura , América do Sul , Tailândia , Estados UnidosRESUMO
The Inter-Health Programme was launched in 1986 by WHO, with the collaboration of a coordination centre (National Public Health Institute, Finland) to control and prevent chronic noncommunicable diseases (CNCDs) among adults. Programmes for action were organized based on the concept that most major CNCDs share common risk factors and that those that are lifestyle related are modifiable through efficient interventions using multifactorial strategies involving community participation and behaviour changes carried out at the primary health care level. Twelve countries from all WHO Regions have joined the programme. A baseline survey was undertaken in all countries with a common protocol, following the criteria and methods employed in the MONICA Project. Altogether 36815 men and women aged 35-64 years were included in the present analysis from the following Inter-Health countries: Chile, China, Cyprus, Finland, Lithuanian SSR, Malta, Mauritius, Russian SFSR, United Republic of Tanzania, and USA. In addition to individual country analysis, centralized analysis was carried out at the Finnish National Public Health Institute and the Department of Community Health, Kuopio University, Finland. Reported here are the mean values of blood pressure, body mass index, and serum total cholesterol as well as specific prevalences of smoking, hypertension, obesity, and hypercholesterolaemia.
PIP: The Inter-Health Program was launched in 1986 by the World Health Organization (WHO) with the collaboration of Finland's National Public Health Institute to control and prevent chronic noncommunicable diseases (CNCDs) among adults. The program consists of interventions designed to modify the levels of the major risk factors of CNCDs in the community through an integrated, community-oriented approach to health promotion and maintenance. 12 countries from all WHO regions have joined the program. The effects of intervention activities were measured by examining changes in the status of risk factors in populations before and after a given intervention. A baseline survey was conducted in all of the Inter-Health countries with a common protocol to identify the relevant risk factors. 36,815 men and women aged 35-64 from Chile, China, Cyprus, Finland, Lithuania, Malta, Mauritius, Russia, Tanzania, and the US were surveyed. This paper reports the mean values of blood pressure, body mass index, and serum total cholesterol as well as specific prevalences of smoking, hypertension, obesity, and hypercholesterolemia.
Assuntos
Doença Crônica/epidemiologia , Inquéritos Epidemiológicos , Adulto , Estudos Transversais , Países Desenvolvidos , Países em Desenvolvimento , Feminino , Indicadores Básicos de Saúde , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Organização Mundial da SaúdeRESUMO
PIP: The Swedish International Development Cooperation Agency (SIDA) has created an Action Program for Promoting Equality Between Women and Men in Partner Countries that emphasizes competency development as a means of achieving gender equality. Competency development goes beyond formal training and utilizes existing entry points while creating innovative ones. SIDA's partnership approach requires clear delineation of roles for SIDA personnel and partner countries, with SIDA 1) applying a gender perspective to assessments, 2) initiating a constructive dialogue about gender equality if needed, 3) assessing the need for gender equality promoting competency development, 4) studying the local context, and 5) developing effective local networks. In addition, the needs of different groups within SIDA should be met with appropriate competency development inputs while SIDA continues support to competency development in partner countries by developing local capacity for gender training and gender sensitization at the regional and national levels. At SIDA, gender training has evolved since 1989 to its current focus on the practical and concrete challenges facing participants. In addition, departments and divisions conduct sector- and issue-specific training, and gender equality is integrated in all SIDA training activities on every topic. The challenges for future competency development are to 1) increase the number of men involved in provision of competency development inputs, 2) improve competency at embassy and field levels, and 3) improve competency in policy dialogues.^ieng
Assuntos
Países em Desenvolvimento , Planejamento em Saúde , Mão de Obra em Saúde , Relações Interpessoais , Mudança Social , Ensino , Países Desenvolvidos , Economia , Educação , Europa (Continente) , Organização e Administração , Países Escandinavos e Nórdicos , SuéciaRESUMO
OBJECTIVE: To determine the risk of maternal mortality in immigrants to England and Wales. DESIGN: Analysis of death registrations, 1970-1985, by country of birth. SETTING: England and Wales. POPULATION: Women dying in England and Wales during pregnancy, childbirth or the puerperium, or dying from malignant tumour of the placenta. MAIN OUTCOME MEASURES: The risk of dying in pregnancy, childbirth or the puerperium, adjusted for age and year of death, and the risk of cause-specific death, adjusted for age, in immigrants compared with women born in England and Wales. RESULTS: Women born in West Africa (relative risk 10.3; 95% CI 8.0-13.2) and the Caribbean (4.6; 3.8-5.7) were at very elevated risk of maternal death and of the main causes of death. Women from Southern Asia (1.6; 1.3-2.0) and "Europe and the USSR' (1.7; 1.2-2.3) were at moderate risk. Adjustment for year of death increased the estimates of risk and women born in the "Rest of the World' and Scotland were at significantly elevated risk. CONCLUSIONS: An increased incidence of obstetric conditions in immigrant groups may account for the elevated risk but it is also possible that differences in care may account for some of the additional risk. The pattern of increased risk does not appear to be explicable by the parity or social class distribution of immigrants as far as data are available on these. Research is required into the aetiology of the differential incidence of obstetric disease. The collection of routine mortality data which include maternal reproductive and social factors would elucidate the significance of such factors to maternal health. Further investigation into possible differences in the process of antenatal care between immigrants and non-immigrants is required, and into whether this affects the risk of maternal mortality.
Assuntos
Emigração e Imigração , Mortalidade Materna , Adulto , África Ocidental/etnologia , Ásia/etnologia , Inglaterra/epidemiologia , Europa (Continente)/etnologia , Feminino , Humanos , Gravidez , Medição de Risco , Fatores de Risco , Federação Russa/etnologia , Escócia , País de Gales/epidemiologia , Índias Ocidentais/etnologiaRESUMO
The efficacy of a low dose of mifepristone, 5 mg/day for the first 15 days of the menstrual cycle, followed by medroxy-progesterone acetate (MPA), 10 mg/day for the next 13 days, for inhibiting ovulation was assessed in ten volunteers who were treated for three successive cycles. Hormonal determinations in blood and urine samples, ovarian ultrasonography and an endometrial biopsy taken on day 21-24 of the third treatment cycle were used to monitor the cycles. Ovulation was confirmed in 11 of the 30 treated cycles and, in these 11, the LH peak and follicular rupture occurred during MPA treatment periods. Out of 19 anovulatory cycles, 16 had no increase in progesterone levels and another 3 developed a luteinized unruptured follicle. Progestin administration induced secretory changes in the endometrium, but irregular or delayed development was found. Regular withdrawal bleeding occurred in all subjects. These data indicate that the sequential regimen can suppress ovulation while maintaining regular bleeding but increased efficacy is needed for phase II clinical trials.
PIP: The efficacy of a low dose of mifepristone, 5 mg/day for the first 15 days of the menstrual cycle, followed by medroxyprogesterone acetate (MPA), 10 mg/day for the next 13 days, for inhibiting ovulation was assessed in 10 Chilean volunteers who were treated for 3 successive cycles. They were healthy, surgically sterilized women with a mean age of 36.6 years and mean weight of 58.6 kg. Hormonal determinations in blood and urine samples, ovarian ultrasonography and an endometrial biopsy taken on days 21-24 of the third treatment cycle were used to monitor the cycles. Treatment inhibited ovulation during the 3 treatment cycles in 5 women. The regimen was partially effective in 3 women and totally ineffective in another 2 women. Ovulation was confirmed in 11 of the 30 treated cycles, and, in these 11, the luteinizing (LH) peak and follicular rupture occurred during MPA treatment periods. Out of 19 anovulatory cycles, 16 had no increase in progesterone levels and another 3 developed a luteinized unruptured follicle. Among the anovulatory cycles, 3 cycles presented a biphasic hormonal profile. In these 3 cycles the luteal phase progesterone level were much lower than in baseline cycles and they were associated with unruptured follicles. The other 16 cycles had a monophasic hormonal profile with no increase in progesterone levels in spite of a delayed rise in LH level. Progestin administration induced secretory changes in the endometrium, but irregular or delayed development was found. Only 9 post-treatment cycles were followed and 5 of these were ovulatory, 1 of them without a detectable LH midcycle peak. Regular withdrawal bleeding occurred in all subjects. These data indicate that the sequential regimen can suppress ovulation while maintaining regular bleeding, but increased efficacy is needed for phase II clinical trials.
Assuntos
Endométrio/efeitos dos fármacos , Hormônios/metabolismo , Acetato de Medroxiprogesterona/administração & dosagem , Mifepristona/administração & dosagem , Ovário/efeitos dos fármacos , Adulto , Biópsia , Endométrio/fisiologia , Estradiol/sangue , Feminino , Humanos , Hormônio Luteinizante/sangue , Ciclo Menstrual/efeitos dos fármacos , Folículo Ovariano/efeitos dos fármacos , Folículo Ovariano/fisiologia , Ovário/diagnóstico por imagem , Ovário/fisiologia , Ovulação/efeitos dos fármacos , Progesterona/sangue , Fatores de Tempo , UltrassonografiaRESUMO
OBJECTIVE: To study the mechanism of action of Uniplant (South to South Corporation in Reproductive Health, Salvador, Brazil), a single Silastic capsule containing nomegestrol acetate (Lutenyl, Theramex, France) in women during 2 years. DESIGN: Comparison between the hormonal levels, follicular development, cervical mucus (CM) production, and endometrial thickness in the menstrual cycle before implant insertion and at 1, 6, 12, 18, and 24 months after implant insertion. PARTICIPANTS: A total of 15 women of reproductive age were enrolled for the 1st year of use. Twelve of these women continued for a 2nd year of Uniplant use. MAIN OUTCOME MEASURES: Hormonal plasma levels were measured in control cycles and at 1, 6, 12, 18, and 24 months of Uniplant use. Cervical mucus, follicular development, and endometrial thickness also were evaluated. RESULTS: In this study, Uniplant blocks ovulation in 86 percent of cycles studied. Disturbances in follicular growth were observed also. Cervical mucus was scanty and viscous in all women during this study. Endometrial thickness was <8 mm in all cycles studied. CONCLUSION: This study shows that Uniplant is a long-acting contraceptive that probably acts at the hypothalamic-pituitary levels, on the ovary, on CM production, and on the endometrium. These properties suggest the use of Uniplant as a contraceptive agent, especially if one considers the lack of androgenic and metabolic effects and the maintenance of periodic bleeding similar to menstruation.
PIP: A total of 15 healthy women volunteers were enrolled in this study. Their mean age was 23 +or- 1.2 years (range, 18-33 years), mean weight was 55.7 +or- 2.6 kg (range, 40-72 kg), and mean parity was 1.1 (range, 0-4). Venous blood samples were drawn every other day from day eight of the cycle until sonographic evidence of a 12-mm follicle, and then every day until sonographic evidence of follicular rupture and thereafter every other day until the next menstrual bleeding. The capsules were removed at the end of one year of Uniplant use, and a new capsule was inserted in 12 subjects. The blood samples for hormonal analyses were taken after 18 and 24 months of Uniplant use in the 12 women who continued in the study. Levels of luteinizing hormone (LH) were significantly lower than in the control cycles during the observation period (p .01, p .05). According to transvaginal sonography, four different patterns of follicular development were found: normal follicular growth and rupture, persistent follicle, follicular cysts, and no follicular growth. Follicular growth and rupture were observed in 20% of the treated cycles. Persistent follicles were present in approximately 15% of the treated cycles. Follicular cysts were observed in 29% of the cycles studied during 24 months of Uniplant use. All subjects had normal cervical cytology before starting treatment, after 12 months, and after 24 months of Uniplant use. The maximum cervical mucus score for pretreatment cycles was 12.8 +or- 0.4. Endometrial thickness was 8 mm in all cycles studied. 58% (7 of 12) of the women showed a normal menstrual cycle (26 to 32 days). 33% (4 of 12) of the women experienced one or two episodes of amenorrhea (90-134 days), whereas 8.3% of women (1 of 12) experienced episodes of spotting, six times in a period of 24 months of Uniplant use (10-30 days). Before Uniplant insertion, plasma concentration of sex hormone binding globulin was 72.3 nmol/L. After 24 months of Uniplant use, the concentration was 78.0 nmol/L.
Assuntos
Muco do Colo Uterino/efeitos dos fármacos , Muco do Colo Uterino/metabolismo , Anticoncepcionais Femininos/administração & dosagem , Megestrol , Norpregnadienos/administração & dosagem , Ovário/efeitos dos fármacos , Ovário/fisiologia , Congêneres da Progesterona/administração & dosagem , Adolescente , Adulto , Implantes de Medicamento , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Hormônio Luteinizante/sangue , Ciclo Menstrual/efeitos dos fármacos , Progesterona/sangue , Globulina de Ligação a Hormônio Sexual/metabolismo , Elastômeros de Silicone , Fatores de TempoRESUMO
PIP: In October 1994, 145 new cases of AIDS were reported in the UK, bringing to 10,000 the total reported from 1982 to October 31, 1994 (68% have died). The World Health Organization (WHO) estimates that more than 17 million people have been infected with the virus worldwide. There are regional differences in which subgroups are primarily affected. In most parts of the world, homosexuals and IV drug users are the predominant group, but in sub-Saharan Africa, the most common mode of transmission is through heterosexual intercourse. In this region, the infection has spread widely and rapidly, with prevalence exceeding 10% in Uganda and Zambia today. In the Republic of South Africa, data from prenatal clinics suggest that the prevalence of HIV has increased threefold from 1990 to 1992. In Thailand, prevalence rates of 20% have been reported among military recruits. The WHO estimates that by the year 2000, 30-40 million people will have been infected with HIV (90% in developing countries), and over 5 million children will have been orphaned by the disease. The sharpest increase is predicted to occur in Asia (from 2.5 to 8 million).^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , Surtos de Doenças , Infecções por HIV/epidemiologia , HIV-1 , Adulto , África/epidemiologia , Ásia/epidemiologia , Criança , Europa (Continente)/epidemiologia , Feminino , Homossexualidade , Humanos , Incidência , Masculino , América do Norte/epidemiologia , Gravidez , Prevalência , Trabalho Sexual , América do Sul/epidemiologia , Transtornos Relacionados ao Uso de Substâncias , Reino Unido/epidemiologiaRESUMO
PIP: Five positive and negative experiences of families dealing with AIDS are recounted. Imrat in Malaysia is an HIV-infected son who was not rejected by his family. Prudence of Botswana is an infected widow with five children who had a less positive experience with her in-laws, while Eric of Sweden considers his friends to constitute his family. His relationships with friends have only strengthened since his HIV-positive status became known. Mary of Zimbabwe, however, was infected with HIV by her husband. She was formerly angry at him for having brought home the virus, but they have since stop quarreling and are focusing upon building a stronger relationship. Finally, the brief story of Juan in Colombia is told. Thirty-two years old, married, and with a 17-month old daughter, Juan did not tell his wife that he was actively bisexual. Once infected with HIV, Juan's wife threw him out, more because he had sex with men than because of his HIV serostatus.^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida , Características da Família , Relações Familiares , Infecções por HIV , África , África Subsaariana , África Oriental , África Austral , América , Ásia , Sudeste Asiático , Botsuana , Colômbia , Países Desenvolvidos , Países em Desenvolvimento , Doença , Europa (Continente) , América Latina , Malásia , Países Escandinavos e Nórdicos , América do Sul , Suécia , Viroses , ZimbábueRESUMO
OBJECTIVE: To produce standard curves of birth weight according to gestational age validated by ultrasonography in the British population, with particular reference to the effects of ethnic origin. DESIGN: Retrospective analysis of computerised obstetric database. SETTING: Three large maternity units associated with Nottingham University with over 16,000 deliveries a year. PATIENTS: 41,718 women with ultrasound dated singleton pregnancies and delivery between 168 and 300 days' gestation. MAIN OUTCOME MEASURES: Length of gestation, ethnic origin, parity, maternal height and weight at booking, smoking during pregnancy; the effect of these variables on birth weight. RESULTS: Birth weights from ultrasound dated pregnancies have a higher population mean and show less flattening of the birthweight curve at term than those of pregnancies dated from menstrual history. Significant differences were observed in mean birth weights of babies of mothers of European origin (3357 g), of Afro-Caribbean origin (3173 g), and from the Indian subcontinent (3096 g). There were also significant interethnic differences in length of gestation, parity, maternal height, booking weight, and smoking habit which affected birth weight. The ethnic differences in birth weight were even greater when the effect of smoking was excluded. CONCLUSIONS: Birthweight standards require precise dating of pregnancy and should describe the population from which they were derived. In a heterogeneous maternity population the accurate assessment of an individual baby's weight needs to take the factors which affect birthweight standards into consideration.
PIP: A new set of standard curves of birth weight for singleton pregnancies with gestational age dated by ultrasonography was generated for the British population. The source of data was a computerized obstetric database of 41,718 pregnancies delivered between 168 and 300 days' gestation, taken from 3 large maternity units in East Midlands, the Nottingham University and City Hospitals, and Derby City Hospital. There were significant differences between the birthweights of 37,336 babies of mothers of English-European origin (3357 gm), 1008 babies of Afro-Caribbean origin (3173 gm), and 1547 babies of Indian subcontinent origin (3096 gm). There were also significant differences between ethnic groups for gestational length, parity, maternal height, weight, and smoking. These differences were greater than smoking was controlled. The effect of smoking was dose-related: at 40 weeks' gestation mean birthweights were 3580 gm for nonsmokers, 3416 gm for 1-9 cigarettes daily, 3374 gm for 10-19 cigarettes daily, and 3377 gm, for over 20 cigarettes daily. About 30% of the European and Afro-Caribbean women smoker, but almost none of the east Indians did. As had been seen elsewhere, ultrasound dating showed a lower gestational age than did menstrual dating (276 vs. 279 days), a discrepancy that is most likely to be clinically relevant in postdate gestations. While ultrasound dating is much more accurate, ethnic origin must be taken into account when assessing individuals.
Assuntos
Peso ao Nascer , Idade Gestacional , Gravidez , Europa (Continente)/etnologia , Feminino , Humanos , Índia/etnologia , Recém-Nascido , Masculino , Gravidez/etnologia , Gravidez/fisiologia , Padrões de Referência , Estudos Retrospectivos , Ultrassonografia Pré-Natal , Reino Unido/etnologia , Índias Ocidentais/etnologiaRESUMO
The issues arising from implementing an early intervention service, developed in the rural United States in the late 1960s in a range of different cultural contexts over a period of a quarter of a century, are explained. Services from India, Bangladesh, Jamaica and the United Kingdom are compared. As well as considering cross-cultural aspects of Portage, variability within one country, the United Kingdom, is considered by comparing one service in an inner-city area and one in a rural area.
PIP: In the late 1960s in rural Wisconsin, the Portage Guide to Early Intervention was developed to manage development delay in preschool children. A parent, usually the mother, teaches the child each day and keeps a record. A home visitor monitors progress weekly and teaches the parent by modelling the program with the child. It operates under basic assumptions, some of which many countries cannot meet. For example, services available in developed countries (e.g., health services) are not available in Bangladesh and India, because resources are limited and the population is so large. Further, there are considerable differences in culture between these countries and the West (e.g., extended family vs. nuclear family). Moreover, the major causes of developmental delay in these South Asian countries are different than in developed countries (birth asphyxia, malnutrition, and deficiency diseases vs. genetic causes). Professionals in India and Bangladesh have incorporated Portage into a variety of early intervention services, thereby modifying the model considerably. In Jamaica, however, professionals use the Portage model with only a few modifications. Fore example, they use it with all disabled children rather than just those with learning disabilities. A problem with using the model is the lack of manufactured toys and play materials listed in the curriculum. Jamaica has a training program for child development aides. Portage services exist throughout the UK. Urban programs serve many more immigrants from developing countries than do the rural programs. This requires modifying the Portage model. In all countries, costs pose a constraint. This overview of Portage services in various countries indicates that these services alone are relatively unimportant as direct agents of social change and may be an important element of broader social changes.
Assuntos
Comparação Transcultural , Atenção à Saúde/economia , Promoção da Saúde , Aculturação , Bangladesh , Criança , Desenvolvimento Infantil , Pré-Escolar , Atenção à Saúde/normas , Atenção à Saúde/estatística & dados numéricos , Países em Desenvolvimento , Educação , Etnicidade , Família , Feminino , Humanos , Lactente , Jamaica , Masculino , Desnutrição Proteico-Calórica/prevenção & controle , Desnutrição Proteico-Calórica/terapia , Reino Unido , Estados UnidosRESUMO
PIP: Tourists traveling internationally lower their inhibitions and take greater risks than they would typically in their home cultures. Loneliness, boredom, and a sense of freedom contribute to this behavioral change. Some tourists travel internationally in search of sexual gratification. This motivation may be actively conscious or subconscious to the traveler. Billed as romantic with great natural beauty, Thailand, the Philippines, Brazil, the Dominican Republic, and Kenya are popular destinations of tourists seeking sex. The Netherlands and countries in eastern Europe are also popular. With most initial cases of HIV infection in Europe having histories of international travel, mass tourism is a major factor in the international transmission of AIDS. While abroad, tourists have sex with casual partners, sex workers, and/or other tourists. Far from all tourists, however, carry and consistently use condoms with these partners. One study found female and non white travelers to be less likely than Whites and males to carry condoms. The risk of HIV infection increases in circumstances where condoms are not readily available in the host country and/or are of poor quality. Regarding actual condom use, a study found only 34% of sex tourists from Switzerland to consistently use condoms while abroad. 28% of men in an STD clinic in Melbourne, Australia, reported consistent condom use in sexual relations while traveling in Asia; STDs were identified in 73% of men examined. The few studies of tourists suggest that a significant proportion engage in risky behavior while traveling. HIV prevalence is rapidly increasing in countries known as destinations for sex tourism. High infection rates are especially evident among teenage sex workers in Thailand. Simply documenting the prevalence of risky behavior among sex tourists will not suffice. More research is needed on travelers and AIDS with particular attention upon the motivating factors supporting persistent high-risk behavior.^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida , Atitude , Preservativos , Comportamento Contraceptivo , Cultura , Estudos de Avaliação como Assunto , Infecções por HIV , Atividades de Lazer , Psicologia , Fatores de Risco , Comportamento Sexual , África , África Subsaariana , África Oriental , América , Ásia , Sudeste Asiático , Comportamento , Biologia , Brasil , Região do Caribe , Anticoncepção , Demografia , Países Desenvolvidos , Países em Desenvolvimento , Doença , República Dominicana , Inglaterra , Europa (Continente) , Europa Oriental , Serviços de Planejamento Familiar , Quênia , América Latina , Países Baixos , América do Norte , Filipinas , População , Características da População , América do Sul , Suíça , Tailândia , Reino Unido , VirosesRESUMO
PIP: The results of public opinion surveys were used to assess the variation in views and attitudes toward the environment among different social strata in several countries. The developed countries have recently become concerned about the disappearance of the rain forests, but mere survival is more of a preoccupation for the majority of Brazilians than damage tot he rain forest. A survey of a representative national sample during the 1989 presidential election indicated that fewer than 10% of Brazilians considered ecological problems among the 3 major national problems. But in a survey to determine which environmental problems in Brazil were considered most serious, burning of the tropical forest was identified by the greatest proportion of respondents, 19%, followed by industrial pollution of rivers and cities, 17%. Surveys in 1990-91 in Great Britain indicated in contrast that some 92% of respondents were in favor of 1 or more measures to limit deterioration of the tropical forest, such as limiting importation of wood from countries not protecting their forests or contributing funds to ecological groups. Opinion surveys in British Columbia, whose main economic activity is forestry, showed that 40% of respondents considered ecological problems to be the most serious, ahead of unemployment, the economy, or social services. But specific questions on clear cutting of forests, preservation of old forest in Vancouver, or pollution controls for the paper industry, which closely affected the local economy, divided opinion and probably demonstrated a desire to protect the environment without too greatly disturbing the local economy. Study of the reactions of developing country populations to environmental problems is difficult because of language and cultural barriers, political instability, war, natural catastrophes, and difficulty of establishing representative samples, among other factors. Results of a study of the opinion of the Maya population of southern Mexico and northern Guatemala on deforestation, land use, and development are expected to appear shortly. A study in Lima identified the proliferation of refuse in the street as the worst ecological problem for 42%, followed by air pollution caused by automotive exhausts for 30%. Only 1% believed disappearance of the rain forest to be the principal problem. The ordering of ecological problems was significantly influenced by social class. A comparison of the views on ecological problems of opinion leaders and the general public was conducted in 1988-89 in 16 countries on 4 continents. In most cases, the opinions of the leaders corresponded to those of the general public. Most respondents in all countries except Saudi Arabia considered their environment of average quality, and a majority believed that the place where they lived had worsening environmental conditions over the past decade. Majorities in all countries except Japan stated they support organizations that protect the environment.^ieng
Assuntos
Conservação dos Recursos Naturais , Coleta de Dados , Países Desenvolvidos , Países em Desenvolvimento , Meio Ambiente , Poluição Ambiental , Liderança , Percepção , Opinião Pública , Classe Social , América , Atitude , Comportamento , Brasil , Canadá , América Central , Comunicação , Economia , Europa (Continente) , Guatemala , Conhecimentos, Atitudes e Prática em Saúde , América Latina , México , América do Norte , Peru , Psicologia , Pesquisa , Estudos de Amostragem , Fatores Socioeconômicos , América do Sul , Reino UnidoRESUMO
PIP: In 1989, the UN General Assembly agreed to sponsor a conference on environment and development and that the Heads of State would attend this 1st ever Earth Summit in June 1992. The planned agenda included making concrete changes to the basis of our economic life, relations between and among nations, and the outlook for the future. This would result in restructuring world priorities. Despite the 1972 Stockholm Conference on the human Environment acknowledging the basic link between environment and development, the environment has deteriorated even further, especially ozone depletion. Yet some governments did set up environmental agencies or ministries, like the US Environmental Protection Agency, but they were not allowed to influence economic policy or the policies and/or practices of major sectoral agencies. These environmental organizations relied too heavily on regulation. The 1992 conference needs to result in a political commitment to place reduction of poverty worldwide as the 1st priority since poverty and underdevelopment are strongly related to destruction of the environment. It is particularly important that developing countries improve their strengths by developing their human resources and institutional capacities (science, technology, management and professional skills) and reduce their vulnerabilities, such as dependence on foreign experts. This can best be achieved if they have access to technology. Moreover they must reduce population growth and reach population stability quickly. The 1992 conference in Brazil should also result in a global partnership based on common interest, mutual need, and shared responsibility. The world ecoindustrial revolution has already begun in some countries, such as Japan which has reduced energy use 40% since 1975. In fact, Japan has proven that environmental improvement can be accomplished with high rates of economic growth.^ieng
Assuntos
Congressos como Assunto , Países Desenvolvidos , Países em Desenvolvimento , Economia , Meio Ambiente , Cooperação Internacional , Legislação como Assunto , População , Comportamento Social , Nações Unidas , América , Ásia , Comportamento , Brasil , Europa (Continente) , Ásia Oriental , Agências Internacionais , Japão , América Latina , América do Norte , Organizações , Países Escandinavos e Nórdicos , América do Sul , Suécia , Estados UnidosRESUMO
Cancer incidence in countries representative of three patterns of reproductive cancer and age-specific mortality was used to estimate the effect of oral contraceptive use on the lifetime probability of reproductive cancer under three sets of assumptions about the effects of oral contraceptives. Under the set of assumptions considered likely, oral contraceptives were estimated to reduce or increase only slightly the lifetime probability of any reproductive cancer in each setting. Under worst-case assumptions, oral contraceptives were estimated to increase the lifetime probability of reproductive cancer only modestly in settings with low cancer rates and in settings with high rates of breast, ovarian, and endometrial cancer, but it might have a large impact on lifetime probability of reproductive cancer in settings with high cervical cancer rates. Under best-case assumptions, oral contraceptives were estimated to decrease the lifetime probability of reproductive cancer in each setting; this reduction was estimated to be greatest in settings where endometrial and ovarian cancer incidence are high.
PIP: Researchers applied published data on cancer incidence and age specific mortality to standard life table techniques to estimate the lifetime probability of developing reproductive cancer for women living in countries representative of 3 patters of risk of reproductive cancer and for long term oral contraceptives (OC) users under best case, worst case, and likely case assumptions. The reproductive cancers included breast, ovarian, endometrial, and cervical cancers. The data consisted of urban women from China, Japan, United States (California), England, Wales, Costa Rica, and Colombia. Under the likely case assumption, OCs just barely reduced or increased the lifetime probability of any reproductive cancer in any setting. Further, under the worst case scenario, OCs increased the lifetime probability or reproductive cancer moderately in countries with low cancer rates (Asian countries) and in countries with high rates of breast, ovarian, and endometrial cancer (Western Europe, North America, and Australia). Yet in countries with high cervical rates (South and Central America), OC use significantly affected the lifetime probability of reproductive cancer. The best case scenario revealed that OCs decreased lifetime probability of reproductive cancer in each country, especially those countries where endometrial and ovarian cancer incidences were great. The analysis also showed that OC use has the greatest effect on lifetime probability of reproductive cancer, be it positive or negative, in countries with high underlying rates of reproductive cancer. Further it demonstrated that the effect of OC use will most likely be small in countries with low incidence of reproductive cancers. Overall the researchers felt reassured about OC use and reproductive cancer. Even though long term OC use increases the risk of breast cancer in young ages.
Assuntos
Neoplasias da Mama/epidemiologia , Anticoncepcionais Orais/farmacologia , Neoplasias do Endométrio/epidemiologia , Neoplasias Ovarianas/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Ásia/epidemiologia , Neoplasias da Mama/mortalidade , Neoplasias da Mama/prevenção & controle , Neoplasias do Endométrio/mortalidade , Neoplasias do Endométrio/prevenção & controle , Europa (Continente)/epidemiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/prevenção & controle , Probabilidade , América do Sul/epidemiologia , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/prevenção & controleRESUMO
PIP: EDAPROSPO, a Peruvian nongovernmental organization, in 1985-87, developed a health training program for students of 13 grammar schools in Huaycan, San Martin de Porres, and Comas. The principle aim of the program is to encourage and prepare children to be responsible for their health and environment, and to strengthen school health delegates and health teams. School health delegates are children selected by their classmates to work with teacher volunteers to form health teams. It is hoped that participants will spread the message to their families, friends, and neighbors. The project is being extended to other 10-14 year old students and community groups in the area. and with the support of the Ministry of Education, should reach 57 schools, 312 student delegates, and 3300 students. Activities will be expanded to include an evaluation of the main health problems in the community, the identification of vulnerable groups, and community leaders who are interested in supporting children in project activities. EDAPROSPO is also collaborating with ALTERNATIVA, a group working with children aged 3-6 years. Both groups are funded by Radda Barnen, a Swedish development agency.^ieng
Assuntos
Publicidade , Educação em Saúde , Saúde , Fenômenos Fisiológicos da Nutrição , Organizações , Grupo Associado , Pesquisa , Instituições Acadêmicas , Estudantes , América , Comunicação , Países Desenvolvidos , Países em Desenvolvimento , Economia , Educação , Europa (Continente) , Conhecimentos, Atitudes e Prática em Saúde , América Latina , Marketing de Serviços de Saúde , Peru , Países Escandinavos e Nórdicos , América do Sul , SuéciaRESUMO
Corinne Hayes and Karen Walker won 1000 pounds in last year's Student Elective Award competition for the protocol of their project. Here, they give an account of their work, the aims of which were to compare the incidence of low birthweight (less than 2.5 kg) and very low birthweight (less than 1.5 kg) babies in the UK and the Caribbean, to assess the outcome of these babies and to compare obstetric practice and the incidence of risk factors for low birthweight in the two populations.
PIP: Birth records were collected from Homerton Hospital from the London Borough of Hackney and in St. Kitts in order to ascertain the incidence of low birth weight (2.5 kg) and very low birth weight (1.5 kg); and relevant maternal factors (smoking, age, pre-pregnancy weight, and disease). St. Kitts averages 1000 deliveries per year compared with 400 each year at the Homerton Hospital. Birth records of 4 years (1984-87) were examined in St. Kitts, and they were compared with records from 1987 in the Homerton Hospital. Babies were divided into 2 groups: Group 1 (1.5 kg), and Group 2 (2.5 kg). Data from the whole of England were used for comparison. The incidence of Group 1 babies in St. Kitts (1.9%) and in the Homerton Hospital (1.8%) was similar, but both differed significantly from the national figure of 1%. The incidence of babies weighing 2.5 kg was lower in the Homerton sample (9.5%) than in the St. Kitts population (11.1%), but both exceeded the national rate (7.2%). Poverty and poor maternal nutrition not race were common in both populations. Stillbirth rates differed greatly between Homerton (7.2/1000) and St. Kitts (15.9/1000). Perinatal mortality was 35/1000 in St. Kitts and 13.1/1000 at Homerton. In Group 1 stillbirths made up 26.5% of all deliveries in St. Kitts vs. 13% at Homerton. Antenatal care with screening procedures for congenital abnormalities (maternal serum alpha-fetoprotein, amniocentesis, and ultrasonography) were not available in St. Kitts. The survival rate of Group 2 babies was 902/1000 in St. Kitts and 956/1000 at Homerton; and the same rate for Group 1 babies was 656/1000 in St. Kitts and 817/1000 at Homerton. Antenatal care improvement is requisite for improving perinatal mortality figures.
Assuntos
Mortalidade Infantil , Recém-Nascido de Baixo Peso , População Negra , Estudos de Coortes , Humanos , Recém-Nascido , Londres , Fatores Socioeconômicos , Índias Ocidentais/etnologiaRESUMO
In 1988, the Government of Norway undertook the following immigration measures: 1) it merged the Office of Immigration, which deals with asylum matters, and the Government Refugee Agency, which handles reception and settlement, into a new Directorate for Immigration under the Ministry of Local Government and Labour; 2) it instituted visa requirements for Chileans; and 3) it established a new reception program, under which five regional reception centers are to be created accommodating 200 to 300 people each, where asylum seekers will be placed until they have completed their police interview and a municipality has agreed to accept them.
Assuntos
Emigração e Imigração , Legislação como Assunto , Organização e Administração , Refugiados , América , Chile , Demografia , Países Desenvolvidos , Países em Desenvolvimento , Europa (Continente) , América Latina , Noruega , População , Dinâmica Populacional , Países Escandinavos e Nórdicos , América do Sul , MigrantesRESUMO
PIP: Factors that increase reproductive risks are examined: maternal age at pregnancy, parity, pregnancy intervals, and abortion. Comparing maternal mortality by age in 3 countries in 1981, Venezuela, Sri Lanka, and England, rates were equal and the lowest were among 20-30 year olds. In another study by the Ministry of Health for Brazil in 1986, Brazil had an infant mortality rate of 70/100,000, 10 times greater that Australia, Scotland, and Sweden, and 5 times greater than the US. 42.8% of those newborns had mothers less than 20 or more than 30 years old. Mother's parity also influenced child mortality. In Recife, Brazil, the probability of death for the 1st child was 13.7%, increasing to 50% for the 5th child. Another problem endemic to Brazil is abortion. In 1986, over 84 thousand complicated abortions were treated by INAMPS, the national health institution. The data shows the importance and need of family planning for health promotion and welfare of the maternal/child population in Brazil.^ieng
Assuntos
Demografia , Mortalidade Infantil , Mortalidade Materna , Mortalidade , Dinâmica Populacional , População , Aborto Induzido , Fatores Etários , América , Ásia , Brasil , Países Desenvolvidos , Países em Desenvolvimento , Inglaterra , Europa (Continente) , Serviços de Planejamento Familiar , América Latina , Características da População , América do Sul , Sri Lanka , Reino Unido , VenezuelaRESUMO
PIP: With 982 registered AIDS cases, Brazil is in 3rd place in the number of AIDS cases, exceeded only by the US and France. The World Health Organization, however, says that Brazil could experience an uncontrolled AIDS epidemic as intense as that in central Africa. A Copenhagen statistician says that AIDS will not continue to grow exponentially the way it did at the beginning of the epidemic. People who have already been infected by AIDS are primarily members of high risk groups in which the disease spreads at least 10 times and more likely 100 times more rapidly than in the remainder of the population. From these statistics one can forecast that the worst case scenario will reach a peak in 1997, after which the AIDS epidemic will grow slowly. The British football league has issued a circular advising athletes on avoiding the risks of AIDS infection. Among other items they are advised not to drink victory champagne from the same bottle. Specialists, however, feel that the risk for AIDS infection in football contact is extremely small and that the biggest danger lies in unsanitary injections in connection with doping. The students at an Innherred, Norway, nursing school have signed a petition in support of a woman who was fired from her bartender job when she told her employer she was HIV-positive. A local magistrate had found that the firing was unfounded but did not order the woman's job restored.^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/enfermagem , Síndrome da Imunodeficiência Adquirida/transmissão , Adulto , África Central , Criança , Europa (Continente) , Feminino , Humanos , Masculino , América do Sul , Estados UnidosRESUMO
Amongst a nationally representative sample of singletons born in one week of April 1970 for whom information was available, 12.3% were reported by their mothers as having developed eczema at some time before their fifth birthday. Data from both the birth and the five-year follow-up surveys have been analysed to identify the independent early predictors of this (reported) condition in 11,920 children. Using an initial set of possible predictors suggested by previous analyses of these data, the dominant risk characteristics have been identified as: a positive maternal history of eczema; a positive maternal history of asthma or hay fever; higher parental educational qualifications and the mother originating from the West Indies or Africa. There were also increased risks for children of mothers born in England (relative to the rest of the United Kingdom) and for children of mothers who used contraceptives in the 18 months prior to the index pregnancy. There was no protective effect of breast-feeding even among children whose mothers had a history of allergy.
PIP: Among a nationally representative sample of singletons born 1 week in APril 1970 for whom information was available, 12.3% were reported by their mothers as having developed eczema some time prior to their 5th birthday. Data from both the birth and 5-year follow-up survey have been analyzed to identify the independent early predictors of this condition in 11,920 children. Using an initial set of possible predictors suggested by previous analyses of this data, the dominant risk factors have been identified as: a positive maternal history of eczema; a positive maternal history of asthma or hay fever; higher parental educational qualifications; and the mother originating from the West Indies or Africa. There were also increased risks for children of mothers born in England (relative to the rest of the UK) and for children of mothers who had used contraceptives in the 18 months prior to the index pregnancy. Breastfeeding offered no protective effect even among children whose mothers had a history of allergy.