Home About us Contact
|
Home About us Contact | ||
|
|
||
WHO
Terms modified by WHO Selected AbstractsCritical appraisal of the management of severe malnutrition: 1.JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 10 2006Epidemiology, treatment guidelines Abstract: Hospital case-fatality rates for severe malnutrition in the developing world remain high, particularly in Africa where they have not changed much over recent decades. In an effort to improve case management, WHO has developed treatment guidelines. The aim of this review is to critically appraise the evidence for the guidelines and review important recent advances in the management of severe malnutrition. We conclude that not only is the evidence base deficient, but also the external generalisability of even good-quality studies is seriously compromised by the great variability in clinical practice between regions and types of health facilities in the developing world, which is much greater than between developed countries. The diagnosis of severe wasting is complicated by the dramatic change in reference standards (from CDC/WHO 1978 to CDC 2000 in EpiNut) and also by difficulties in accurate measurement of length. Although following treatment guidelines has resulted in improved outcomes, there is evidence against the statement that case-fatality rates (particularly in African hospitals) can be reduced below 5% and that higher rates are proof of poor practice, because there is wide variation in severity of illness factors. The practice of prolonged hospital treatment of severe malnutrition until wasting and/or oedema has resolved is being replaced by shorter hospital stays combined with outpatient or community follow-up because of advances in dietary management outside of hospital. [source] Current usage of nomenclature for parasitic diseases, with special reference to those involving arthropodsMEDICAL AND VETERINARY ENTOMOLOGY, Issue 2 2001R. W. Ashford Abstract. Terminological confusion has been aggravated by efforts to develop a standardized nomenclature for parasitic diseases (SNOPAD) arising from the proposal by Kassai et al., 1988) for a standardized nomenclature of animal diseases (SNOAPAD). To restabilize international nomenclature of parasitic diseases it is recommended that, whenever appropriate, names should follow the ,International Nomenclature of Diseases' (IND) compiled by the Council for International Organizations for Medical Sciences (CIOMS/WHO, 1987). For diseases not included in IND, familiarity should guide the choice of name: traditional English language names of diseases should be preferred, e.g. ,malaria', ,scabies' or, for parasitic diseases having no traditional name, the taxonomic name of the causative organism should be applied, e.g. ,Brugia timori microfilaraemia'; ,Plasmodium malariae infection'; ,Simulium allergy' , instead of the generic derivatives proposed by SNOPAD, i.e. brugiosis, plasmodiosis and simuliidosis, respectively. For names of new diseases or those rarely mentioned, the suffix -osis would normally take precedence. Generally, the name of choice for any disease in any language should be the vernacular term, with commonest English usage preferred for international communication, and publications should include synonyms in the list of keywords. [source] Alcohol use and abuse in adolescence: proposal of an alternative analysisCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 3 2008C. Simões Abstract Background A national, representative, school-based sample of Portuguese youths was used to examine the prevalence of alcohol use in this population and to analyse differences between demographic variables such as gender and age, as well as to propose a statistical procedure that optimally quantifies categorical variables. Methods Data on 6109 state school students from Portugal, in the 6th, 8th and 10th grades, aged 11,18, who participated in the 2002 (Health Behaviour in School-aged Children/WHO) survey of adolescent health, were analysed. Adolescents aged between 11 and 14 were placed in the younger group, and those 15,18 years old were placed in the older group. Optimal scaling was used to optimize the computation of factor scores, which were subsequently submitted to multiple regression analysis in order to analyse the impact of gender and age on alcohol use. Results The results of this study show that the majority of Portuguese school-aged adolescents attending regular school at 6th, 8th and 10th grades do not drink alcoholic beverages (beer, wine or spirits) on a regular basis (at least once a month). However, about 8% of these adolescents do drink beer, 3% do drink wine and 12% do drink spirits on a regular basis. With regard to age and gender, about a quarter of the older boys stated that they drink beer or spirits regularly. The multiple regression analysis showed that age and gender had a significant impact on alcohol use. Conclusion Alcohol , in particular spirits , is a substance used by some Portuguese adolescents. Alcohol use and abuse is more frequent in boys and increases with age. The importance of these findings for health promotion strategies is discussed. [source] Effects of Fertilizer Phosphorus on Yield Traits of Dekoko (Pisum sativum var. abyssinicum) Under Field ConditionsJOURNAL OF AGRONOMY AND CROP SCIENCE, Issue 1 2003A. Yemane Abstract Cool-season food legumes (CSFLs) are important supplementary protein sources and soil fertility restorers for subsistence farmers in Ethiopia. Yields of CSFLs, however, are limited by low soil fertility, as they are grown in poor soils, often without fertilizer. Dekoko (Pisum sativum var. abyssinicum) is one of the CSFLs cultivated in Tigray, Northern Ethiopia. It is highly appreciated by the local people for its taste. This paper reports on the effect of phosphorus (P) on the yield and nutrition value of Dekoko under field conditions, and compares the results with those obtained for Ater (Pisum sativum var. sativum). The experiment was conducted in the 1998 and 1999 growing seasons. Three rates of P equivalent to zero, 30, and 60 kg ha,1 P2O5 were tested. Biomass, leaf area index, branches/plant, pods/m2 and yield responded positively while seeds/pod and seed weight were not significantly affected by P. Tissue P contents in shoots and roots increased with an increase in P application rate, while P in the nodules was not affected. Crude protein (CP) content increased from 24.9 % of dry matter (DM) at P0 to 26.2 % at P2, and from 24.3 % at P0 to 25.2 % at P2, in Dekoko and Ater seeds, respectively, while total sugars decreased with an increase in P application rate. Cysteine in Dekoko and asparagine and threonine in both varieties decreased, while lysine and other amino acids were not significantly affected by P. P improved seed yield and CP content without greatly affecting the amino acid profile of Dekoko, when compared with that of the FAO/WHO (1991, Protein Quality Evaluation. Food and Nutrition, Paper 51. FAO/WHO, Rome) standard pattern of amino acid for children 2,5 years of age. Thus, improving yield through fertilization may help to improve nutritional quality and household food security for subsistence farmers. [source] Essential elements and contaminants in tissues of commercial pelagic fish from the Eastern Mediterranean SeaJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 9 2009Beyza Ersoy Abstract BACKGROUND: It is important to determine the concentrations of essential and non-essential metals in fish for human health. The essential elements and contaminants (Pb and Cd) were determined seasonally in the muscle and liver of some pelagic fish species round herring (Etrumeus teres), chub mackerel (Scomber japonicus), golden grey mullet (Liza aurata) and Mediterranean horse mackerel (Trachurus mediterraneus) from the Iskenderun Bay, Eastern Mediterranean Sea. RESULTS: The Na, K, Ca and Mg were the most abundant elements in muscle and liver tissues. The Na, K, Ca and Mg concentrations in fish tissues were between 51.7 and 3426 mg kg,1. Muscle accumulated the lowest levels of elements. Trace element and contaminant levels in muscle were highest in spring and summer. The Cu, Zn and Cr concentrations were highest in summer. The Ni, Mn and Fe concentrations were highest in spring. The maximum Pb concentrations in the muscle and liver of fish species was 0.39 and 0.80 mg kg,1 in autumn. The maximum Cd concentration in the muscle of fish was 0.27 mg kg,1 in spring and the maximum Cd concentration in the liver was 0.78 mg kg,1 in summer. CONCLUSION: The Cr, Pb, Cd, Cu and Zn levels in muscle were found to be lower than permissible limits reported by various authorities. Estimated weekly and daily intake for Pb and Cd by consumption of fish muscle were far below the PTWI and PTDI values established by FAO/WHO. Copyright © 2009 Society of Chemical Industry [source] Comparison of conventional FASTA identity searches with the 80 amino acid sliding window FASTA search for the elucidation of potential identities to known allergensMOLECULAR NUTRITION & FOOD RESEARCH (FORMERLY NAHRUNG/FOOD), Issue 8 2007Gregory S. Ladics Abstract Food and Agriculture Organization/World Health Organization (FAO/WHO) recommended that IgE cross-reactivity between a transgenic protein and allergen be considered when there is ,F 35% identity over a sliding "window" of 80 amino acids. Our objective was to evaluate the false positive and negative rates observed using the FAO/WHO versus conventional FASTA analyses. Data used as queries against allergen databases and analyzed to assess false positive rates included: 1102 hypothetical corn ORFs; 907 randomly selected proteins; 89 randomly selected corn proteins; and 97 corn seed proteins. To evaluate false negative rates of both methods: Bet v 1a along with several crossreacting fruit/vegetable allergens and a bean ,-amylase inhibitor were used as queries. Both methods were also evaluated for their ability to detect a putative nonallergenic test protein containing a sequence derived from Ara h 1. FASTA versions 3.3t0 and 3.4t25 were utilized. Data indicate a conventional FASTA analysis produced fewer false positives and equivalent false negative rates. Conventional FASTA versus sliding window derived E scores were generally more significant. Results suggest a conventional FASTA search provides more relevant identity to the query protein and better reflects the functional similarities between proteins. It is recommended that the conventional FASTA analysis be conducted to compare identities of proteins to allergens. [source] The Need for Double-Sampling Designs in Survival Studies: An Application to Monitor PEPFARBIOMETRICS, Issue 1 2009Ming-Wen An Summary In 2007, there were 33.2 million people around the world living with HIV/AIDS (UNAIDS/WHO, 2007). In May 2003, the U.S. President announced a global program, known as the President's Emergency Plan for AIDS Relief (PEPFAR), to address this epidemic. We seek to estimate patient mortality in PEPFAR in an effort to monitor and evaluate this program. This effort, however, is hampered by loss to follow-up that occurs at very high rates. As a consequence, standard survival data and analysis on observed nondropout data are generally biased, and provide no objective evidence to correct the potential bias. In this article, we apply double-sampling designs and methodology to PEPFAR data, and we obtain substantially different and more plausible estimates compared with standard methods (1-year mortality estimate of 9.6% compared to 1.7%). The results indicate that a double-sampling design is critical in providing objective evidence of possible nonignorable dropout and, thus, in obtaining accurate data in PEPFAR. Moreover, we show the need for appropriate analysis methods coupled with double-sampling designs. [source] Childhood cancer,mainly curable so where next?ACTA PAEDIATRICA, Issue 4 2000AW Craft More than 70% of childhood cancer is now curable with best modern therapy. The treatment is expensive but in terms of cost per life year saved, USD 1750, compares very favourably with other major health interventions. The rate of improvement in survival is slowing down. New, "designer", treatments are needed and, better still, prevention. The causes of childhood cancer are beginning to emerge. The origin for many is probably in utero and may be initiated by dietary and other environmental exposures perhaps in susceptible individuals. However, one of the great challenges for the future must be to extend the benefits of modern treatment to the 80% of the world's children who currently have little or no access to it in economically disadvantaged and emerging nations. The International Paediatric Oncology Society (SIOP) is leading the way in bringing hope for children with cancer worldwide. In India, with the support of the WHO, there is a "train the trainers" programme. In Africa, pilot studies of cost-effective treatments for Burkitt's lymphoma are producing gratifying results in Malawi and there are several examples of twinning programmes between major centres in developed and less well-developed countries. Conclusions: The future for children with cancer is bright. Most are curable and prevention may be just over the horizon. [source] Prediction of cardiovascular and total mortality in Chinese type 2 diabetic patients by the WHO definition for the metabolic syndromeDIABETES OBESITY & METABOLISM, Issue 1 2006G. T.-C. Aim:, The aim of this study is to investigate the prevalence of metabolic syndrome (MES) in type 2 diabetic patients and the predictive values of the World Health Organization (WHO) and National Cholesterol Education Programme (NCEP) definitions and the individual components of the MES on total and cardiovascular mortality. Methods:, A prospective analysis of a consecutive cohort of 5202 Chinese type 2 diabetic patients recruited between July 1994 and April 2001. Results:, The prevalence of the MES was 49.2,58.1% depending on the use of various criteria. There were 189 deaths (men: 100 and women: 89) in these 5205 patients during a median (interquartile range) follow-up period of 2.1 (0.3,3.6 years). Of these, 164 (87%) were classified as cardiovascular deaths. Using the NCEP criterion, patients with MES had a death rate similar to those without (3.51 vs. 3.85%). By contrast, based on the WHO criteria, patients with MES had a higher mortality rate than those without (4.3 vs. 2.4%, p = 0.002). Compared to patients with neither NCEP- nor WHO-defined MES, only the group with MES defined by the WHO, but not NCEP, criterion had significantly higher mortality rate (2.6 vs. 6.8%, p < 0.001). Using Cox regression analysis, only age, duration of diabetes and smoking were identified as independent factors for cardiovascular or total death. Among the various components of MES, hypertension, low BMI and albuminuria were the key predictors for these adverse events. Conclusions:, In Chinese type 2 diabetic patients, the WHO criterion has a better discriminative power over the NCEP criterion for predicting death. Among the various components of the MES defined either by WHO or NCEP, hypertension, albuminuria and low BMI were the main predictors of cardiovascular and total mortality. [source] Prevalence of the metabolic syndrome in the island of Gran Canaria: comparison of three major diagnostic proposalsDIABETIC MEDICINE, Issue 12 2005M. Boronat Abstract Aims The present study was conducted to estimate the prevalence of the metabolic syndrome in a Canarian population, and to compare its frequency as defined by the most commonly used working definitions. Methods Cross-sectional population-based study. One thousand and thirty adult subjects were randomly selected from the local census of Telde, a city located on the island of Gran Canaria. Participants completed a survey questionnaire and underwent physical examination, fasting blood analyses, and a 75-g standardized oral glucose tolerance test. The prevalence of the metabolic syndrome was estimated according to the definitions proposed by the World Health Organization (WHO), the European Group for the Study of Insulin Resistance (EGIR) and the National Cholesterol Education Program (NCEP), the latter with the original (6.1 mmol/l) and the revised criterion (5.6 mmol/l) for abnormal fasting glucose. Results The adjusted prevalence of the metabolic syndrome was 28.0, 15.9, 23.0 and 28.2%, using the WHO, EGIR, NCEP and revised NCEP criteria, respectively. The measure of agreement (, statistic) was 0.57 between the WHO and the original NCEP definitions, and 0.61 between the WHO and the revised NCEP definitions. After excluding diabetic subjects, the agreement between the EGIR and WHO proposals was fairly good (, = 0.70), whereas concordance of the EGIR with the original and the revised NCEP definitions was moderate (, = 0.47 and 0.46, respectively). Conclusions Whichever the considered diagnostic criteria, the prevalence of the metabolic syndrome in this area of the Canary Islands is greater than that observed in most other European populations. [source] Association between MspI polymorphism of the APO AI gene and Type 2 diabetes mellitusDIABETIC MEDICINE, Issue 6 2005S. Morcillo Abstract Aims Genes of the Apo AI/CIII/AIV cluster on chromosome 11 have been related to plasma lipid patterns. The close relationship between carbohydrate metabolism and lipid metabolism warrants investigation of the association between this cluster and Type 2 diabetes mellitus. We therefore examined the possible association between polymorphisms of this cluster and Type 2 diabetes mellitus as part of a study of the prevalence of diabetes and the metabolic syndrome in southern Spain. Methods A total of 1224 persons were selected randomly from the town of Pizarra in the province of Malaga, southern Spain. The sample errors for the prevalence of Type 2 diabetes mellitus and the three polymorphisms studied were all , 4%. All subjects underwent phenotyping after an oral glucose tolerance test (75 g) (WHO 1998 criteria) and the XmnI and MspI polymorphisms of Apo AI and the SstI polymorphism of Apo CIII were genotyped. Results Those subjects with the mutated AA genotype of the MspI polymorphism (,75 G,A) of Apo AI had a greater risk of impaired glucose tolerance [odds ratio (OR) = 1.95, CI = 1.02,3.8, P = 0.05], Type 2 diabetes mellitus, both known (OR = 7.38, CI = 1.3,39.7, P = 0.02) and unknown (OR = 3.7, CI = 1.4,9.9, P = 0.009). This risk was independent of age, sex, obesity, triglyceride level, HDL cholesterol and pattern of insulin resistance. Conclusions Pending confirmation in prospective studies, the AA genotype of the MspI polymorphism of the Apo AI gene, within the Apo A-I/C-III/A-IV cluster, seems to be a risk factor for Type 2 diabetes mellitus. [source] Prevalence of undiagnosed Type 2 diabetes and impaired fasting glucose in older B ritish men and womenDIABETIC MEDICINE, Issue 6 2005M. C. Thomas Abstract Aim To estimate the prevalence of undiagnosed diabetes and impaired fasting glucose in older British men and women, using the 1999 World Health Organization (WHO) thresholds based on fasting glucose measurements. Methods Participants in the British Regional Heart Study and the British Women's Heart and Health Study were selected from one socially representative general practice in 24 British towns. Included in this analysis were 3736 men and 3642 women aged 60,79 years (predominantly white), who provided a single fasting blood sample at a clinical examination between 1998 and 2001, and who had no previous diagnosis of diabetes. Results Two hundred and eleven men (5.7%) and 190 women (5.2%) had a fasting blood glucose level consistent with the WHO threshold for a diagnosis of diabetes (, 7.0 mmol/l), whilst a further 667 men (17.9%) and 642 women (17.6%) had impaired fasting glucose levels (6.1 , 7 mmol/l). When analyses were restricted to subjects who had fasted for at least 8 h, and whose blood sample was taken before 12.00 h, the predicted prevalence of undiagnosed diabetes (based on two separate measurements) was 6.7% in men and 6.0% in women. The predicted prevalence of impaired fasting glucose (based on two separate measurements) was approximately 20% in both sexes. Conclusions More than one-fifth of older white British men and women have either undiagnosed diabetes or impaired fasting glucose according to new WHO criteria. Strategies for the primary and secondary prevention of Type 2 diabetes among older individuals are urgently needed. [source] Increasing prevalence of Type 2 diabetes mellitus in all ethnic groups in MauritiusDIABETIC MEDICINE, Issue 1 2005S. Söderberg Abstract Aims To describe the prevalence of different stages of glucose intolerance in a population from Mauritius followed over 11 years. Methods Population-based surveys were undertaken in the multiethnic nation of Mauritius in 1987, 1992 and 1998, with 5083, 6616, and 6291 participants, respectively. Questionnaires, anthropometric measurements, and a 2-h 75-g oral glucose tolerance test were included. Subjects aged between 25 and 75 years with classifiable data were identified; 4991, 6463 and 5392 from 1987, 1992 and 1998, respectively. Glucose tolerance was classified according to WHO 1999 criteria. Results The prevalence of Type 2 diabetes increased significantly during the period studied, from 12.8% in 1987, to 15.2% in 1992, and 17.9% in 1998. The increasing prevalence was seen in both men and women, and in all age groups. The prevalence of known diabetes (KDM) increased progressively, and more markedly than the increase in newly diagnosed diabetes (NDM). A diagnosis of impaired glucose tolerance (IGT) was more prevalent amongst women whereas impaired fasting glucose (IFG) was more common amongst men. The prevalences of IGT and IFG did not change markedly during the period. The prevalence of diabetes and IGT was similar for participants of Indian, Creole and Chinese background in each survey, and the increasing prevalence of diabetes was seen in all ethnic groups. Conclusion In this study, we report an increasing prevalence of diabetes over an 11-year period in Mauritius. This increase was seen in both sexes, and in all age and ethnic groups, and was mainly due to an increase in the numbers of those with known diabetes. [source] Prevalence of the metabolic syndrome among the Inuit in Greenland.DIABETIC MEDICINE, Issue 11 2004A comparison between two proposed definitions Abstract Aims To estimate the prevalence of the metabolic syndrome among Greenland Inuit according to the World Health Organization (WHO) definition and the definition suggested by the National Cholesterol Education Program (NCEP). Methods From 1999 to 2001, 917 adult Inuit participated in a health survey in Greenland. The examination included a 75-g oral glucose tolerance test (OGTT). Body mass index (BMI), waist circumference, waist-to-hip ratio and blood pressure were measured. Plasma glucose, serum insulin, lipids and urine albumin/creatinine ratio were measured. The metabolic syndrome was diagnosed according to the WHO criteria 1999 and to the working definition suggested by the NCEP 2001. Results Using the WHO and the NCEP criteria, 20.7% and 17.9% of the participants had the metabolic syndrome, respectively. There was a moderate agreement between the two definitions, , = 0.56 (95% CI 0.51,0.61). Of those with the WHO metabolic syndrome, 37.9% did not have the NCEP syndrome, and 28.5% of those with the NCEP syndrome were not classified with the metabolic syndrome under the WHO criteria. Compared with the WHO syndrome, men with the NCEP syndrome had higher mean values of waist circumference, BMI and triglycerides, and lower mean values of high-density lipoprotein (HDL) cholesterol; among women, triglycerides were higher with the NCEP syndrome. Conclusion The metabolic syndrome is common among Inuit using either the WHO definition or the proposed NCEP definition. The classification disagreement is considerable and a universally accepted definition is needed. [source] Comparison of ADA and WHO criteria for the diagnosis of diabetes in elderly KoreansDIABETIC MEDICINE, Issue 10 2002K. M. Choi Abstract Aims This study was conducted to compare the prevalence and cardiovascular risk factors of different categories of glucose tolerance in the elderly Korean population using World Health Organization (WHO) and American Diabetes Association (ADA) criteria. Methods This study included 1456 non-diabetic subjects over the age of 60 years, selected from a cross-sectional study, which was conducted in 1999 in Seoul, Korea. Fasting and post-challenge 2-h plasma glucose, insulin levels, body mass index (BMI), waist,hip ratio (WHR), blood pressure, and lipid profiles were examined. Prevalence of glucose tolerance categories and the level of agreement (, statistics) were obtained using WHO 2-h criteria and ADA fasting criteria. Comparison of cardiovascular risk factors among several concordant and discordant glucose intolerance groups was done. Results The prevalence rates of newly diagnosed diabetes of elderly men defined by WHO 2-h criteria and ADA fasting criteria were 11.8% and 4.8%, respectively. That of elderly women was 8.1% by WHO 2-h criteria and 3.1% by ADA fasting criteria. The prevalence of impaired glucose tolerance (IGT) by WHO criteria was also higher than that of impaired fasting glucose (IFG) by ADA criteria (23.5% vs. 10.0% men, 23.7% vs. 7.5% women). The level of agreement between ADA fasting criteria and WHO 2-h criteria was low (weighted , = 0.228 men, weighted , = 0.301 women). The concordant diabetic women by both ADA fasting criteria and WHO 2-h criteria showed higher BMI, WHR, diastolic blood pressure, total cholesterol and triglyceride levels than concordant normal subjects. However, the isolated post-challenge hyperglycaemia (IPH) women group was not different significantly from the concordant normal women group except in BMI. Conclusions Our results clearly show that the 1997 ADA fasting criteria are less sensitive for diagnosing diabetes than oral glucose tolerance test (OGTT)-based WHO criteria in elderly Koreans. Also, there is a poor agreement of different categories of glucose tolerance between ADA and WHO criteria; therefore, the OGTT remains a valuable test in diagnosing diabetes and classifying various categories of glucose intolerance, especially in elderly Koreans. [source] Prevalence and determinants of diabetes mellitus and glucose intolerance in a Canarian Caucasian population , comparison of the 1997 ADA and the 1985 WHO criteria.DIABETIC MEDICINE, Issue 3 2001The Guía Study. Summary Aims To estimate the prevalence of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance in a Canarian population according to the 1997 ADA and the 1985 WHO criteria; and to study the cardiovascular risk factors associated with these categories. Methods A total of 691 subjects over 30 years old were chosen in a random sampling of the population (stratified by age and sex). An oral glucose tolerance test was performed (excluding known diabetic patients) and lipids were determined in the fasting state. Anthropometric and blood pressure measurements were performed, and history of smoking habits and medications was recorded. Results The prevalence of diabetes was 15.9% (1997 ADA) and 18.7% (1985 WHO); the prevalence of impaired fasting glucose and impaired glucose tolerance was 8.8 and 17.1%, respectively. The age-adjusted prevalence of diabetes (Segi's standard world population) for the population aged 30,64 years was 12.4% (1985 WHO). The risk factors significantly associated with diabetes (1997 ADA and 1985 WHO) were age, body mass index; waist-to-hip ratio, systolic and mean blood pressure, triglycerides, total cholesterol and low HDL-cholesterol. Age, body mass index and systolic blood pressure were associated with impaired fasting glucose and impaired glucose tolerance; triglycerides were also associated with impaired fasting glucose. Conclusions The prevalence of diabetes mellitus and glucose intolerance in Guía is one of the highest among studied Caucasian populations. The new 1997 ADA criteria estimate a lower prevalence of diabetes. Impaired fasting glucose also had a lower prevalence than impaired glucose intolerance and the overlap of these categories was modest. [source] Comparison of ADA 1997 and WHO 1985 criteria for diabetes in south Indians , the Chennai Urban Population StudyDIABETIC MEDICINE, Issue 12 2000R. Deepa SUMMARY Aims To compare the American Diabetes Association (ADA) fasting criteria and World Health Organization (WHO) 2-h criteria for diabetes in an urban south Indian population. Methods Subjects were drawn from the Chennai Urban Population Study. Of the 1001 subjects studied, 52 (5.2%) were diagnosed as having diabetes according to WHO 2-h criteria and 32 (3.2%) according to the ADA fasting criteria. Results Twenty-five (48%) of the subjects diagnosed with diabetes by the WHO 2-h criteria were not classified as having diabetes by the ADA fasting criteria. Similarly, of the 78 subjects (7.8%) classified as having impaired glucose tolerance (IGT), only eight (10.3%) had impaired fasting glucose (IFG) according to the ADA fasting criteria. The overall agreement between the WHO 2-h criteria and ADA fasting criteria was poor (, = 0.40). Conclusions Use of the ADA fasting criteria results in a lower prevalence rates of diabetes in this lean urban south Indian population. [source] Angiocentric glioma: A case report and review of the literatureDIAGNOSTIC CYTOPATHOLOGY, Issue 6 2010Ryan T. Mott M.D. Abstract Angiocentric glioma (AG) is a rare central nervous system (CNS) neoplasm that was only recently recognized by the World Health Organization (WHO). AG occurs in a broad age range, shows no gender predilection, and arises superficially in the cerebrum, usually resulting in medically intractable seizures. Most cases are cured by surgical excision alone, consistent with a WHO grade I neoplasm. We report a case of an AG in the right frontal lobe of a 57-year-old female, emphasizing the cytologic and immunohistochemical features, including confirmation and comparison with the surgical specimen. To our knowledge, this is the first report detailing the cytology of AG, including demonstration of important diagnostic findings that were only appreciated in the cytologic preparations and not in the smears or the surgical specimen. We also compare and contrast AG to other entities in the differential diagnosis and include a review of the literature. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. [source] Mental health in Europe: problems, advances and challengesACTA PSYCHIATRICA SCANDINAVICA, Issue 2001W. Rutz Objective:,To describe mental health care needs and challenges across the WHO European region of 51 nations. Method:,Based on morbidity and mortality data from HFA Statistical Database and Health21, the policy framework of WHO Europe, major trends in mental health care needs, psychiatric reform and mental health promotion are discussed. Results:,There is a mortality crisis related to mental ill health in Eastern European populations of transition. Destigmatization is required to improve early intervention and humanization of services, and national mental health audits are needed to create the basis for national mental health planning, implementation and monitoring. There are both problems and advances in service restructuring, and comprehensive mental health promotion programmes, preventive and monitoring strategies are required. Conclusion:,Partnerships between national and international organizations, especially WHO and the European Union, have to be strengthened to make progress on the way to integrated community mental health services. [source] Setting up an early warning system for epidemic-prone diseases in Darfur: a participative approachDISASTERS, Issue 4 2005Augusto Pinto Abstract In April,May 2004, the World Health Organization (WHO) implemented, with local authorities, United Nations (UN) agencies and non-governmental organisations (NGOs), an early warning system (EWS) in Darfur, West Sudan, for internally displaced persons (IDPs). The number of consultations and deaths per week for 12 health events is recorded for two age groups (less than five years and five years and above). Thresholds are used to detect potential outbreaks. Ten weeks after the introduction of the system, NGOs were covering 54 camps, and 924,281 people (IDPs and the host population). Of these 54 camps, 41 (76%) were reporting regularly under the EWS. Between 22 May and 30 July, 179,795 consultations were reported: 18.7% for acute respiratory infections; 15% for malaria; 8.4% for bloody diarrhoea; and 1% for severe acute malnutrition. The EWS is useful for detecting outbreaks and monitoring the number of consultations required to trigger actions, but not for estimating mortality. [source] Risk factors for suicide attempts in patients with alcohol dependence or abuse and a history of depressive symptoms: A subgroup analysis from the WHO/ISBRA studyDRUG AND ALCOHOL REVIEW, Issue 1 2010ÖZGÜR YALDIZLI Abstract Introduction and Aims. Alcoholism, depression and suicide attempts (SA) are strongly interrelated. The aims were to determine risk factors and develop a prognostic predictor model for SA in a subgroup of patients with a history of alcohol dependence or abuse and depressive symptoms. Design and Methods. A subgroup analysis from the data of the World Health Organisation (WHO)/the International Society for Biomedical Research on Alcoholism (ISBRA)-collaborative study on biological state and trait marker of alcohol use and dependence, an international multi-centre study with a cross-sectional design, based on a standardised questionnaire. We analysed from 1314 variables 43 factors,including demographic characteristics, dependence variables, comorbid disorders, personality trait markers and family history,that were supposed to be most predictive for SA according to the literature. Correlation analyses by the ,2 -test and Mann,Whitney U -test were performed to obtain statistical meaningful parameters for logistic regression analysis. Results. Of the 1863 persons included in the WHO/ISBRA study, 292 had both a history of depressive symptoms and alcohol dependence or abuse and were included in the subgroup analysis. In the logistic regression analysis, drinking status, depressive symptoms, adverse drinking experiences during alcohol consumption, bad experiences from drug abuse and antidepressant therapy were found to be independent risk factors for SA. Positive family history of alcoholism was a model-improving co-factor. This predictive model explains approximately 60% of the variance (Nagelkerkes' square). Discussion and Conclusions. This prognostic model derived from data of the WHO/ISBRA collaborative study shows important risk factors for SA in patients with history of alcohol abuse or dependence and depressive symptoms. [ Yaldizli Ö, Kuhl HC, Graf M, Wiesbeck GA, Wurst FM. Risk factors for suicide attempts in patients with alcohol dependence or abuse and a history of depressive symptoms: A subgroup analysis from the WHO/ISBRA study. Drug Alcohol Rev 2009] [source] Measurements in the Addictions for Triage and Evaluation (MATE): an instrument based on the World Health Organization family of international classificationsADDICTION, Issue 5 2010Gerard M. Schippers ABSTRACT Aims To present and evaluate a measurement tool for assessing characteristics of people with drug and/or alcohol problems for triage and evaluation in treatment. Measurements in the Addictions for Triage and Evaluation (MATE) is composed of 10 modules, selected on the basis of a detailed set of specifications. Conceptually, the MATE was constructed according to the ICD and International Classification of Functioning (ICF) in the World Health Organization (WHO) classification system. Two of the ICF-related modules were newly designed. Design Monitoring feasibility and field-testing in a treatment-seeking population with researcher and clinician-administered test,retest interviews, construct validation with related instruments and evaluation of the dimensional structure of the ICF-related modules. Setting The research was conducted in a large, regional substance abuse treatment centre in the Netherlands and at the Municipal Health Service of Amsterdam. Participants A total of 945 treatment-seeking patients were recruited during routine intakes, 159 of whom were interviewed twice; 32 problem drug users were also recruited from the Amsterdam cohort studies among problem drug users. Findings Completion time was reasonably short, and there were relatively few missing data. The factor structure of the ICF-related modules revealed a three-factor model with an acceptable fit. Inter-rater reliability ranged between 0.75 and 0.92 and was satisfactory, but interviewer reliability ranged between 0.34 and 0.73, indicating that some of subscales need to be improved. Concurrent validity was indicated by significant correlations (>0.50) between the ICF-related modules and the WHO Disability Assessment Schedule II (WHODAS II) and WHO Quality of Life brief version (WHOQOL-BREF). Conclusions The MATE can be used to allocate patients to substance abuse treatment. Because it is a comprehensive but flexible measurement tool that is also practical to use, the MATE is well suited for use in a heterogeneous population. [source] Addiction research centres and the nurturing of creativity: The Swiss Institute for the Prevention of Alcohol and Drug Problems.ADDICTION, Issue 5 2009future, present ABSTRACT The aim of this paper is to offer an account of the history, the current status and the future of substance use research at the Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA). Although founded originally by the temperance movement in 1901, its policy has shifted over time towards one which accepts an alcohol-consuming culture made up of self-determined but well-informed consumers, while still supporting those who choose to live an abstinent life. In the beginning, SIPA was involved primarily in collecting alcohol-related information and making it available to professionals and the general public. From the late 1960s SIPA began conducting its own research projects; by the mid-1970s it had set up its own in-house research department. In 2001, SIPA was appointed a World Health Organization (WHO) Collaborating Centre for Substance Abuse, Research, Prevention and Documentation. As a private non-governmental organization, most of its funding comes from external research commissions. SIPA participates in a variety of international projects [e.g. Gender Alcohol and Culture: An International Study (GenACIS), European School Survey Project on Alcohol and Drugs (ESPAD) and Health Behaviour in School-aged Children (HBSC)] and contributes to numerous national research projects dealing with substance use. It has also forged close links with more than 50 other research institutions in Switzerland and world-wide. Thanks to its work over the last 30 years, SIPA has become a chief port of call for alcohol use research in Switzerland. In the future, SIPA will continue to monitor substance use, while stepping up its prevention research activities and ensuring that it is able to react more promptly to emerging phenomena. [source] Carcinogenicity of acetaldehyde in alcoholic beverages: risk assessment outside ethanol metabolismADDICTION, Issue 4 2009Dirk W. Lachenmeier ABSTRACT Aims In addition to being produced in ethanol metabolism, acetaldehyde occurs naturally in alcoholic beverages. Limited epidemiological evidence points to acetaldehyde as an independent risk factor for cancer during alcohol consumption, in addition to the effects of ethanol. This study aims to estimate human exposure to acetaldehyde from alcoholic beverages and provide a quantitative risk assessment. Methods The human dietary intake of acetaldehyde via alcoholic beverages was estimated based on World Health Organization (WHO) consumption data and literature on the acetaldehyde contents of different beverage groups (beer, wine, spirits and unrecorded alcohol). The risk assessment was conducted using the European Food Safety Authority's margin of exposure (MOE) approach with benchmark doses obtained from dose,response modelling of animal experiments. Life-time cancer risk was calculated using the T25 dose descriptor. Results The average exposure to acetaldehyde from alcoholic beverages was estimated at 0.112 mg/kg body weight/day. The MOE was calculated to be 498, and the life-time cancer risk at 7.6 in 10 000. Higher risk may exist for people exposed to high acetaldehyde contaminations, as we have found in certain unrecorded alcohol beverages in Guatemala and Russia, for which we have demonstrated possible exposure scenarios, with risks in the range of 1 in 1000. Conclusions The life-time cancer risks for acetaldehyde from alcoholic beverages greatly exceed the usual limits for cancer risks from the environment set between 1 : 10 000 and 1 : 1 000 000. Alcohol consumption has thus been identified as a direct source of acetaldehyde exposure, which in conjunction with other sources (food flavourings, tobacco) results in a magnitude of risk requiring intervention. An initial public health measure could be to reduce the acetaldehyde content in alcoholic beverages as low as technologically possible, and to restrict its use as a food flavour additive. [source] Monitoring pyrethroid resistance in field collected Blattella germanica Linn. (Dictyoptera: Blattellidae) in IndonesiaENTOMOLOGICAL RESEARCH, Issue 2 2009Intan AHMAD Abstract The German cockroach, Blattella germanica, is a major and the most common pest in public areas in Indonesia. Although intensive control measures have been carried out to control the populations of this pest, results have been far from successful, which is believed to be because of its resistance to insecticides. A standard World Health Organization (WHO) glass jar test was carried out to determine the resistance level of this insect to pyrethroid insecticides, the most commonly used insecticides for cockroach control in Indonesia. A susceptible S1 strain collected from Tembagapura Papua was compared with four strains collected from Bandung, West Java: strain S2, from a local restaurant; strain S3, from the Bandung train station; and strains S4 and S5, from two different hotels. All strains showed low resistance to the pyrethroid, except the S5 strain, which had a Resistance Ratio (RR)50 of 95 for permethrin. The addition of piperonyl butoxide (PBO) suggests that the detoxifying enzyme mixed function oxidases (MFO) played an important role in the development of resistance to permethrin in the S5 strain, suggested by the high Synergist Ratio (SR) of 70.4. However, the low level of resistance to cypermethrin was not affected by PBO, suggesting that other mechanisms of pyrethroid resistance are involved. Our study is the first report of German cockroach resistance to permethrin in Indonesia, and the findings can be used in formulating potential strategies for cockroach resistance management. [source] An international survey of training programs for treating tobacco dependenceADDICTION, Issue 2 2009Nancy A. Rigotti ABSTRACT Aims The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) requires countries to implement tobacco dependence treatment programs. To provide treatment effectively, a country needs trained individuals to deliver these services. We report on the global status of programs that train individuals to provide tobacco dependence treatment. Design Cross-sectional web-based survey of tobacco treatment training programs in a stratified convenience sample of countries chosen to vary by WHO geographic region and World Bank income level. Participants Key informants in 48 countries; 70% of 69 countries who were sent surveys responded. Measurements Program prevalence, frequency, duration and size; background of trainees; content (adherence to pre-defined core competencies); funding sources; challenges. Findings We identified 61 current tobacco treatment training programs in 37 (77%) of 48 countries responding to the survey. Three-quarters of them began in 2000 or later, and 40% began after 2003, when the FCTC was adopted. Programs estimated training 14 194 individuals in 2007. Training was offered to a variety of professionals and paraprofessionals, but most often to physicians and nurses. Median program duration was 16 hours, but programs' duration, intensity and size varied widely. Most programs used evidence-based guidelines and reported adherence to core tobacco treatment competencies. Training programs were less frequent in low-income countries and in Africa. Securing funding was the major challenge for most programs; current funding sources were government (58%), non-government organizations (23%), pharmaceutical companies (17%) and, in one case, the tobacco industry. Conclusion Training programs for tobacco treatment providers are diverse and growing. Most upper- and middle-income countries have programs, and most programs appear to be evidence-based. However, funding is a major challenge. In particular, more programs are needed for non-physicians and for low-income countries. [source] Assessing the validity of potential alcohol-related non-fatal injury indicatorsADDICTION, Issue 3 2008John Langley ABSTRACT Aim To assess critically the face validity of the World Health Organization's (WHO's) International Guide for Monitoring Alcohol Consumption and Related Harm (MACRH) for deriving indicators, for the purposes of developing non-fatal alcohol-related injury indicators in New Zealand. Design MACRH's five solutions for deriving indicators are: (i) use only alcohol-specific cases; (ii) identify subsets of events known to be highly alcohol-related; (iii) utilize control indicators that are rarely alcohol-related; (iv) estimate alcohol attributable fractions (AAFs) and adjust indicators accordingly; and (v) develop composite indicators. These were assessed in terms of their face validity with particular reference to New Zealand. Findings There are significant face validity issues with each of the five options. Solution 4 offers the greatest promise, provided that: (i) valid AAFs can be derived and they are updated regularly; and (ii) appropriate adjustment is made for extraneous influences on the estimates of alcohol-related harm. To date, the latter has not been carried out. Conclusions Most potential sources of data on alcohol-related harm are subject to extraneous influences, which vary over time and space. While the attempt by WHO to offer solutions to this problem is laudable, the solutions do not address the problem adequately. MACRH guidelines need to be revised to include criteria for a valid outcome indicator. [source] Content and distribution of arsenic in soils, sediments and groundwater environments of the southern Pampa region, ArgentinaENVIRONMENTAL TOXICOLOGY, Issue 6 2006M. del C. Blanco Abstract The health of a large rural population in the southern Pampa (Argentina) is at risk owing to newly detected areas where As-groundwater exceeds 0.01 mg/L standard (WHO (1995) Guidelines for drinking water quality, 2nd edition. pp 43,45). Currently, devitrification of volcanic glass is invoked to interpret the origin of arsenic in the aquifers hosted in a sequence of pampean loess (Plio-Pleistocene) juxtaposed with postpampean loess (Holocene). Our data suggest that arsenic is not specifically associated with volcanic glass and that other minerals contribute to As-release into groundwater. The goals were (1) to understand As-groundwater spatial variability, (2) to explore soils/sediments/water relationships and to identify the probable As-provenance. Comparable As concentrations of the light and the heavy sand fractions suggest that though detrital glass is a major light constituent, other existing primary minerals are As-bearers that contribute to As-release into groundwater. Grouping of materials according to their As-content indicated spatial variability in the sedimentary distribution pattern leading to differences in the frequencies of occurrence of As-bearing minerals. Phreatic waters were Ca + Mg bicarbonate and devoid of As in the intake areas (Ventania System) and Na-carbonate but As-rich towards the discharge (Atlantic coast and local depressions). As-groundwater reflects a patchy distribution within the pampean landscape. A correspondence between As-high groundwater, EC >1 dSm, CO3H,, alkaline pH and a longer water residence time do exist triggering As extraction from the loess sand fraction and desorption from charged fine particles which lead to As-toxicity towards groundwater discharge. © 2006 Wiley Periodicals, Inc. Environ Toxicol 21: 561,574, 2006. [source] How the 1977 World Health Organization report on alcohol-related disabilities came to be written: a provisional analysisADDICTION, Issue 11 2007Griffith Edwards ABSTRACT Background In 1977 the World Health Organization (WHO) published a report entitled ,Alcohol-Related Disabilities'. The crucial contribution of this report was to differentiate between alcohol dependence, on one hand, and alcohol-related disabilities (or problems) on the other hand. Essentially, it offered a bi-axial mapping of the field of concern. Aims This paper seeks to identify the multiple influences which shaped the evolution of this report. Methods Use is made of unpublished archival material and recall of personal involvement, together with relevant published material. Results Three major influences made it possible to move beyond the confines of previous WHO thinking on alcohol: the multi-disciplinary nature of the input; the internationality of the enterprise; and the expectations set that the concepts developed should speak to the practical world. Conclusions The arena of drug and alcohol policy has, for more than a century, been rich in its reports. This case study, although limited in its immediate content, points to the need for further analysis of the history of such reports. [source] Seasonal production and molecular characterization of microcystins in Oneida Lake, New York, USAENVIRONMENTAL TOXICOLOGY, Issue 3 2005Amber Hotto Abstract Oneida Lake, northeast of Syracuse, New York, in the United States, is a shallow eutrophic lake with a well-established toxic cyanobacterial population. Samples for DNA, toxin, and phycological analyses were collected from six stations throughout the summers of 2002 (78 samples) and 2003 (95 samples). DNA was amplified by PCR using primer sets specific to the nonribosomal microcystin synthetase complex (mcyB and mcyD). PCR analysis in 2002 indicated that the microcystin genes were present in the water column from mid-June through October, as 88% of the samples tested positive for mcyB and 79% of the samples tested positive for mcyD. In both years the onset of microcystin production was detected as early as mid-July by the protein phosphatase inhibition assay, reaching a maximum in 2002 of 2.9 ,g L,1 and in 2003 of 3.4 ,g L,1. Beginning in mid- to late August of both years the microcystin level at all six stations was in excess of the World Health Organization (WHO) advisory level of 1.0 ,g L,1. In the present study we compared microcystin occurrence and potential production at the six stations using protein phosphatase inhibition assay, high-performance liquid chromatography, and polymerase chain reaction analyses. © 2005 Wiley Periodicals, Inc. Environ Toxicol 20: 243,248, 2005. [source] | |||||||||||||||||||||||||||||||||||||||||||