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Public Health Importance (public + health_importance)
Selected AbstractsAsymptomatic Hypertension in the Emergency Department: A Matter of Critical Public Health ImportanceACADEMIC EMERGENCY MEDICINE, Issue 11 2009Phillip D. Levy MD Abstract Asymptomatic hypertension (HTN) is commonly encountered in the emergency department (ED), but in most circumstances little is done about it. While many factors may contribute to this, the failure to recognize asymptomatic HTN as a public health problem is particularly important. Given the established long-term consequences of elevated blood pressure (BP), a reconsideration of methods that could enhance surveillance and intervention in the ED is needed. In this article, we discuss the relevant epidemiology of asymptomatic HTN and present a novel approach using a modified version of the Haddon's matrix to systematically address the challenges that contribute to ineffective screening and suboptimal outcomes. [source] Kava in Arnhem Land: a review of consumption and its social correlatesDRUG AND ALCOHOL REVIEW, Issue 3 2000Alan R. Clough Abstract The debate about the effects and public health importance of the way Aboriginal people drink kava has been confounded by claims, based on anecdote, of imputed health effects. Anecdote and comment have promoted the perception that dosage levels among Aboriginal people are much greater than in Pacific island societies. In this paper we review published data about kava consumption, and evaluate it with respect to information collected from observation of one Aboriginal community in Arnhem Land (Northern Territory) where people tend to consume kavaat a steady tempo; 37g of kava powder containing around 3800mg of kava lactones in 670ml of water in an hour. The highest levels of consumption in Arnhem Land have been reported to be up to 900g/week of kava powder with heavy consumers drinking at least 610g/week, levels comparable to estimates for Pacific-island societies. The significance of a steady drinking tempo means that an individual's weekly kava consumption relates directly to the amount of time spent drinking which, in turn, is correlated with categories of social setting of drinking (p < 0.0002). Lone drinkers appear to be the heaviest users while lowest consumption takes place in private domestic situations, where people enjoy kava as part of family group activities. Surrogates of consumption levels may be found in local socio-economic circumstances. This approach may be useful when more direct measurement of consumption is difficult or impossible. [source] Surrogate Alcohol: What Do We Know and Where Do We Go?ALCOHOLISM, Issue 10 2007Dirk W. Lachenmeier Background:, Consumption of surrogate alcohols (i.e., nonbeverage alcohols and illegally produced alcohols) was shown to impact on different causes of death, not only poisoning or liver disease, and appears to be a major public health problem in Russia and elsewhere. Methods:, A computer-assisted literature review on chemical composition and health consequences of "surrogate alcohol" was conducted and more than 70 references were identified. A wider definition of the term "surrogate alcohol" was derived, including both nonbeverage alcohols and illegally produced alcohols that contain nonbeverage alcohols. Results:, Surrogate alcohol may contain substances that cause severe health consequences including death. Known toxic constituents include lead, which may lead to chronic toxicity, and methanol, which leads to acute poisoning. On the other hand, the role of higher alcohols (e.g., propanol, isobutanol, and isoamyl alcohol) in the etiology of surrogate-associated diseases is currently unclear. Whether other constituents of surrogates have contributed to the high all-cause mortality over and above the effect of ethanol in recent studies also remains unclear. Conclusions:, Given the high public health importance associated with the consumption of surrogate alcohols, further knowledge on its chemical composition is required as well as research on its links to various disease endpoints should be undertaken with priority. Some interventions to reduce the harm resulting from surrogate alcohol could be undertaken already at this point. For example, the use of methanol or methanol-containing wood alcohol should be abolished in denatured alcohol. Other possible surrogates (e.g., automobile products) should be treated with bittering agents to avoid consumption. [source] Analysis of carotenoids in ripe jackfruit (Artocarpus heterophyllus) kernel and study of their bioconversion in ratsJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 2 2005UG Chandrika Abstract Vitamin A deficiency is of public health importance in Sri Lanka. Carotenoids are a significant source of provitamin A. The objective of this study was to analyse the carotenoid composition of jackfruit (Artocarpus heterophyllus sinhala: Waraka) kernel using MPLC and visible spectrophotometry and to determine the bioavailability and bioconversion of carotenoids present in jackfruit kernel by monitoring (i) the growth and (ii) levels of retinol and carotenoids in the liver and serum of Wistar rats provided with jackfruit incorporated into a standard daily diet. Carotenoid pigments were extracted using petroleum ether/methanol and saponified using 10% methanolic potassium hydroxide. Six carotenoids were detected in jackfruit kernel. The carotenes ,-carotene, ,-carotene, ,-zeacarotene, ,-zeacarotene and ,-carotene-5,6-epoxide and a dicarboxylic carotenoid, crocetin, were identified, corresponding theoretically to 141.6 retinol equivalents (RE) per 100 g. Our study indicated that jackfruit is a good source of provitamin A carotenoids, though not as good as papaya. Serum retinol concentrations in rats supplemented with jackfruit carotenoids were significantly higher (p = 0.008) compared with the control group. The same was true for liver retinol (p = 0.006). Quantification was carried out by RP-HPLC. These results show that the biological conversion of provitamin A in jackfruit kernel appears satisfactory. Thus increased consumption of ripe jackfruit could be advocated as part of a strategy to prevent and control vitamin A deficiency in Sri Lanka. Copyright © 2004 Society of Chemical Industry [source] Carotenoids in yellow- and red-fleshed papaya (Carica papaya L)JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 12 2003U Gamage Chandrika Abstract Vitamin A deficiency is a disorder of public health importance in Sri Lanka. A recent national survey revealed that 36% of preschool children in Sri Lanka have vitamin A deficiency (serum retinol <0.2 µg ml,1). In view of its well-established association with child morbidity and mortality, this is a reason for concern. One of the main fruits which has been recommended for prevention of vitamin A deficiency in Sri Lanka is papaya (Carica papaya L). In this study the carotenoid profiles of yellow- and red-fleshed papaya were analysed by medium-pressure liquid chromatography (MPLC) and UV-vis spectrophotometry. A section of yellow-fleshed papaya showed small carotenoid globules dispersed all over the cell, whereas in red-fleshed papaya the carotenoids were accumulated in one large globule. The major carotenoids of yellow-fleshed papaya were the provitamin A carotenoids ,-carotene (1.4 ± 0.4 µg g,1 dry weight (DW)) and ,-cryptoxanthin (15.4 ± 3.3 µg g,1 DW) and the non-provitamin A carotenoid ,-carotene (15.1 ± 3.4 µg g,1 DW), corresponding theoretically to 1516 ± 342 µg kg,1 DW mean retinol equivalent (RE). Red-fleshed papaya contained the provitamin A carotenoids ,-carotene (7.0 ± 0.7 µg g,1 DW), ,-cryptoxanthin (16.9 ± 2.9 µg g,1 DW) and ,-carotene-5,6-epoxide (2.9 ± 0.6 µg g,1 DW), and the non-provitamin A carotenoids lycopene (11.5 ± 1.8 µg g,1 DW) and ,-carotene (9.9 ± 1.1 µg g,1 DW), corresponding theoretically to 2815 ± 305 µg kg,1 DW mean RE. Thus the carotenoid profile and organisation of carotenoids in the cell differ in the two varieties of papaya. This study demonstrates that carotenoids can be successfully separated, identified and quantified using the novel technique of MPLC. Copyright © 2003 Society of Chemical Industry [source] Evaluation of metaflumizone granular fly bait for management of housefliesMEDICAL AND VETERINARY ENTOMOLOGY, Issue 2 2009A. AHMAD Abstract The housefly, Musca domestica L. (Diptera: Muscidae), is a pest of great veterinary and public health importance. In this study, the efficacy of metaflumizone granular fly bait was assessed on first generation (F1) housefly adults raised from flies collected at a cattle feedlot in Kansas. All bioassays were conducted as choice tests, with flies having ad libitum access to water, granular sugar and bait. A commercial methomyl-based bait (Golden MalrinTM) was used as positive control; no bait (water and granular sugar only) was used as negative control. Fly mortality was recorded on days 2, 7 and 14. The metaflumizone bait was significantly more slow-acting than the methomyl bait (mortality rates after 2 days of exposure were 49.9% and 57.9%, respectively). However, there were no significant differences in cumulative mortality later in the bioassays. Cumulative mortality rates on days 7 and 14 were 96.1% (metaflumizone), 91.4% (methomyl) and 99.0% (metaflumizone), 97.6% (methomyl), respectively. Our results demonstrate that the metaflumizone granular fly bait may be an effective modality for incorporation into management programmes for houseflies in and around livestock production facilities as well as in residential settings. [source] Zinc Nutrition and HIV InfectionNUTRITION REVIEWS, Issue 3 2002Roland Kupka BS The trace element zinc is involved in many important immune processes. A number of immunologic impairments owing to zinc deficiency are also evident in HIV disease, most notably a reduction in the number of circulating T lymphocytes. Observational epidemiologic studies have provided conflicting results on the role of zinc status in HIV disease progression. Randomized, placebo-controlled trials are needed to resolve this controversy. Studies must also address the role of zinc in vertical transmission of HIV from mother to child and its role in reducing the risk of adverse pregnancy outcomes, both of which are of considerable public health importance in developing countries. [source] Diagnostic accuracy of verbal autopsies in ascertaining the causes of stillbirths and neonatal deaths in rural GhanaPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 5 2008Karen M. Edmond Summary This study evaluated the diagnostic accuracy of a verbal autopsy (VA) tool in ascertaining the causes of stillbirths and neonatal deaths in rural Ghana and was nested within a community-based maternal vitamin A supplementation trial (ObaapaVitA trial). All stillbirths and neonatal deaths between 1 January 2003 and 30 June 2004 were prospectively included. Community VAs were carried out within 6 months of death and were classified with a primary cause of death by three experienced paediatricans. The reference standard diagnosis was obtained by the study paediatrician in 4 district hospitals in the study area. There were 20 317 deliveries, 661 stillbirths and 590 neonatal deaths with a VA diagnosis in the study population. A total of 311 stillbirths and 191 neonatal deaths had both a VA and a hospital reference standard diagnosis. The VA performed poorly for stillbirth diagnoses such as congenital abnormalities and maternal haemorrhage. Accuracy was higher for intrapartum obstetric complications and antepartum maternal disease. For neonatal deaths, sensitivity was >60% for all major causes; specificity was 76% for birth asphyxia but >85% for prematurity and infection. Overall, VA diagnostic accuracy was higher than expected in this rural African setting. Our classification system was based on the expected public health importance of the individual causes of death, differing implications for intervention and the ability to distinguish between the individual causes in low-resource settings. We believe this system was easier to use than traditional approaches and resulted in high precision and accuracy. However, further simplifications are needed to allow use of the World Health Organisation VA in routine child health programmes. The diagnostic accuracy of the VA tool should also be assessed in other regions and in multicentre studies. [source] Factors associated with cancer distress in the Asbestos Post-Exposure Survey (APEXS),AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2009Marion Maurel MSc Abstract Objectives CT-scan screening programs for lung cancer detection have been proposed in high-risk subjects, and more recently in former asbestos-exposed subjects. However, to date no data are available on psychological impact of such programs. The aim of this study is to examine the risk factors of psychological distress at baseline of a CT-scan screening program among asbestos-exposed subjects. Methods The Asbestos Post-Exposure Survey (APEXS) was carried out in France between October 2003 and December 2005 in order to screen asbestos-related diseases by CT-scan. Volunteers underwent self-administered questionnaires including an asbestos exposure assessment and, for a large sub-sample, a validated psychological distress scale. Non-exposed subjects were used as reference group. Results At baseline, a significant higher level of distress was observed in exposed subjects (n,=,3,122) relative to the reference group (n,=,486) after adjustment on age, sex, and tobacco status. This distress is associated independently with the self-perception of (i) intensity of asbestos exposure and (ii) the risk of current or future disease related to the asbestos exposure. The perception of the cancer risk related to asbestos seems to play a fundamental role in this psychological distress. Conclusion In this study, asbestos-exposed subjects experienced a higher significant cancer distress than previously described in literature. These findings may be of potential public health importance. First, the impact of such occupational exposures on quality of life of patients who suffer from cancer related to these exposures has to be appraised. Secondly, the assessment of psychological impact of CT-scan screening programs among asbestos-exposed subjects is also required. Am. J. Ind. Med. 52:288,296, 2009. © 2009 Wiley-Liss, Inc. [source] New insights into Chlamydia intracellular survival mechanismsCELLULAR MICROBIOLOGY, Issue 11 2009Jordan L. Cocchiaro Summary Chlamydia sp. are responsible for a wide range of diseases of significant clinical and public health importance. In this review, we highlight how recent cellular and functional genomic approaches have significantly increased our knowledge of the pathogenic mechanisms used by these genetically intractable bacteria. As the extensive repertoire of chlamydial proteins that are translocated into the mammalian host is identified and characterized, a molecular understanding of how Chlamydiae co-opt host cellular functions and block innate immune pathways is beginning to emerge. [source] Research Psychotherapy: Aspirin or Music?CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 3 2009John F. Curry Beutler's call for an expanded psychotherapy agenda is appropriate but does not require downgrading the role of randomized clinical trials (RCTs). Large-scale RCTs are necessary to address questions of general public health importance. Within RCTs, psychotherapy can be conducted in a flexible, creative manner, similar to the practice of good clinicians. The aspirin analogy drawn from Klerman is not illustrative of how psychotherapy is actually conducted in contemporary clinical trials. A better analogy is that of music, which not only involves known ingredients and trainable, replicable skills, but also permits tailoring and improvisation. By conducting large RCTs, secondary analyses of these studies, and smaller controlled trials, psychotherapy researchers can address many clinically relevant questions. [source] | ||||||||||||||||