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Los Angeles, CA, United States

This article reviews the different steps taken during the past 20 years for the prevention and control of non-communicable diseases (NCDs) in the Seychelles. National surveys revealed high levels of several cardiovascular risk factors and prompted an organized response, starting with the creation of an NCD unit in the Ministry of Health. Information campaigns and nationwide activities raised awareness and rallied increasingly broad and high-level support. Significant policy was developed including comprehensive tobacco legislation and a School Nutrition Policy that bans soft drinks in schools. NCD guidelines were developed and specialized 'NCD nurses' were trained to complement doctors in district health centers. Decreasing smoking prevalence is evidence of success, but the raising so-called diabesity epidemic calls for an integrated multi-sector policy to mould an environment conducive to healthy behaviors. Essential components of these efforts include: effective surveillance mechanisms supplemented by focused research; generating broad interest and consensus; mobilizing leadership and commitment at all levels; involving local and international expertise; building on existing efforts; and seeking integrated, multi-disciplinary and multi-sector approaches. Source

Altinsoy H.,Bogazici University | Altinsoy H.,Social Republic | Yildirim H.A.,Sakarya University
International Journal of Biometeorology

Occupational fatalities and work-related injuries are more common in Turkey than in most developing and developed countries. Several precautions have been taken concerning the matter, and The Occupational Health and Safety Act (OHSL 2012) has been passed. These efforts, however, have failed to incorporate in their framework the role of global warming. New legislation is underway for the prevention of occupational diseases, injuries, and fatalities. This is particularly worrisome given that Turkey is in the forefront of countries projected to be affected seriously by climate change. Consequently, a study on the direct and indirect impact of climate change on workers' health and labour productivity is paramount. The main purpose of this research is to present diminishing labour productivity as a consequence of decreased working hours via an estimate of rest hours of workers in manual labour. The climatic outputs of Regional Climate Model (RegCM3) obtained from the ENSEMBLES Project are used to calculate the wet bulb globe temperature (WBGT) over western Turkey. The study covers the span of years between 1971 and 2100. Moreover, spatial distributions of observed domain are estimated by means of a seasonal analysis, preliminary to a more detailed research. Critical regions, more adversely influenced than others, are identified. The total number of loss days for these critical regions are presented for various time periods. As a result, labour productivity particularly in agriculture and construction is expected to diminish seriously over Central Anatolia, Cyprus, and parts of the Aegean and eastern Mediterranean coastal areas. Between 2071 and 2100, deficiency in labour productivity may reach up to 52 % during the summer across some of these critical regions. Though it will be seen that the present study has focused primarily on manual labour and outdoor work in particular, it foreshadows nevertheless the dangerous impact of climate change on occupational health and labour productivity in general. © 2014, ISB. Source

Fuksa L.,Social Republic | Micuda S.,Charles University | Grim J.,Charles University | Ryska A.,Charles University | Hornychova H.,Charles University
Cancer Investigation

Neoadjuvant chemotherapy (NCT) of breast cancer enabled improved outcomes especially in patients with advanced and inflammatory diseases. Biological heterogeneity of these tumors, however, requires better molecular characterization of the malignant tissue with consequent individualization in the selection of appropriate agents. To date, numerous molecular markers have been identified, and some of them (e.g., measurement of hormonal or growth factors receptors) are already routinely used for breast cancer classification before NCT. In the present article, we summarize current knowledge about established as well as promising biomarkers which have demonstrated prognostic or predictive value in NCT of breast cancer. © 2012 Informa Healthcare USA, Inc. Source

Agency: Cordis | Branch: FP7 | Program: CP-FP | Phase: HEALTH-2007-2.4.3-1 | Award Amount: 7.70M | Year: 2008

Preliminary data indicate that there is a strong association between the incidence of immune-mediated diseases and improving standard of living and hygiene. One of the steepest gradient in standard of living worldwide is present at the border between Russian Karelia and Finland with a sevenfold difference in the gross national product, while Estonia represents a country in rapid transition. These three populations comprise a living laboratory providing a unique possibility to test the hygiene hypothesis in the development of immune-mediated diseases. The incidence of type 1 diabetes (T1D) is six times lower in Russian Karelia than in Finland, whereas there are very limited differences in the frequency of risk HLA genotypes in the background population. This proposal aims at comparing (i) the frequency of beta-cell autoimmunity and other organ-specific autoantibodies; (ii) the frequency of IgE-specific sensitisation and signs of allergy; (iii) the frequency of various infections; (iv) the gut microbial flora; and (v) dietary intake in young children between the three populations. The birth cohort arm of the study aims at (i) delineating the ontogeny of the immune system by using modern tools of functional genomics; (ii) comparing the functional characteristics of regulatory T cells; (iii) characterising the gut microbial colonisation in infants; (iv) assessing the timing of exposure to foreign proteins in infancy (v) defining the interrelations between dietary factors, gut microbial flora and acute microbial infections. The objectives will be approached by studying 1600 children at the age of 3 and 5 years and by observing a birth cohort comprising about 320 subjects with HLA-conferred susceptibility to autoimmunity from birth up to the age of 3 years in each country. This proposal is expected to provide new data on the reasons and mechanisms behind the increasing rates of T1D and other immune-mediated diseases seen in most developed countries after World War II.

Kruk M.E.,Columbia University | Rockers P.C.,Harvard University | Varpilah S.T.,Social Republic | MacAuley R.,Social Republic | MacAuley R.,Basic Support for Institutionalizing Child Survival BASICS
Medical Care

Background: Liberia is rebuilding its health system after a lengthy civil war in which traditional health care was the only reliable source of care. Objective: This study explored individual, village, and health system factors related to the utilization of health clinics versus informal providers (eg, healers, medicine sellers) in Liberia. Research Design, Participants, And Measures: This was a cross-sectional population-representative survey of 1435 adults living in rural Nimba County, Liberia. Participants were asked about past year visits to traditional and formal health care providers and demographics, health, and trauma indicators. The association between formal and informal visits and potential determinants was estimated in separate models using generalized estimating equations to adjust for village-level clustering. Results: The median number of visits in the past year to formal and informal providers was 3 and 10, respectively. Clinic visits increased with younger age and female sex, past trauma exposure, the number of traditional healers, and the presence of a facility dispenser. Frequency of informal visits increased with poor self-reported mental and physical health, the presence of facility fees and decreased with literacy and wealth and satisfaction with the formal health system. Conclusions: Rural Liberians use both formal and informal health care extensively and as complements rather than substitutes. The reliance on traditional medicine to address health needs is of concern in a country with a high disease burden. Health system investments that build public confidence in the health system may help shift demand from informal to formal health care. Copyright © 2011 by Lippincott Williams & Wilkins. Source

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