International conference to ban landmines

Dramatic economic growth over the last 50 years has been accompanied by widening inequalities world‐wide in wealth and energy consumption, diminished life expectancy in some countries, and deteriorating indices of environmental sustainability including loss of bio‐diversity. Raised output of carbon dioxide (CO₂) and other greenhouse gases due to increased economic and industrial activity is causing progressive climate change, leading in turn to direct and indirect adverse effects on health. Emissions of greenhouse gases can be lowered by increased use of renewable energy sources, for example, wind power in the United Kingdom (UK), greater energy efficiency and other measures to promote sustainability. The experience of some developing countries shows that favourable indicators of health and development can accompany a low output of greenhouse gases. It is unclear whether contemporary political and social systems can deliver improved human development without increased use of fossil fuels and other resources.     

Pesticide use among greenhouse workers in Turkey

Pesticides are chemicals use of which has increased worldwide since the Second World War in order to improve the quality and the quantity of agricultural products. Their harmful effects on the environment and the human health have also been seen as usage increases. Although there have been studies about the harmful effects of pesticides on human health in the developing countries, there is limited data about the use of pesticides in Turkey. The aim of our study was to obtain data about the use of pesticides in greenhouse in Turkey. About 131 greenhouse workers were interviewed with within the province of Izmir: 63.8% graduated from primary school; 49.2% were living in region where the greenhouses were located; 46.2% were working in their own greenhouses; 42.3% had health insurance; 86.9% used pesticides and 59.3% did not take protective cautions during use pesticide. The application technique, location, amount, time or any other required information of the pesticides used have not been recorded by the greenhouse workers.     

The climate change convention and human health

The United Nations Framework Convention on Climate Change, signed at Rio in June 1992, is intended to minimize climate change and its impact. Much of its text is ambiguous and it is not specifically directed to health considerations. It is, however, recognized that adverse effects of climate change on health are a concern of humankind, and health is an integral part of the Convention. The Convention includes commitments by the developed countries to reduce emissions of greenhouse gases and to increase public awareness of these commitments. The significance of the Convention in these respects is discussed critically and future developments considered.     

Climate change and malaria: Exploring the risks

That the enhanced greenhouse effect may prove to influence human health will come as no surprise. One of the potential health consequences is a change in distribution patterns of vector‐borne diseases. In tropical countries, such diseases are a major cause of illness and death. One of the most important vector‐borne diseases in the world is malaria, which is associated with one of four species of parasite and transmitted by a mosquito vector. Climatic conditions, and temperature in particular, directly influence mosquito development, feeding‐frequency and longevity of the mosquito, as well as the time in which the parasite develops inside the mosquito. Other environmental factors such as vegetation and breeding sites are indirectly influenced by climate conditions. In order to assess the impact of an anthropogenic climate change on the transmission of malaria, an integrated assessment model has been developed. In this integrated model, the direct effects of a change in temperature and precipitation on the transmission potential of a mosquito population is assessed by means of the vectorial capacity. The effect of a human‐induced climate change on human health is evaluated by assessing the change in malaria prevalence and disease burden. A sustainable development index, which is an aggregate of an environmental pressure indicator, a health indicator and a socio‐economic development indicator is introduced and discussed. Such an index can be used to determine whether future projections are sustainable.     

Nuclear forensic science in Australia: current status and future plans

ABSTRACT

The use of nuclear and other radioactive material is expanding globally. An increasing number of countries are signalling their intention to employ nuclear power to meet the energy needs of rapidly growing populations, while socioeconomic development is leading to an increased application of medical and industrial radioisotopes. It is critical that rigorous nuclear security systems are established and maintained to accommodate the increased storage, movement and use of such materials. One aspect of nuclear security is nuclear forensics, which is defined by the International Atomic Energy Agency (IAEA) as ‘the scientific analysis of nuclear or other radioactive material, or of other evidence that is contaminated with radionuclides, in the context of international or national law’. In Australia, forensic examination of nuclear or other radioactive material is undertaken by ANSTO, whilst the current capability for the forensic examination of evidence contaminated with radionuclides is jointly held by ANSTO and the Australian Federal Police (AFP). This article describes some of the recent activities undertaken by ANSTO and the AFP to maintain and further develop Australia’s nuclear forensic science capability and outline future plans to enhance Australia’s capability to provide nuclear forensic support to nuclear security.     

Climate change and world food supply

Climate change could have far‐reaching effects on agriculture, trade patterns, development and food security. This article examines quantitatively the impact of climate change on food production and numbers at risk of hunger, allowing for factors such as latitude and farming practice. Globally, a doubling of atmospheric carbon dioxide (CO2) level may lead to a small to moderate decrease in food production, but developing countries would bear the brunt of the consequences. To prevent widespread hunger, the agricultural industry should develop management programmes for hot and dry conditions, in conjunction with measures to slow the growth of the human population and reduce emissions of greenhouse gases.     

Sustainability: Concept,implementation, economic implications

This paper defines environmental sustainability and draws attention to the aggregate unsustainability of current human lifestyles and economic activities. It lists a set of sustainability conditions which imply a fundamental transformation in patterns of production and consumption, and the ways in which government policies could help to bring this transformation about. The effects of such policies on macroeconomic quantities such as output, inflation, unemployment and the balance of payments are uncertain and depend to a large extent on whether new technologies or institutional arrangements will allow the transformation to be achieved at little or no net cost — a point of controversy between technological optimists and pessimists. Whether or not moves towards environmental sustainability will permit continuing economic growth, there is no likelihood of living standards collapsing under the challenge, but new approaches to unemployment will have to be developed. Finally, although economic growth may come about as a result of environmental sustainability becoming the dominant policy objective, the converse is unlikely to be true. Putting sustainability first is both the prudent and responsible policy orientation.     

Climate change & health: the case for sustainable development

The Earth's climate has been stable for around 10,000 years, though it has been very variable in earlier periods and has occasionally changed abruptly through natural processes. Industrialization and population growth have brought an exponential rise in the use of carbonaceous fuels, which is now having an observable impact on the composition of the atmosphere. Carbon dioxide levels are already substantially above pre-industrial levels, and rising appreciably year on year. Climate models suggest that the anthropogenic rise in carbon dioxide and other greenhouse gases will lead to rapid climate change over the twenty-first century, with an increase in global average temperatures in the region of two to five degrees Celsius. This will present problems of adaptation for many natural systems and have largely negative effects on human health through both direct and indirect mechanisms. There is also a possibility of unpredicted catastrophic impacts arising from non-linear effects of climate change, which may have more damaging effects on human and other populations. Policy responses have to be directed towards both adaptation needs and mitigation. Mitigation in particular presents formidable social, political and technological challenges, but it may bring net health benefits in the short as well as the longer term.     

The role of exercise in weight regulation in nonathletes

Obesity is an extremely prevalent condition that is associated with a range of deleterious health effects. While traditionally considered a disorder primarily of energy intake, accumulating evidence underscores the importance of energy expenditure in the development and treatment of obesity. As the most variable component of energy expenditure, physical activity can influence the development of obesity as well as success in achieving both initial and long term weight loss. Among the types of exercise-related physiological and behavioural factors most likely to be involved in the development of obesity are reductions in the amount of physical activity actually performed, differences in the effect of physical activity on diet-induced thermogenesis, and modeling of deleterious dietary and exercise patterns on the part of the family and other facets of the environment. In contrast, there is relatively little evidence supporting the common belief that obese individuals have a significantly greater energy intake than nonobese individuals. With respect to weight reduction in the already obese, while increased physical activity levels often augment caloric restriction programmes in aiding initial weight loss, evidence suggests that physical activity may be particularly important in helping to sustain initial losses through increased total energy output, preservation of lean body mass, and changes in substrate utilisation. The psychological benefits received from regular participation in a physical activity programme may serve as an additional impetus for engaging in such activities over the long run. Developing programmes to aid in long term adherence to physical activity regimens remains the most critical challenge. Recent results suggest the utility of regular, brief contacts in aiding sustained physical activity participation in individuals attempting to control their weight.     

Anabolic steroids and cardiovascular risk

Recent reports from needle exchange programmes and other public health initiatives have suggested growing use of anabolic steroids (AS) in the UK and other countries. Data indicate that AS use is not confined to body-builders or high-level sportsmen. Use has spread to professionals working in emergency services, casual fitness enthusiasts and subelite sportsmen and women. Although the precise health consequences of AS use is largely undefined, AS use represents a growing public health concern. Data regarding the consequences of AS use on cardiovascular health are limited to case studies and a modest number of small cohort studies. Numerous case studies have linked AS use with a variety of cardiovascular disease (CVD) events or endpoints, including myocardial infarction, stroke and death. Large-scale epidemiological studies to support these links are absent. Consequently, the impact of AS use upon known CVD risk factors has been studied in relatively small, case-series studies. Data relating AS use to elevated blood pressure, altered lipid profiles and ECG abnormalities have been reported, but are often limited in scope, and other studies have often produced equivocal outcomes. The use of AS has been linked to the appearance of concentric left ventricular hypertrophy as well as endothelial dysfunction but the data again remains controversial. The mechanisms responsible for the negative effect of AS on cardiovascular health are poorly understood, especially in humans. Possibilities include direct effects on myocytes and endothelial cells, reduced intracellular Ca2+ levels, increased release of apoptogenic factors, as well as increased collagen crosslinks between myocytes. New data relating AS use to cardiovascular health risks are emerging, as novel technologies are developed (especially in non-invasive imaging) that can assess physiological structure and function. Continued efforts to fully document the cardiovascular health consequences of AS use is important to provide a clear, accurate, public health message to the many groups now using AS for performance and image enhancement.     

Assessment of Internet-based tele-medicine in Africa (the RAFT project).

The objectives of this paper on the Réseau Afrique Francophone de Télémédecine (RAFT) project are the evaluation of feasibility, potential, problems and risks of an Internet-based tele-medicine network in developing countries of Africa. The RAFT project was started in Western African countries 5 years ago and has now extended to other regions of Africa as well (i.e. Madagascar, Rwanda). A project for the development of a national tele-medicine network in Mali was initiated in 2001, extended to Mauritania in 2002 and to Morocco in 2003. By 2006, a total of nine countries are connected. The entire technical infrastructure is based on Internet technologies for medical distance learning and tele-consultations. The results are a tele-medicine network that has been in productive use for over 5 years and has enabled various collaboration channels, including North-to-South (from Europe to Africa), South-to-South (within Africa), and South-to-North (from Africa to Europe) distance learning and tele-consultations, plus many personal exchanges between the participating hospitals and Universities. It has also unveiled a set of potential problems: (a) the limited importance of North-to-South collaborations when there are major differences in the available resources or the socio-cultural contexts between the collaborating parties; (b) the risk of an induced digital divide if the periphery of the health system in developing countries is not involved in the development of the network; and (c) the need for the development of local medical content management skills. Particularly point (c) is improved through the collaboration between the various countries as professionals from the medical and the computer science field are sharing courses and resources. Personal exchanges between partners in the project are frequent, and several persons received an education at one of the partner Universities. As conclusion, we can say that the identified risks have to be taken into account when designing large-scale tele-medicine projects in developing countries. These problems can be mitigated by fostering South-South collaboration channels, by the use of satellite-based Internet connectivity in remote areas, the appreciation of local knowledge and its publication on-line. The availability of such an infrastructure also facilitates the development of other projects, courses, and local content creation.     

An overview of the challenges facing death investigation systems in certain resource limited countries

A properly operated death investigation system (DIS) serves multiple stakeholders. Law enforcement, public health departments and members of the public, benefit in various ways from the information that it provides. This information must be collected systematically and efficiently. The system must also be flexible enough to respond to pressures on its resources such as occurs during mass disasters. These obligations on a DIS require an investment of public money. However even in affluent Western countries the recent world economic crisis has led to a cut in spending on public services that affect both the healthcare system and services associated with death investigation. Although pathologists and other stake holders (judiciary, police, families) would like to see death investigations conducted to international standards, the fact is that policy makers in resource limited countries face additional population health and sociopolitical pressures which generally result in very little funding for the service. The purpose of this paper is to review some of the challenges that impede the proper functioning of a death investigation system in resource limited countries in Sub-Saharan Africa and the Caribbean. Possible solutions are discussed.     

天山北坡中段草原畜牧业生产经营优化模式研究

本文从系统工程原理和方法出发,对新疆天山北坡中段草地畜牧业生产经营系统进行分析研究,运用定量化分析方法通过有机组织人工种值．草原利用与养殖生产,实现资源的优化配置,建立数量化模型。通过研究提出天山北坡中段草地畜牧业生产经营系统的优化模式,确立其生产方式为旺季（夏、秋）放牧 １８５ｄ,冷季舍饲 １２０ ｄ,初冬和早春放牧 ６０ ｄ。在此前提下,近期牧民种植水平相对较低,可采用二元种植结构,粮食作物：饲草料作物＝１：１５,牧民人均收入达２３７７． ５３元;当牧民种植水平得以提高后,可采用三元种植结构,粮食作物：经济作物：饲草料作物＝１：６：９,牧民人均收入达 ２６２２．８８元。畜产品产出 ＮＥ／饲草料投入 ＧＥ和畜产品产出 ＮＥ／饲草料投入 ＤＥ从现状中的１．２％和１．７％分别提高到１．６％和２．２％,比现状提高２３．１％和２９．４％。     

Innovation in veterans' health care and assistance: the Department of Veterans Affairs 10 years after the Gulf War

The Department of Veterans Affairs (VA) has responded to significant challenges in treating and compensating Persian Gulf War veterans by adapting existing programs and developing new ones. The VA established a Gulf War health examination registry and expanded existing "Vet Centers" to provide assistance to Gulf War veterans. Health care eligibility income limitations were eliminated. Outreach efforts included a national newsletter, veterans' organization briefings, and other products. The VA is developing targeted training programs and continuing medical education for health care providers. Numerous major research initiatives have begun. Innovations include the establishment of environmental hazards research centers, clinical demonstration projects, and centers for the study of war-related illness. These efforts required increased coordination among federal agencies and collaboration with other countries. In a precedent-setting development, Congress gave the VA authority to compensate certain veterans with undiagnosed illnesses. Veterans from future conflicts and peacekeeping missions can expect improved services from the VA as a result of these initiatives.     

Biomechanical factors affecting running economy

PURPOSE: The present study was designed to investigate kinematics, kinetics, and muscle activity for explaining running economy at different running speeds. METHODS: A total of 17 young endurance runners ran at 12-13 different running speeds. Respiratory gases were collected. Kinematic records were obtained by a high-speed video camera, and 3-D ground reaction forces (GRF) were measured simultaneously with telemetric EMG recordings of the selected leg muscles. In the analysis, joint moments and power were calculated by inverse dynamic methods. RESULTS: The oxygen consumption and energy expenditure increased quite linearly with increasing running speed. However, already at the slowest speed, interindividual differences in running economy were noticed, and they increased with increasing running speed. Simultaneously, the instantaneous joint moment-angular velocity curves of the ankle and knee joints shifted to the right and upward, thus increasing joint power in the push-off phase of contact. Most definitive was the increase in EMG-activity of the BF muscle and its correlation with energy expenditure (r = 0.48, P < 0.05). This two-joint muscle seems to be very active during the maximal running: its amplitude increased (P < 0.05) both in the swinging and contact phases with increasing running speed. CONCLUSIONS: The increased EMG of working muscles and the associated increase in power output may partly explain the increased energy expenditure with increasing running speed. Lower performances in running economy by some of the athletes may also be explained by poor running technique, such as unusually high braking and mediolateral forces, which may be caused by limited action of the hamstring muscles. However, no exclusive biomechanical parameters could be identified to explain the running economy.     

Militarism,militarization, health and the Third World

This paper examines the relationship between militarism, militarization, health and development. It draws attention to the fact that world military expenditure has continued to soar since the Second World War. Wars increasingly exact a heavy civilian toll. Third World countries are consuming, producing, and exporting more armaments than ever before. The rate of growth of military expenditure in developing countries has been far greater than their rate of growth in gross national product or in foreign economic aid. Countries under military control tend to be more repressive and to have suffered more years at war than those under civilian rule. Widespread availability of arms makes the settlement of disputes through violence more likely. Internal wars and violence are stimulated by a range of factors including inequalities in political and economic power, uneven development, and lack of popular participation in policy decisions by the majority of the population. The support of the industrialized countries for armament sales should be monitored, challenged and made politically unpalatable. Local development and regional cooperation should be stimulated. Health workers, as witnesses to the destruction to public health caused by war and violence, should play a part in advocating a reduction in the arms trade and the promotion of development in Third World countries.     

A financial analysis of digital image acquisition for portable and table-top radiography.

The use of photostimulable phosphors as a method for obtaining digital radiographic images during traditional portable and table-top radiography has become a subject of increased interest and controversy in recent years. Proponents of this technology argue that a Picture Archival and Communications System--or PACS--is now within the grasp of most medical communities. However, there still exists concerns relating to the financial and economic effectiveness of this technological development. Does direct digital image acquisition during portable and table-top radiography present a financial benefit to the average health care facility? An in-depth financial analysis of the costs incurred by computed radiographic imaging provides sufficient information to state that financial benefits are a function of exposure-related repeat procedure volumes which can be reduced or eliminated through the use of this new technology. Repeat procedure volumes must be reduced by at least 6,000 procedures if the health care facility intends to avoid a financial loss from the use of photostimulable phosphor technology during portable and table-top radiography.     

Marijuana as doping in sports

A high incidence of positive cases for cannabinoids, in analyses for doping control in sports, has been observed since the International Olympic Committee (IOC) included them in the 1989 list of prohibited drugs under the title of classes of prohibited substances in certain circumstances. Where the rules of sports federations so provide, tests are conducted for marijuana, hashish or any other cannabis product exposure by means of urinalysis of 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid (carboxy-THC) the main metabolite of delta-9-tetrahydrocannabinol (THC). Concentrations >15 ng/mL (cut-off value) in confirmatory analytical procedures are considered doping. Cannabis is an illicit drug in several countries and has received much attention in the media for its potential therapeutic uses and the efforts to legalise its use.Studies have demonstrated that the use of cannabinoids can reduce anxiety, but it does not have ergogenic potential in sports activities. An increase in heart rate and blood pressure, decline of cardiac output and reduced psychomotor activity are some of the pharmacological effects of THC that will determine a decrease in athletic performance. An ergolytic activity of cannabis products has been observed in athletes of several different sport categories. In Brazil, analyses for doping control in sports, performed in our laboratories, have detected positive cases for carboxy-THC in urine samples of soccer, volleyball, cycling and other athletes.It is our intention to discuss in this article some points that may discourage individuals from using cannabis products during sports activities, even in the so-called permitted circumstances defined by the IOC and some sports federations.     

Health technology assessment: principles, methods and current status

Purpose

This paper analyses the methodological and technical aspects of health technology assessment (HTA) as a tool for evaluating health technologies and procedures, with special reference to diagnostic imaging; describes the main experiences with HTA at the international and national level; outlines the most important HTA projects in Italy, and analyses the effects of HTA on health care strategies and policies.

Materials and methods

The work was carried out in three phases. In the first phase, the authors analysed the principles, methods and instruments of HTA; in the second, they evaluated the current status of HTA in different countries; and in the third, they defined the impact of HTA on the decision-making process in health care.

Results

Since the 1970s, technological innovation has been accompanied by the development of methods for the multidisciplinary assessment of the technical, scientific, economic, ethical and social aspects inherent in the use of new technologies. The method is implemented at an international level by a network of public and private bodies that carry out HTA in support of health care policies.

Conclusions

Because the application of HTA is still in its early stages in Italy, it is necessary to promote its development by drawing on consolidated international experiences.     

Bio-medicolegal scientific research in Europe. A country-based analysis

The European mosaic of socio-cultural, economic and legal realities is reflected in forensic and legal medicine, in which a great variety of operational modes of forensic medical services, organisational systems, structures, functional competences and scientific research strategies can be observed. The present work analyses the European bio-medicolegal scientific output of the last 5.5 years (exact time window, January 1, 2005–June 1, 2010), categorising papers by nationality of the corresponding author and forensic sub-discipline in question, in order to identify the peculiarities of national sub-specialised competences and to build up international research projects. This country-based bibliometric analysis, based on the number of articles and the impact factor produced by each European country, also considering its economic profile (gross domestic product and per capita gross domestic product), highlights the prevailing productive role of Western and Southern Europe (Germany, Great Britain, Italy, Switzerland, Spain and France). Categorising scientific output by forensic sub-discipline and branch, significant in terms of impact factor are contributions from Germany (coming first in Pathology, Toxicology, Genetics, Anthropology and Biological Criminalistics), Great Britain (first in Clinical Forensic Medicine, Malpractice and Invalidity-Social Insurance), Switzerland (first in Criminology), Italy (second in Toxicology, Anthropology and Invalidity-Social Insurance), The Netherlands (third in Clinical Forensic Medicine and Medical Law and Ethics), Spain (third in Genetics, Criminalistics and Invalidity-Social Insurance) and France (third in Toxicology and Malpractice). Interestingly, several countries with low gross domestic product, such as Poland, Turkey and other Eastern European nations, show notable scientific production in specific sub-disciplines such as Pathology, Toxicology and Forensic Genetics, suggesting that fruitful international cooperation could be planned and be of interest to funding sources within the European Community, also taking into account funds reserved for depressed areas undergoing development.