The risks associated with alcohol use and alcoholism

Alcohol consumption, particularly heavier drinking, is an important risk factor for many health problems and, thus, is a major contributor to the global burden of disease. In fact, alcohol is a necessary underlying cause for more than 30 conditions and a contributing factor to many more. The most common disease categories that are entirely or partly caused by alcohol consumption include infectious diseases, cancer, diabetes, neuropsychiatric diseases (including alcohol use disorders), cardiovascular disease, liver and pancreas disease, and unintentional and intentional injury. Knowledge of these disease risks has helped in the development of low-risk drinking guidelines. In addition to these disease risks that affect the drinker, alcohol consumption also can affect the health of others and cause social harm both to the drinker and to others, adding to the overall cost associated with alcohol consumption. These findings underscore the need to develop effective prevention efforts to reduce the pain and suffering, and the associated costs, resulting from excessive alcohol use.     

王克荣：一名“白衣天使”的选择

王克荣,1963年出生,北京地坛医院红丝带之家护士长,全国先进工作者,第五届“贝利·马丁奖”获得者,第44届南丁格尔奖章获得者,被誉为“艾滋病患者的知心大姐”,至今从事艾滋病患者救助工作已有17年。     

Mad Cows and Sick Birds: Financing International Responses to Animal Disease in Developing Countries

Because many animal diseases have strong transboundary attributes, their control can be reasonably characterised as an international public good. The potential for reservoirs of transboundary diseases to persist in developing countries that lack the capacity or incentives to control them implies a need for international financial transfers to fund control. However, the costs of control can be large compared with development assistance budgets, and the benefits small compared with the global benefits of control and the local benefits of other priority investments. This article outlines a framework for setting priorities for international development assistance for animal disease control based on the incidence of market and non‐market impacts and the context in which outbreaks take place in endemic and susceptible countries.     

Blood pressure control by home monitoring in Dalat city,Lam Dong province,Vietnam

As low and middle-income countries, such as Vietnam, experience the health transition to chronic diseases, the morbidity and mortality from hypertension will rise. Twenty-five percent of the adult population in Vietnam has hypertension, but less than half are aware of their condition. Blood pressure is one important risk factor for managing many chronic diseases. The use of home blood pressure monitoring(HBPM) to assess hypertensive control is unknown in Vietnam. This study determined using rate Home blood pressure monitoring in Lam dong province, Vietnam. Participants were mainly recruited from six medical center wards at the Lam dong province hospital and twelve health stations in Da lat city. A total of 325 hypertensive patients were selected in 2 months only 22.2 % used HBPM. From this result, we had been some suggestions for the management of hypertension in Vietnam.     

Socioeconomic Status and Health Disparity in the United States

Abstract

Low socioeconomic status (SES) has been associated with high rates of many chronic diseases. This study was a cluster analysis of data from 9,830 adults in the 1994-96 Continuing Survey of Food Intakes by the Individuals (1994-96 CSFII) in order to characterize more fully the biologic and social factors that might be associated with chronic diseases. The study employed cluster analysis to define three SES groups (low, middle, and high) based on income, education, age, gender, and race. A significant increase was found in self-reported diabetes, hypertension, heart disease, obesity, and stroke across these groups, being highest in the lowest SES group. Results revealed that health disparity in the U.S. may be substantial, with some population groups bearing a disproportionate burden of chronic diseases.     

Work and health in Gnosjö: a longitudinal study

This study includes women and men born between 1934 and 1953 in the municipality of Gnosj? in the south of Sweden and covers the period 1998 to 2001. Compared with the country, a large proportion of the population of the municipality of Gnosj? works in the manufacturing industry. The aim was to examine associations between physical and psychological stress factors in and outside work, sickness absence and cardiovascular and musculoskeletal diseases, from a gender perspective. Information about working conditions and other aspect of life was collected by a questionnaire in 1998, and register data about sickness absence, cardiovascular diseases and musculoskeletal diseases 1999-2001. The impact on sickness absence consisted mainly of demand and control aspects of the psychosocial working conditions, but also temporary employment and of low sense of coherence. In relation to musculoskeletal health, demand and control was important among women, but not among men. Very few physical factors in the work environment were related to musculoskeletal diseases. Low sense of coherence had an impact also on musculoskeletal diseases. Cardiovascular diseases among women were influenced by demand and control and by life style related factors. We hope that the knowledge gained from our study makes it possible to develop better tools for both the preventive work in Gnosj? and for the rehabilitation of the people already ill. Because of our holistic approach, both public health aspects and working life aspects are covered. The municipality of Gnosj? is small, and therefore foreseeable in a way that many municipalities are not. Still, we do believe that our finding, in this longitudinal study, can be of value also in the public efforts and the efforts to develop adequate and successful rehabilitation approaches.     

Obesity over the life course

Obesity in middle-aged humans is a risk factor for many age-related diseases and decreases life expectancy by about 7 years, which is roughly comparable to the combined effect of all cardiovascular disease and cancer on life span. The prevalence of obesity increases up until late middle age and decreases thereafter. Mechanisms that lead to increased obesity with age are not yet well understood, but current evidence implicates impairments in hypothalamic function, especially impairments in the ability of hypothalamic pro-opiomelanocortin neurons to sense nutritional signals. The rapid increase in the prevalence of obesity at all ages in the past decade suggests that, in the next two or three decades, diseases associated with obesity, especially diabetes, will begin to rise rapidly. Indeed, these trends suggest that for the first time in modern history, the life expectancy of people in developed societies will begin to decrease, unless the rapid increase in the prevalence of obesity can be reversed.     

Current issues in HIV disease and AIDS: Implications for health and rehabilitation professionals

HIV disease and AIDS are being redefined as chronic, long-term conditions that are suitable for vocational rehabilitation interventions. With the advent of more effective medical interventions, many individuals with these diseases are living longer and are interested in pursuing employment options. In this article, physiological and neurological symptoms, psychological and mental health issues, psychosocial issues affecting women, and employment-related issues and interventions are discussed as they apply to the health and rehabilitation practitioner working with individuals with HIV disease and AIDS.     

Osteoporosis: implications for risk reduction in the college setting.

Osteoporosis is often considered a chronic disease of older adulthood. As with many chronic diseases, lifestyle behaviors adopted during young adulthood are important risk factors for future development of osteoporosis. The college student population represents the age group in which optimal bone development is likely to occur and certain lifestyle behaviors are reinforced. Therefore, risk factors for osteoporosis, including nutritional insufficiency of calcium and vitamin D, smoking, alcohol abuse, excessive exercise, use of steroids, and high-protein diets, have special relevance for this target population. The authors examine risk factors for osteoporosis that are especially relevant to the college health setting and offer intervention strategies for college health professionals.     

Physical activity, genes, and lifetime predisposition to chronic disease

This mini-review summarizes the main associations between physical activity and chronic diseases and discusses the basic concepts related to the role of genetic factors in studies evaluating the effects of physical activity/exercise therapy on chronic disease prevention/treatment during the life course. Many observational cohort studies have shown that high physical activity during young adulthood or middle age is associated with reduced later life morbidity, mobility limitations and mortality. Physical activity or exercise therapy has a positive effect on health via many disease-specific mechanisms. The most consistent finding of the various randomized controlled studies conducted to date is that aerobic/functional capacity and/or muscle strength can be improved by exercise training among patients with different chronic diseases. Genes are known to play a role in chronic disease predisposition and to contribute to physical fitness levels, physical activity participation and ageing. Physical fitness, physical activity and health outcomes may be partly due to underlying genetic factors that have a favourable effect on all these traits (genetic pleiotropy). This means that in observational studies, the relationship between baseline activity and the later occurrence of diseases may not be interpreted entirely as causal. Increased knowledge on the role of nuclear genome, mitochondrial genome, epigenetics, telomeres and regulation of gene expression will increase our understanding of their relationships with physical activity and morbidity.     

Stakeholder participation for sustainable waste management

Inadequate environmental sanitation in many cities is a major cause of diseases and is a drain on the economy by way of lost workdays, cost of treatment and cleanup activities. Municipal authorities and policymakers need to act fast to address this issue. Sustainable waste management provides a comprehensive inter-disciplinary framework for addressing the problems of managing urban solid waste, in the resource constrained developing countries where quality of such services are poor and costs are high often with no effective means of recovering them. Upgrading the coverage of waste management and services and increasing their efficiency is a precondition for improving the environmental quality of cities. This paper highlights the fact that the involvement and participation of all the stakeholders such as the waste generators, waste processors, formal and informal agencies, non-governmental organisations and financing institutions is a key factor for the sustainable waste management.     

'Doing Motherhood': some experiences of mothers with physical disabilities

In this paper, we discuss the experiences of physically disabled mothers. We interviewed 30 women in the age group 28-49 with medical diagnoses such as: multiple sclerosis, neuromuscular diseases, cerebral palsy and spinal cord injury Becoming a mother implied for many 'capturing' a gender or 'recapturing' a lost gender. They women felt they had to go to great lengths to 'present' themselves and their children as managing 'normally' in order to be accepted as 'ordinary' mothers. Eventually, they feared that their children might be taken away from them if they did not live up to other people's expectations. One possible explanation for what they experienced as other people's scepticism might be that disabled people on the whole are primarily still looked upon as being dependent on other people's help and care. In short, they are often looked upon by professionals and lay people as receivers, and not as carers.     

Emerging methods for the physiological assessment of occupational stress

Occupational stress is implicated as an etiology for a variety of diseases. Many of the etiological theories surrounding these associations incriminate some deviation of autonomic nervous system activity. New methods of analyzing cardiovascular data obtained from a Holter monitor provide a window into a worker's autonomic nervous system throughout the day, in many cases for two days. These methods allow a variety of comparisons, for example, between workers of varying job stress levels, between work days and rest days, day and night, and between high stress and low stress periods. Identifying altered autonomic nervous system activity patterns throughout the day may: 1. provide insight into the etiology of stress related pathologies; 2. allow quantification of exposure; 3. investigate possible interaction effects of different exposures; 4. lead to monitoring methods capable of identifying whether an employee's job stress is increasing his or her risk for disease.     

Preparedness for Field Education Placement: Social Work Students' Experiences in Papua New Guinea

Papua New Guinea is seen by many to be one of the most troubled countries in the world today; it is challenged by infectious diseases, including HIV/AIDS, by violence—both in the home and in the broader community—as well as by the difficulties associated with responding to communities who are largely rural, remote and inaccessible. It is in this context that the profession of Social Work exists and in which students undertake their fieldwork practicum. The University of Papua New Guinea (UPNG) is the primary provider of Social Work education in the country. This small study sought to investigate third-year UPNG Social Work students' reflections on their first fieldwork experience and their perceptions of preparation. Twenty-three students provided data via a written questionnaire. Content analysis revealed that most students felt only ‘just prepared’ for placement. While many highlighted the value of communication skills to them during fieldwork, there was considerable uncertainty about the role and nature of Social Work, with administrative duties seeming to dominate. Students were, however, clear about improvements; these focused primarily on the sequencing of the curriculum, to ensure that they had covered core learning materials prior to placement. The implications for practice and the challenges to implementation are discussed.     

A gulf of difference: disputes over Gulf War-related illnesses.

The social discovery of Gulf War-related illnesses, like other occupational and environmental disease, is firmly rooted in ongoing disputes over causation. Pressure from veterans groups, as well as intra-governmental disputes, have driven innovative research directions and challenged the dominant epidemiological paradigm. This dominant epidemiological paradigm was originally a position that viewed stress as the primary causal factor. In the emerging dominant epidemiological paradigm, researchers view veterans' symptoms as similar to other multi-symptom diseases and conditions, but with a firmer respect for the reality of those symptoms. In addition, some researchers pursue interactions between stress and physical exposure. We examine the evolution of the DEP to demonstrate that in many disease disputes, an affected population challenges government and science decision-making, and even ways of knowing, in an attempt to negotiate a disease definition and etiology that results in better treatment and prevention. After considerable research effort, only limited evidence has been found for environmental causation, and even many researchers sympathetic to veterans are doubtful that much more will be found. We analyze the social discovery and ongoing contestation of these illnesses, and the consequent effects on health and public policy. For extension to other disease disputes, we provide an overall model of disease discovery and contestation, examining the key forces of government, science, and citizens.     

Why females live longer than males: control of longevity by sex hormones

Females live longer than males in many species, including humans. We have traced a possible explanation for this phenomenon to the beneficial action of estrogens, which bind to estrogen receptors and increase the expression of longevity-associated genes, including those encoding the antioxidant enzymes superoxide dismutase and glutathione peroxidase. As a result, mitochondria from females produce fewer reactive oxygen species than those from males. Administering estrogens has serious drawbacks, however--they are feminizing (and thus cannot be administered to males) and may increase the incidence of serious diseases such as uterine cancer in postmenopausal women. Phytoestrogens, which are present in soy or wine, may have some of the favorable effects of estrogens without their undesirable effects. Study of gender differences in longevity may help us to understand the basic processes of aging and to devise practical strategies to increase the longevity of both females and males.     

“I AM STILL SUFFERING:” THE DILEMMA OF MULTIPLE RECOVERIES IN THE LIVES OF METHADONE MAINTENANCE PATIENTS

This study examines narratives on the meaning of addiction recovery through interviews with 45 methadone maintenance treatment (MMT) patients. Results show that heroin addicts are dealing with multiple recoveries and many are simultaneous to each other: recoveries concerning (1) addiction, (2) associational disruptions, (3) self-identity and actualization, (4) drug induced diseases (HIV/AIDS, HCV, etc.), and (5) catalyzing event(s). The research findings, anathema of clinical MMT views on recovery, suggest that drug addicted individuals might benefit from interventions that address their multiple recovery issues as opposed to ones that emphasize recovery strictly in sobriety terms.