bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community self-help and the homeless poor in Latin America
Authors: Stewart J , Balchin P 
Published: November 2005

Finding realistic housing solutions that are able to respond to the realities of poverty in the developing, or newly industrialising, world are frequently distinct from those suited to the developed world due to levels of poverty and differing welfare regimes. This requires a different understanding of the concept of housing and shelter for developing and developed countries. Population increase and emerging habitation patterns in parts of Latin America have required that policy-makers review traditional ‘top down’ approaches to the way the homeless poor are treated and how self-help or ‘bottom up’ schemes are increasingly seen as a sustainable way forward in providing affordable housing options to both governments and communities. Over the last decades, mass in-migration to cities has put pressure on governments to provide public housing - but two major problems arose: firstly, governments found it difficult to finance the increasing demand for public housing; and secondly, the nature of employment and the informal economy in the developing world meant that this new housing was often too costly for the urban poor, in some cases increasing homelessness still further. Recent policy developments tend to favour supporting what the poor are and have been able to achieve for themselves, with appropriate government support. Upgrading shack settlements is now recognised as a community driven and cost-effective response that can, if appropriately supported, offer an initial and sustainable solution to urban housing need by tapping into additional non-governmental sources of funding. In the absence of a major public sector housing stock to meet demand, governments are also recognising that self-help housing schemes for families able to access funding and resources offer a further innovative approach to meeting housing need. The nature of housing and shelter in the developing world requires a unique response so that it remains attainable and affordable to the poor. Neo-liberal policies, increasingly adopted in Latin America, are not able to provide suitable, sustainable and affordable housing delivery and alternatives need to be explored. This paper traces some developments in Latin American housing policy and explores some of the challenges that are faced in responding to the unique housing needs of the urban poor.
Audit of primary care angina management in Sandwell, England
Authors: Stewart A , Rao J , Osho-Williams G , Fairfield M , Ahmad R 
Published: November 2005

This audit aimed to assess the identification and treatment of coronary risk factors, lifestyle advice given and use of drug therapy, among patients with angina in Sandwell. It was designed to help general practices evaluate their angina management, and highlight areas where practice could be improved. Criteria were based on Sandwell’s published angina audit and local clinical guidelines. Each participating practice was asked to identify all patients with angina, from which a 10% sample was randomly selected. The notes of each selected patient were examined for evidence showing whether agreed standards of care had been achieved. Fifteen practices took part, and contributed data on a total of 358 patients. Of patients without contraindications, 66.5% were taking aspirin, 62.1% were prescribed short-acting nitrates and 58.4% were prescribed beta-blockers. Non-white patients were significantly less likely to receive short-acting nitrates (p<0.001) and women were significantly less likely to receive beta-blockers (p<0.01). A total of 83.5% of patients had received smoking cessation advice, 75.1% had weight advice, 75.1% were advised about alcohol use and 64.5% about exercise. Overall, 77.4% had a blood pressure check within the previous twelve months, 40.5% had their cholesterol measured and 33.5% had their blood glucose measured. Non-white patients were significantly less likely to receive smoking cessation, weight, exercise and alcohol advice and were less likely to have their blood pressure checked (all p<0.0001). Patients aged 65 and over were significantly less likely to receive a cholesterol check (p<0.0001). None of the auditable standards were actually met. This study shows that there is considerable scope to improve the management of angina patients, with particular regard to aspirin. We recommend that practices develop systems to ensure that the appropriate treatment, advice and checks are given to all patients with angina, paying particular attention to those from ethnic minority backgrounds.
Risks associated with herbal slimming remedies
Authors: Corns C , Metcalfe K 
Published: November 2005

The market for non-conventional, natural herbal medicines is growing. This marketing opportunity has been seized upon by some unscrupulous practitioners to sell potentially unsafe ‘herbal’ products. Several people attended a Chinese herbalist for weight loss advice and were sold ‘herbal’ preparations that contained fenfluramine, a drug which was withdrawn from sale in the West in 1997 after its use was linked to primary pulmonary hypertension and valvular heart disease. Adulteration of Chinese medicines with Western drugs is becoming an increasing problem, and deaths have been reported from Japan and other Far Eastern countries linked to Chinese slimming aids containing N-nitroso-fenfluramine. There is a need for increased public awareness of such risks associated with the use of unlicensed medicines; a system of registration for medical herbalists is also required to protect both the reputable practitioners and the general public.
Integrating Western medicine and Traditional Chinese Medicine in GP surgeries and the community: a review of two pilot schemes
Authors: Au S , Hiew S 
Published: November 2005

The popularity of complementary medicine has been relentless over the past decade. Among the most popular are Traditional Chinese Medicine (TCM) which has a long and unbroken history. This article reports on two integrated health care pilot schemes where TCM and Western medicine are merged, to varying degrees, for the benefits of patients. One of the schemes focuses on general medicine whilst the other focuses on mental health. The authors conclude that the integrated schemes have many advantages and, on the whole, are beneficial for patients. The issues involved and learning points are discussed.
Physicians of the future: Renaissance of polymaths?
Authors: Piko B F , Stempsey W E 
Published: November 2005

Science and technology are crucial in modern medicine; societies devote enormous amounts of time, money and effort to developing new diagnostic and therapeutic procedures. However, the fact that people now report higher rates of disability, symptoms and general dissatisfaction with their health and well-being calls us to rethink the functions of health care and medical education. There is a need for a new medical paradigm, which should involve and reconcile the natural and the social scientific paradigms (‘two cultures’). Medicine should be viewed as an integrative, biopsychosocial science. Therefore, medical education must involve the study of the biological structures and psychosocial functioning of human beings not as separate systems, but as interactive ones. This mandate suggests that the physician needs to become a sort of ‘neo-polymath’ in a ‘new Renaissance’. The new paradigm, however, should not demand the acquisition of more and more information. Instead, the crucial principle would focus on the appropriate selection of information.
Reducing waiting times associated with an integrated child health service
Authors: Clow D , Mustafa A , Szollar J , Wood N , Reid J , Sinden S 
Published: November 2005

Following an increase in average waiting times associated with a child health service in East London, an initiative to rapidly reduce the numbers of children waiting long periods following a referral was undertaken over the period May to June 1999. A multi-disciplinary cooperative approach was adopted operating within the existing available resources and involved medical, nursing, managerial and administrative staff. The initiative involved a review of the accuracy of the waiting list, followed by an invitation to remaining patients to provide an option of continuing to wait to be seen or offering attendance at a rapid response clinic associated with reduced waiting and consultation times. Half-hourly appointments were routinely offered instead of hourly appointments and proformas were adopted for history taking and onward referrals to save time spent on administration. A total of 162 patients were seen over the course of a month and a satisfaction questionnaire completed by relatives indicated a preference for the new service. The mean waiting time was reduced to under a quarter of the time at the start of the initiative to a mean of less than two months. The purpose of the study was to see if the waiting list could be reduced by using existing staff. We wanted to ascertain the parents’ views whether shorter waits and shorter consultation periods were acceptable, and to ascertain if the waiting list could be kept down or whether the waiting list would rapidly recur after the rapid response clinics stopped. The findings are discussed in relation to initiatives elsewhere and the need to maintain a high quality service.
Levelling the playing fields of England: promoting health in deprived communities
Authors: Roff M 
Published: November 2005

Health promotion is about focusing on systems in which those ‘waiting to be ill’ are living their lives now. Unlike the old, the new public health agenda is about developing and implementing healthy public policies. This stance involves everyone working together to develop change in the conditions of living. This article presents a brief overview of the role of the health promotion specialist in a Primary Care Trust working with six Sure Start Programmes in a town that has high levels of poverty and deprivation. To demonstrate the principles of ‘health for all’, the article concludes with an overview of the development of a partnership to promote initiation and continued exclusive breastfeeding using collaborative working, community participation and equity.
Mixed signals from Kerala’s improving health status
Authors: Michael E J , Singh B 
Published: November 2005

It can be said that health policy is about creating the conditions to free a population from disease and impairment, and so prolong the quality of life for all. If this is its purpose, then the practice of public health policy in the Indian state of Kerala presents a conundrum for health promotion analysts. On the one hand, Kerala has had remarkable success in reducing its infant mortality rates to around one-third of the Indian average, but on the other, its morbidity rates have risen to impose an economic cost more than three times the national level. This paper sets out to explain this apparent contradiction in outcomes, serving both to provide a review of Kerala’s health status and as an illustrative guide for the interpretation of the effects of health policy in some other developing areas. While the essential health data for Kerala might imply an unsatisfactory future, the authors argue that the rapid improvements that have occurred simultaneously in public education are more likely to explain an increase in the effective reporting of disease conditions, thus suggesting a more optimistic scenario for future practice that can lead to a sustained improvement in health care.
The survival and recovery of bacteria in vacuum cleaner dust
Authors: Haysom I W , Sharp K 
Published: November 2005

The possibility exists that environmental dust could be a source of gastro-intestinal infection in the domestic environment and that the causative microbes are collected during vacuum cleaning. This study examines the survival of total bacterial populations, Enterobacteriaceae and salmonella species in vacuum cleaner dust in vitro and in use. Total counts remain constant at around 106-108 colony forming units (cfu) g-1 for at least 60 days. Enterobacteriaceae showed only a slight decline over the same period. Recovery of salmonellae artificially inoculated into vacuum dust was dose and time dependent: even relatively small inocula (<100 cfu g-1) were recoverable more than one month after inoculation. Questionnaires and vacuum cleaner dust samples were received from 76 households. A significant association was found between total bacterial counts and whether the household was in a rural or urban situation and the number of people in the household. No association was found between total bacterial counts and the number of children in the household, the presence of pets, wearing shoes indoors, the make, model and age of the vacuum cleaner, the type of dust collector or dust bag, how often the vacuum cleaner was used and the length of time between sample collection and microbiological testing. Salmonella species were isolated from vacuum cleaner dust from three of the 76 households although no factors could be identified linking the homes. This study shows that vacuum cleaners are effective collectors and reservoirs of microbial contamination and that these contaminants are able to survive for up to two months. Vacuum cleaner dust could thus be a useful indicator of environmental contamination in the home.
Human genetics information on the web
Authors: Abu-Amero K 
Published: November 2005

The genetics revolution is in full swing, especially following the recent release of the complete human genome sequence which will change forever the world in which we live by providing potential for new drugs and therapies and the means of preventing inherited genetic diseases. As a result of establishing the whole human genome sequence and the associated media publicity, the general public have become familiar with and more eager to learn about the subject of genetics and its potential impact on both their own lives and those of their families. One of the main sources of information available to the public today is the World Wide Web. Vast amounts of information are contained in the numerous websites available through the Internet. However, finding the right information can be very tedious, especially with the huge number of websites currently available. This article guides the public to key websites and webpages that cover information on genetics. All sites listed here have been tested and proven to be beneficial and informative.
Prevalence of HIV-1 infection among patients with leprosy and pulmonary tuberculosis in a semi-arid region, Nigeria
Authors: Moses A E , Adelowo K A , Ajayi B B 
Published: November 2005

Much evidence exists on pulmonary tuberculosis (PTB) as a presenting feature of HIV infection or AIDS-related complex, while few reports exist of a direct association between HIV infection and leprosy. This study was carried out to see whether or not an association between leprosy and HIV infection existed, similar to that of PTB in the region of Maiduguri, Nigeria. Of 105 patients with leprosy, 11(10.5%) were positive for HIV antibody. Of 58 patients with suspected PTB, 11(19%) were positive for HIV antibody. Twenty-seven (47%) of the 58 had active PTB, with results of sputum smear and culture positive for mycobacterium, and six of these (22.2%) were also positive for HIV antibody. Odds ratios (OR) obtained by conditional logistic regression (matched) analysis were 3.52 (95%, CI 1.03-12.07) and 2.53 (95%, CI 1.04-6.15) for association between HIV-1 and PTB and leprosy, respectively. HIV infection was more prevalent among leprosy patients aged under 30 years, OR=4.25 (95%, CI 1.25-14.42). The prevalence of HIV-1 infection was at borderline significance, higher in PTB and leprosy patients than in blood donors, Fisher’s exact test (two-tailed) p=0.07 and p=0.05, respectively.
Lessons to be learned: a case study approach
Authors: Redgrave K 
Published: November 2005

Posttraumatic stress disorder (PTSD) is commonly treated by psychotherapy, which may draw upon behavioural psychology or cognitive-behavioural psychology, thereby making use of desensitisation techniques - amongst others; hypnotherapy may also be used. Hypnotherapy and psychotherapy are also available for helping patients who suffer from symptoms associated with general stress or who show phobic symptoms, such as a fear of heights or of walking across bridges. Studies of patients with such disorders have not always linked emotional (affective) and behavioural symptoms with psychophysical factors, which correlate with the symptoms. The present article not only does this, but also shows that it is possible for brain function and psycho-emotional outcome to mislead a person and ‘trick’ him or her into believing that certain fears or panics appear ‘out of the blue’ or might be due to experiences other than the true cause. These may be important when, for instance, childhood memories form an issue in any court case.
Do we really know vitamin and mineral requirements for infants and children?
Authors: Bender D A 
Published: November 2005

Infants and young children require vitamins and minerals not only to replace losses through metabolic turnover, but also to increase body reserves as they grow. For infants up to six months of age it is generally assumed that breast milk provides adequate intakes, and average breast milk composition provides the basis of reference intakes for this age group, and the basis for infant formula. It is questionable to what extent the micronutrient content of breast milk reflects the infant’s requirements as opposed to the mother’s nutritional status. For obvious ethical reasons there have been very few (if any) experiments to determine the micronutrient requirements of infants and children, although studies of intakes in areas where deficiency is common provide an estimate of minimum requirements in some cases. Different national and international authorities have approached the problem of estimating reference intakes for infants and young children in four main ways: linear interpolation between adequate intakes estimated from breast milk composition and the experimentally-determined requirements of young adults; extrapolation forwards from breast milk composition and backwards from the requirements of young adults on the basis of metabolic body weight (body weight0.75), corrected by growth factors; extrapolation backwards from the requirements of young adults on the basis of the energy density of the diet; and by factorial calculation. Despite this, there is considerable concordance between the figures published by different authorities as a result of rounding off to avoid spurious precision.
Advances in the nutrition of preterm infants
Authors: Marriott L D , Foote K D 
Published: November 2005

The greatly improved survival rate of infants born both preterm and low birth weight (LBW) has led to the subsequent growth and development of these infants becoming an important focus for research. Preterm infants begin life with, or acquire as a result of their prematurity, greater morbidity than term born babies, growth deficits, an increased risk of developmental delay and an increased risk of later adult diseases compared with appropriate for gestational age (AGA) term born babies. Research in recent decades has confirmed that there are marked differences in the nutritional requirements of preterm LBW infants compared with their AGA term born counterparts, both in the neonatal period and probably for all of infancy. In addition to the increased requirement for energy and protein, preterm LBW infants demonstrate a greatly increased requirement for some of the mineral elements, particularly iron, zinc and calcium, when compared with the needs of term AGA infants. In the UK, feeding practices for preterm infants in neonatal units and throughout infancy after hospital discharge are variable and many questions remain as to the optimal nutritional regimen for preterm LBW infants (and for subgroups of these infants) at different stages of infancy. There is some concern that the 2002 World Health Organization recommendations on infant feeding may be applied to all infants, including preterm infants, without consideration of their special nutritional needs, which may further compromise their growth and development. A brief résumé of the work of prominent researchers in the field of preterm infant nutrition in the UK, notably Lucas, Cooke and Fewtrell, is included in the review, together with information from papers published by the authors of the review. The review concludes with a summary of the generally accepted recommendations on feeding preterm LBW infants after hospital discharge and information on some practical help available to the parents of these children and to health workers in the field.
Some aspects of the public health importance of measurement of growth
Authors: Dickerson J W T 
Published: November 2005

Growth is a fundamental process of life which in complex animals is influenced by genetic constitution, nurture and nutrition. Increase in size is accompanied by processes of development and both growth and development are closely linked with time - the age of the individual. This paper considers ways in which simple measurements of different aspects of the growth of children have contributed, and are continuing to contribute, to our understanding of the origins of disease. The results of these measurements can help those involved in the care of children to identify individuals at risk of disturbances of growth and the possibility of the development of diseases associated with them. It can also help instigate preventative measures that may help children to develop more fruitful and longer disease-free lives.
Accumulating aerobic exercise for effective weight control
Authors: Sykes Kevin , Choo Lau Leong , Cotterrell Mary 
Published: November 2005

Purpose: To compare the effects of different patterns of regular treadmill walking and cycle ergometry on body weight, body composition, waist and hip circumferences in overweight adult Singaporean females. Methods: Thirty overweight (BMI > 23 kg/m2) Singaporean females, aged 42.2 ± 5.4 yr (mean ± SD), all spasmodically physically active, were randomly assigned to two different eight-week programmes of aerobic exercise. One programme involved walking and cycling on indoor exercise machines at a moderate, comfortable intensity until 400 kcals had been expended, five times a week, thus giving a total weekly energy expenditure of 2,000 kcal. The other programme involved the same type of exercise but expending 1,000 kcal per session on two days a week, thereby giving the same weekly energy expenditure. Body weight, body mass index, body composition, waist and hip circumferences were measured before and after each programme. Prior to commencement of the study all subjects attended a one hour seminar on nutrition, health and fitness where the project structure was explained. They were asked not to change their eating habits during the intervention period and food diaries were kept and monitored weekly. Results: All subjects completed the eight-week programmes of exercise. Both programmes significantly reduced body weight, body mass index, percentage body fat and waist circumference (all p<0.05). These reductions were identical in both the short-bout and long-bout programmes. No changes were observed in either group for hip circumference or lean body mass. Conclusion: These findings demonstrated the effectiveness of moderate aerobic exercise in reducing body weight, body fat percentage and waist circumference whilst maintaining lean body mass in moderately overweight Singaporean females. The study also demonstrated that whether the exercise is performed in a series of short bouts five times a week or in longer bouts twice a week, the results are identical, providing that the total weekly energy expenditure remains the same.