Displaying 1-20 of 57 key documents
Source: New England Journal of Medicine
In this review article, published after the Fukushima accident, medical scientists examine published information on the short- and long-term health risks of exposure to ionising radiation. The article describes two previous nuclear accidents — at Three Mile Island in the USA, and Chernobyl in Ukraine — and explains the types and doses of radiation that can damage biological systems. It discusses the mechanisms behind exposure, and radiation-induced illness and injury, including long-term cancer risks. The authors also review measures that can be taken to reduce the effects of radiation exposure, including potassium iodide tablets used in the aftermath of Chernobyl. The article stresses that clear communication on radiation exposure levels and health risks is a key component of the response to a nuclear incident.
Source: Health Research Policy and Systems
This paper discusses how researchers promote the use of research in policy by examining the practices of 'boundary organisations' that cross the boundary between science and politics to facilitate evidence-based policies and programmes. It identifies key lessons for organisations looking to engage policymakers and decision-makers.
The study focuses on the Regional Network on AIDS, Livelihoods and Food Security (RENEWAL), a regional 'network of networks' active in Kenya, South Africa, Uganda, and Zambia which engages government officials on programmes that could inform policies on food, nutrition and HIV/AIDS. It describes the challenges and successes of efforts to promote research in these areas; challenges include adherence to scientific principles while maintaining close relationships with political authority, and ensuring accountability to the communities within which the research is conducted.
The paper offers recommendations to strengthen efforts to get research into policy, and concludes that the concept of a boundary organisation can help researchers engage people and processes that have decision-making power.
Source: The Royal Society Philosophical Transactions B | 12 October 2011
This special issue of the journal Philosophical Transactions of the Royal Society B: Biological Science explores how vaccines can fulfil their full potential for addressing global health challenges. It charts the progress to date, reviewing successes as well as challenges in the development and distribution of both human and veterinary vaccines.
The articles describe how vaccines can help mitigate and treat the world's major infectious diseases such as malaria, tuberculosis and HIV/AIDS, as well as chronic diseases, such as cancer. They explore vaccine policy and financing, ways to accelerate the development of new vaccines, issues surrounding public acceptance, and the logistics of getting vaccines to where they are needed. Also discussed is the use of vaccines to treat diseases in livestock — making an important link between health interventions, agricultural output and economic consequences.
The papers in this issue were presented at the meeting, 'New vaccines for global health', held at the Royal Society in London, United Kingdom, in November 2010.
Source: Trends in Pharmacological Sciences | March 2010
This paper, co-authored by Paul Newton of the Mahosot Hospital in Laos — who has collaborated closely with INTERPOL in its anti-counterfeiting operations — summarises evidence on the prevalence of counterfeit drugs, and details their medical and economic impact on poor countries. It outlines how the international community can tackle the problem, which the authors say needs to be taken more seriously. Although the trade in counterfeit drugs has obvious health impacts, its indirect effects are no less significant and include a loss of confidence in health systems and health workers.
Source: PLoS Medicine | June 2009
This study documents the chemical composition of drugs randomly sampled from pharmacies in Delhi and Chennai in India, and aims to offer the government guidance on improving drug regulation. India is a major producer and consumer of pharmaceuticals but, with quality control standards varying significantly between states, the country has high levels of counterfeit drugs. The study shows that 12 per cent of Delhi samples and 5 per cent of Chennai samples collected in 2008 and 2009 did not meet international quality standards. Although these numbers roughly match the government's estimates, there were differences between pharmacies in the types of drugs commonly counterfeited. And while some had no fake drugs, others had up to 30 per cent.
Source: US Centers for Disease Control and Prevention | October–December 2006
This report makes a case for the importance of antimalarial drug monitoring as an integral part of disease surveillance programmes in developing countries. Antimalarials are some of the most commonly counterfeited drugs — the high prevalence of malaria translates to a large consumer market in the developing world. The problem is serious in South-East Asia but is expected to become significant in African countries too. The report suggests that scientists ensure drugs are genuine and of a good quality before conducting efficacy or resistance studies in areas where counterfeits circulate widely.
Source: Science | July 2005
This essay by Chunli Bai, executive vice president of the Chinese Academy of Sciences (CAS), explains the reasons behind the rapid progress of nanotechnology in China. A key factor, says Bai, has been "extraordinary" government support for the field since the early 1980s, which led to the creation of research institutes and significant grant money. But, cautions Bai, public communication on nanotechnology research, and ongoing monitoring and assessment of nanotechnology risks is needed.
Source: Bulletin of the WHO | August 2008
This article presents an ethical framework for conducting international traditional medicine research, including clinical trials. The authors emphasise the need for such research to both have a social value — which may justifiably differ across countries — and be scientifically valid. They highlight the role that international collaborations can play in achieving the ethical requirements for traditional medicine research.
Source: PLoS ONE | April 2009
Ensuring that traditional medicines are safe and effective is a major challenge. This study uses mathematical models to show that the treatments that become popular through communities and get passed down through generations are not necessarily the most efficacious. Often, ineffective treatments that are based on superstition can spread because, the authors say, their very ineffectiveness means that patients use the treatment for longer than medicine that actually works.
Source: Medical Anthropology Quarterly | March 2010
This article argues that unless the modernisation of traditional medicine in Nepal is treated with care, it could create gender inequalities and the increased social marginalisation of women. Healthcare in Nepal is slowly being modernised to fit more with a model of Western medicine than with traditional Ayurveda. Ayurveda attracts many female practitioners since it is one of the few professions in this patriarchal society in which women are accorded high status.
Source: BMC International Health and Human Rights | October 2009
Too few effective antimalarials and poor use of bednets are two main reasons offered for why malaria still kills millions every year. This systematic review suggests that social and cultural factors in tackling malaria are often ignored. For example, many people in the developing world still use traditional medicine to treat malaria, which is often blamed on spiritual problems or curses, and can be a barrier to effective treatment.
Source: Evidence-Based Complementary and Alternative Medicine | May 2009
According to the author of this review, only 7.4 per cent of complementary and alternative medicine (CAM) — which includes homeopathy and acupuncture — is evidence-based. The author evaluates research evidence from clinical trials and systematic reviews to reach this conclusion. By contrast, he says, more than half of all interventions in general internal medicine, and more than 65 per cent in psychiatry are based on sound evidence, including results from randomised controlled trials.
Source: The Lancet | April 2010
This article from The Lancet provides useful background information on Chagas disease including its transmission, epidemiology, pathogenisis, diagnosis and treatment. The disease affects eight million people in Latin America and poses a growing health problem in non-endemic areas due to increased trade and travel.
Source: The Lancet
This report gives an overview of progress in developing an HIV/AIDS vaccine, including new adjuvant strategies, novel vectors for antigen delivery and presentation, and alternative ways of eliciting antibody responses. The authors call for continued commitment to basic research to identify an effective and affordable HIV vaccine.
Source: Nanomedicine | February 2010
This Nanomedicine paper reviews a range of strategies based on nanotechnology that are currently being used or tested to improve HIV/AIDS treatment and prevention. The authors review nanomedical advances in antiretroviral therapy, gene therapy, immunotherapy, vaccines and microbicides.
They conclude that nanotechnology promises great improvements in all of these areas but they warn that the field still faces many challenges including the toxicity of nanomaterials, their stability in physiological settings and the question of how to mass-produce them.
Source: The Lancet | January 2008
This collection of articles, published by The Lancet, describes the burden of maternal and child undernutrition in the developing world and highlights proven effective interventions to reduce stunting and micronutrient deficiencies.
Undernutrition is entirely preventable yet causes more than 3.5 million child deaths. It produces stunting, wasting and intrauterine growth restriction among other problems and is particularly prevalent in Africa, Asia, the Middle East and western Pacific.
The window of opportunity for tackling undernutrition is short: from pregnancy to two years of age. After the age of two, the damage on health and brain development caused by undernutrition is irreversible.
But, as the collection shows, there are plenty of interventions that have been proved to improve child nutrition. The most effective include breastfeeding counselling, vitamin A supplementation and zinc fortification.
Source: Organogenesis | July 2008
This review article explores the evidence that inappropriate levels of certain nutrients before or just after birth can predispose some individuals to obesity and examines how this could be applied to a clinical setting.
The brain regulates appetite and food preferences and is highly sensitive to its nutritional environment in early life.
Newborn rats whose mothers were fed a low-protein, high-carbohydrate diet during pregnancy and lactation were more likely to choose high-fat food after weaning. These food preferences may be set during lactation. Tests on another group of rats revealed that newborns exposed to junk food such as doughnuts and crisps in the womb and during lactation were more likely to want that type of food. Newborns whose mothers switched from a junk-food to a healthier diet during lactation did not have this preference.
The authors suggest that hormones such as leptin — long thought to be a crucial factor in appetite regulation — are key in regulating the development of appetite in later life.
Source: Food Nutrition Bulletin | December 2006
This paper explains how interdisciplinary collaboration in health, nutrition, and agriculture has helped the Millennium Villages Project in 12 African villages meet the Millennium Development Goals.
Global science is increasingly under pressure to become more interdisciplinary. Econutrition is a good example of a cross-sector concept that joins environmental and human health, focusing on crosscutting areas such as agriculture and ecology.
Soil erosion and decreasing biodiversity causes environmental damage that lowers food production. A lack of food results in malnutrition and illness that, in turn, lead to poorer labour productivity and poorer agricultural management.
The Millennium Villages Project emphasises community engagement and leadership, and the case study from the Nyanza Province near Lake Victoria in Kenya illustrates that this can work well in improving nutrition.
One-fifth of adults in the area have HIV and many have malaria and TB. People in the region go hungry for up to seven months a year and are malnourished. The villagers constructed a health clinic and organised teams of community healthcare workers trained in nutrition.
Farmers receive fertilisers and plants if they donate ten per cent of their harvest towards a school lunch programme that concentrates on providing missing nutrients. For example, by adding local crops such as sweet potatoes common vitamin A deficiencies are eliminated. The key to success, say the authors, is to ensure that farmers are supported, especially in producing a variety of crops.
Source: American Journal of Clinical Nutrition | August 2006
This review examines the global 'nutrition transition', the ongoing shift in dietary patterns that results from socioeconomic and demographic change.
The author finds that while dietary changes are fairly well documented, other aspects such as how global media or activity-levels influence these changes are poorly recognised. For example, how the drop in manual labour that results as a society becomes more prosperous might affect activity levels.
The author takes an evolutionary view of the nutrition transition, acknowledging that populations have repeatedly striven to make food more plentiful and better tasting (which has often translated to more processed or higher calorie contents) and to expend as little physical energy in the process.
He argues that rapidly-developing countries must consider how to ensure that their richer, well-fed populations do not succumb to degenerative or chronic diseases. There is a strong economic incentive: sick populations drain the economy.
Source: Clinical Infectious Diseases | October 2009
This article unpicks the links between nutrition and HIV/AIDS, and looks how to break the cycle between the two. Every year millions of dollars are pumped into tackling HIV/AIDS including antiretrovirals and research for vaccines and drugs. But poor nutrition remains a major barrier to preventing sickness and death from the virus.
The effects of poor nutrition on HIV status are clear: malnourishment weakens the immune system. But it also has indirect non-biological effects. For example, a lack of food can trigger dangerous coping strategies such as selling sex for food or selling assets, both of which lead to economic instability and a higher risk of HIV infection.
People with HIV are less able to absorb nutrients. And crucially, undernutrition also affects the ability of HIV-infected people to process antiretrovirals such as nevirapine.
The authors call for better targeting of food aid to HIV-infected people.