World Alzheimer Report

The World Alzheimer Report 2010 provides the clearest, most comprehensive global picture yet of the economic impact of Alzheimer's disease and dementia.The report includes an estimate of the worldwide cost of dementia, including direct medical costs, direct non-medical costs and costs of informal (family) care. The estimates are broken down by world region and include analysis of the differences between low and high income countries. The report also contains important policy recommendations and makes clear to key decision-makers that doing nothing is not an option.The report can be found here.

Low human papillomavirus prevalence in head and neck cancer: results from two large case-control studies in high-incidence regions

Background Recent studies support an important role for human papillomavirus (HPV) in a subgroup of head and neck squamous cell carcinomas (HNSCC). We have evaluated the HPV deoxyribonucleic acid (DNA) prevalence as well as the association between serological response to HPV infection and HNSCC in two distinct populations from Central Europe (CE) and Latin America (LA). Methods Cases (n = 2214) and controls (n = 3319) were recruited from 1998 to 2003, using a similar protocol including questionnaire and blood sample collection. Tumour DNA from 196 fresh tissue biopsies was analysed for multiple HPV types followed by an HPV type-specific polymerase chain reaction (PCR) protocol towards the E7 gene from HPV 16. Using multiplex serology, serum samples were analysed for antibodies to 17 HPV types. Statistical analysis included the estimation of adjusted odds ratios (ORs) and the respective 95% confidence intervals (CIs). Results HPV16 E7 DNA prevalence among cases was 3.1% (6/196), including 4.4% in the oropharynx (3/68), 3.8% in the hypopharynx/larynx (3/78) and 0% among 50 cases of oral cavity carcinomas. Positivity for both HPV16 E6 and E7 antibodies was associated with a very high risk of oropharyngeal cancer (OR = 179, 95% CI 35.8-899) and hypopharyngeal/laryngeal cancer (OR = 14.9, 95% CI 2.92-76.1). Conclusions A very low prevalence of HPV DNA and serum antibodies was observed among cases in both CE and LA. The proportion of head and neck cancer caused by HPV may vary substantially between different geographical regions and studies that are designed to evaluate the impact of HPV vaccination on HNSCC need to consider this heterogeneity.

Effects of health decentralization, financing and governance in Mexico

OBJECTIVE: To identify the effects of decentralization on health financing and governance policies in Mexico from the perspective of users and providers. METHODS: A cross-sectional study was carried out in four states that were selected according to geopolitical and administrative criteria. Four indicators were assessed: changes and effects on governance, financing sources and funds, the final destination of resources, and fund allocation mechanisms. Data collection was performed using in-depth interviews with health system key personnel and community leaders, consensus techniques and document analyses. The interviews were transcribed and analyzed by thematic segmentation. RESULTS: The results show different effectiveness levels for the four states regarding changes in financing policies and community participation. Effects on health financing after decentralization were identified in each state, including: greater participation of municipal and state governments in health expenditure, increased financial participation of households, greater community participation in low-income states, duality and confusion in the new mechanisms for coordination among the three government levels, absence of an accountability system, lack of human resources and technical skills to implement, monitor and evaluate changes in financing. CONCLUSIONS: In general, positive and negative effects of decentralization on health financing and governance were identified. The effects mentioned by health service providers and users were related to a diversification of financing sources, a greater margin for decisions around the use and final destination of financial resources and normative development for the use of resources. At the community level, direct financial contributions were mentioned, as well as in-kind contributions, particularly in the form of community work.

Competence Development and Capacity Building of Sawmill Enterprises in Kenya – A Human Resources Development Approach

The Kenyan forestry and sawmilling industry have been subject to a changing environment since 1999 when the industrial forest plantations were closed down. This has lowered raw material supply and it has affected and reduced the sawmill operations and the viability of the sawmill enterprises. The capacity of the 276 registered sawmills is not sufficient to fulfill sawn timber demand in Kenya. This is because of the technological degradation and lack of a qualified labor force, which were caused because of non-existent sawmilling education and further training in Kenya. Lack of competent sawmill workers has led to low raw material recovery, under utilization of resources and loss of employment. The objective of the work was to suggest models, methods and approaches for the competence and capacity development of the Kenyan sawmilling industry, sawmills and their workers. A nationwide field survey, interviews, questionnaire and literature review was used for data collection to find out the sawmills’ competence development areas and to suggest models and methods for their capacity building. The sampling frame included 22 sawmills that represented 72,5% of all the registered sawmills in Kenya. The results confirmed that the sawmills’ technological level was backwards, productivity low, raw material recovery unacceptable and workers’ professional education low. The future challenges will be how to establish the sawmills’ capacity building and workers’ competence development. Sawmilling industry development requires various actions through new development models and approaches. Activities should be started for technological development and workers’ competence development. This requires re-starting of vocational training in sawmilling and the establishment of more effective co-operation between the sawmills and their stakeholder groups. In competence development the Enterprise Competence Management Model of Nurminen (2007) can be used, whereas the best training model and approach would be a practically oriented learning at work model in which the short courses, technical assistance and extension services would be the key functions.

Interdisciplinary Pedagogical Experience for Health Human Resources Focused on the Holistic Promotion of Health and the Prevention of the Disease

The object of this experience is to offer the students the opportunity to take part in the construction of a pedagogic strategy centred on the ludic, for the promotion of the integral health and the prevention of the disease with an educational community; directed to supporting and qualifying the well-being so much individually as group. The project is designed to five years, about interdisciplinary character (Speech Therapy, Medicine, Psychology, Nursery, Occupational Therapy), interinstitutional (Universidad del Rosario, Universidad de San Buenaventura y Universidad de Cundinamarca) and intersectorial (Education and Health). It considers the different actors of the educational community and school and the home as propitious scenes for the strengthening potential, beside being the fundamental spaces for the construction of knowledges and learnings concerning the integral health. To achieve the target, one has come constructing from the second semester of 2003, one pedagogic strategy centred on the ludic and the creativity, from which they are planned, they develop and evaluate the actions of promotion of skills, values, behaviors and attitudes in the care of the health and the prevention of disease, orientated to the early, opportune and effective detection of risk factors and problematic of the development that they affect the integral health. The above mentioned strategy raises a so called scene Bienestarópolis: A healthy world for conquering, centred on prominent figures, spaces and elements that alternate between the fantasy and the reality to facilitate the approximation, the interiorización and the appropriation of the integral health. Across this one, the children motivated by the adults enter an imaginary world in that theirs desires, knowledges and attitudes are the axis of his development. Since Vigotsky raises it, in the game the child realizes actions in order to adapt to the world that surrounds it acquiring skills for the learning. The actions of the project have involved 410 children and 25 teachers, of the degrees Zero, The First and The Second of basic primary; 90 parents of family, and an average of 40 students and 8 teachers of the already mentioned disciplines.

Implementing Human Papillomavirus Testing in a Public Health Hospital: Challenges and Opportunities

Objectives: Robust evidence now supports human papillomavirus (HPV) testing as a more effective option to screening and as more sensitive than cytology in detecting high-grade cervical intraepithelial neoplasia. Our goal was to analyze the performance of the Hybrid Capture II (HC2) assay for high-risk HPV (hrHPV) in women undergoing gynecological examination at a public health hospital as part of the evaluation of HPV screening as an alternative or complement to cytology. Study Design: This analysis is a subset of a cross-sectional study carried out at a large public hospital serving a predominantly low-resource population. A total of 705 women were enrolled; the sensitivity and specificity of each test were estimated and compared. Results: The analysis identified 272 hrHPV-positive women (mean age 36.3 years) and 433 hrHPV-negative women (mean age 41.2 years). HPV testing showed a significantly increased sensitivity of the HC2 assay versus cytology (84.5 vs. 69.7%; p < 0.0001) but a lower specificity (49.90 vs. 88.78%; p < 0.0001). Conclusion: The combination of both methods seems to be useful in improving detection of cervical lesions. Copyright (C) 2012 S. Karger AG, Basel

Arsenic, antimony and selenium in urban soils: potential risks for human health in urban gardening

The benefits of urban agriculture are many and well documented, ranging from health improvement to community betterment, more sustainable urban development and environment protection. On the negative side, urban soils are commonly enriched in toxic trace elements that have accumulated over time through the deposition of atmospheric particles (generated by automotive traffic, heating systems, historical industrial activities and resuspended street dust), and the uncontrolled disposal of domestic, commercial and industrial wastes. This in turn has given rise to concerns about the level of exposure of urban farmers to these elements and the potential health hazards associated with this exposure. Research efforts in this field have started relatively recently and have almost systematically omitted the influence of Sb and Se, and to a lesser extent of As, although all three have proven toxic effects.

Long-term modifications of synaptic efficacy in the human inferior and middle temporal cortex.

The primate temporal cortex has been demonstrated to play an important role in visual memory and pattern recognition. It is of particular interest to investigate whether activity-dependent modification of synaptic efficacy, a presumptive mechanism for learning and memory, is present in this cortical region. Here we address this issue by examining the induction of synaptic plasticity in surgically resected human inferior and middle temporal cortex. The results show that synaptic strength in the human temporal cortex could undergo bidirectional modifications, depending on the pattern of conditioning stimulation. High frequency stimulation (100 or 40 Hz) in layer IV induced long-term potentiation (LTP) of both intracellular excitatory postsynaptic potentials and evoked field potentials in layers II/III. The LTP induced by 100 Hz tetanus was blocked by 50-100 microM DL-2-amino-5-phosphonovaleric acid, suggesting that N-methyl-D-aspartate receptors were responsible for its induction. Long-term depression (LTD) was elicited by prolonged low frequency stimulation (1 Hz, 15 min). It was reduced, but not completely blocked, by DL-2-amino-5-phosphonovaleric acid, implying that some other mechanisms in addition to N-methyl-DL-aspartate receptors were involved in LTD induction. LTD was input-specific, i.e., low frequency stimulation of one pathway produced LTD of synaptic transmission in that pathway only. Finally, the LTP and LTD could reverse each other, suggesting that they can act cooperatively to modify the functional state of cortical network. These results suggest that LTP and LTD are possible mechanisms for the visual memory and pattern recognition functions performed in the human temporal cortex.

A report on public and community health personnel : prepared for the Committee on Interstate and Foreign Commerce, House of Representatives and the Committee on Labor and Human Resources, United States Senate, as required by section 793 of the Public health service act

"December 7, 1979."

Barriers to health care/children's health [microform] : hearing before the Committee on Labor and Human Resources, United States Senate, Ninety-ninth Congress, second session, on review of access to health care for the poor and uninsured and improved health for America's children, July 16, 1986.

CIS Microfiche Accession Numbers: CIS 87 S541-16

The health care crisis and the American family : hearing before the Committee on Labor and Human Resources, United States Senate, One Hundred Second Congress, first session ... January 10, 1991.

Item 1043-A, 1043-B (MF)

Medicaid prescription drug diversion : a major problem, but state approaches offer some promise : statement of Janet L. Shikles, Director, Health Financing and Policy Issues, Human Resources Division, before the Select Committee on Narcotics Abuse and Control, House of Representatives /

"July 29, 1992."

Health insurance : more resources needed to combat fraud and abuse : statement of Janet L. Shikles, Director, Health Financing and Policy Issues, Human Resources Division, before the Committee on the Judiciary, United States Senate /

"July 28, 1992."

Health and educational effects of marijuana on youth : hearing before the Subcommittee on Alcoholism and Drug Abuse of the Committee on Labor and Human Resources, United States Senate, Ninety-seventh Congress, first session on examination of the health and educational effects of marijuana or youth, October 21, 1981.

Mode of access: Internet.