Ministry Of Health Research Articles

Predicting skin cancer risk from facial images with an explainable artificial intelligence (XAI) based approach: a proof-of-concept study

Efficient identification of individuals at high risk of skin cancer is crucial for implementing personalized screening strategies and subsequent care. While Artificial Intelligence holds promising potential for predictive analysis using image data, its application for skin cancer risk prediction utilizing facial images remains unexplored. We present a neural network-based explainable artificial intelligence (XAI) approach for skin cancer risk prediction based on 2D facial images and compare its efficacy to 18 established skin cancer risk factors using data from the Rotterdam Study. The study employed data from the Rotterdam population-based study in which both skin cancer risk factors and 2D facial images and the occurrence of skin cancer were collected from 2010 to 2018. We conducted a deep-learning survival analysis based on 2D facial images using our developed XAI approach. We subsequently compared these results with survival analysis based on skin cancer risk factors using cox proportional hazard regression. Among the 2810 participants (mean Age=68.5±9.3 years, average Follow-up=5.0 years), 228 participants were diagnosed with skin cancer after photo acquisition. Our XAI approach achieved superior predictive accuracy based on 2D facial images (c-index=0.72, 95% CI: 0.70-0.74), outperforming that of the known risk factors (c-index=0.59, 95% CI 0.57-0.61). This proof-of-concept study underscores the high potential of harnessing facial images and a tailored XAI approach as an easily accessible alternative over known risk factors for identifying individuals at high risk of skin cancer. The Rotterdam Study is funded through unrestricted research grants from Erasmus Medical Center and Erasmus University, Rotterdam, Netherlands Organization for the Health Research and Development (ZonMw), the Research Institute for Diseases in the Elderly (RIDE), the Ministry of Education, Culture and Science, the Ministry for Health, Welfare and Sports, the European Commission (DG XII), and the Municipality of Rotterdam. G.V. Roshchupkin is supported by the ZonMw Veni grant (Veni, 549 1936320).

Association between a malnutrition screening tool and mealtime observation checklist items in older people receiving oral intake support: A cross-sectional study of four long-term care facilities.

Multiple nutritional screening tools are available for older people; however, few screening tools include specific eating behaviours as risk factors that could lead to poor food intake. The 24-item mealtime observation checklist (MOCL), developed by the Japanese Ministry of Health, Labour and Welfare in 2015, comprises signs, symptoms and conditions during mealtime that reflect eating and swallowing functions and oral conditions. To examine factors associated with malnutrition among the MOCL items in older people. A cross-sectional study was conducted using data from a retrospective cohort study conducted at four long-term care facilities in Japan. Among the older people residing in the facilities, 198 who received oral intake support were included in the analyses. Nutritional status was assessed using the Mini Nutritional Assessment-Short Form (MNA®-SF), and comparisons were made between 'malnutrition' and 'at-risk or well-nourished'. The association between each MOCL item and malnutrition was assessed using multivariable logistic regression analysis. Of the 198 participants, 98 (49.5%) were classified as 'malnutrition', 98 (49.5%) as 'at-risk' and 2 (1%) as 'well-nourished' by MNA®-SF. After adjusting for participant characteristics such as age and sex, significant associations with malnutrition were observed for four items from the 24-item MOCL: 'Has fatigue due to extended mealtime (odds ratio [OR] = 3.20, 95% confidence interval [CI]: 1.36-7.53)', 'Food residues in the oral cavity are conspicuous (OR = 2.77, 95% CI: 1.38-5.52)', 'Has difficulty swallowing food and takes time to swallow (OR = 3.78, 95% CI: 1.45-9.84)' and 'Assisted feeding is required (OR = 3.70, 95% CI: 1.73-7.91)'. The four signs, symptoms and conditions during mealtime identified in this study may be associated with malnutrition in older people. These may indicate the potential eating problems that can lead to malnutrition. By incorporating them into early intervention and prevention measures, health care providers may help prevent malnutrition and improve the nutritional status of older people.

Experiences, Lessons, and Challenges With Adapting REDCap for COVID-19 Laboratory Data Management in a Resource-Limited Country: Descriptive Study.

The COVID-19 pandemic brought challenges requiring timely health data sharing to inform accurate decision-making at national levels. In Botswana, we adapted and integrated the Research Electronic Data Capture (REDCap) and the District Health Information System version 2 (DHIS2) platforms to support timely collection and reporting of COVID-19 cases. We focused on establishing an effective COVID-19 data flow at the national public health laboratory, being guided by the needs of health care professionals at the National Health Laboratory (NHL). This integration contributed to automated centralized reporting of COVID-19 results at the Ministry of Health (MOH). This paper reports the experiences, challenges, and lessons learned while designing, adapting, and implementing the REDCap and DHIS2 platforms to support COVID-19 data management at the NHL in Botswana. A participatory design approach was adopted to guide the design, customization, and implementation of the REDCap platform in support of COVID-19 data management at the NHL. Study participants included 29 NHL and 4 MOH personnel, and the study was conducted from March 2, 2020, to June 30, 2020. Participants' requirements for an ideal COVID-19 data management system were established. NVivo 11 software supported thematic analysis of the challenges and resolutions identified during this study. These were categorized according to the 4 themes of infrastructure, capacity development, platform constraints, and interoperability. Overall, REDCap supported the majority of perceived technical and nontechnical requirements for an ideal COVID-19 data management system at the NHL. Although some implementation challenges were identified, each had mitigation strategies such as procurement of mobile Internet routers, engagement of senior management to resolve conflicting policies, continuous REDCap training, and the development of a third-party web application to enhance REDCap's capabilities. Lessons learned informed next steps and further refinement of the REDCap platform. Implementation of REDCap at the NHL to streamline COVID-19 data collection and integration with the DHIS2 platform was feasible despite the urgency of implementation during the pandemic. By implementing the REDCap platform at the NHL, we demonstrated the possibility of achieving a centralized reporting system of COVID-19 cases, hence enabling timely and informed decision-making at a national level. Challenges faced presented lessons learned to inform sustainable implementation of digital health innovations in Botswana and similar resource-limited countries.

Guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance in Japan: A tiered approach for the assessment of clinically meaningful driving impairment.

In December 2022, the Ministry of Health, Labour and Welfare (MHLW) of Japan issued and implemented the guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance. This guideline recommends the use of a tiered approach to assess clinically meaningful driving impairment. It is noted that adverse events cannot be solely explained by pharmacokinetics, as the onset and duration of these events vary. Among these adverse events, those affecting alertness, such as drowsiness caused by psychotropic drugs on driving performance, are more frequently observed during initial treatment stages and dose escalation. Hence, when evaluating the effects of psychotropic drugs on driving performance, it becomes crucial to assess the persistence of clinically meaningful impairment. Therefore, the MHLW guideline, developed by the authors, emphasizes the need to assess the temporal profile of adverse events affecting driving in all clinical trials. Additionally, the guideline states that when conducting driving studies, the timing of multiple dosing should consider not only the pharmacokinetics of the investigational drug but also its tolerance.

Cost-effectiveness of a radio intervention to stimulate early childhood development: protocol for an economic evaluation of the SUNRISE trial in Burkina Faso

IntroductionApproximately 250 million children under 5 years of age are at risk of poor development in low-income and middle-income countries. However, existing early childhood development (ECD) interventions can be expensive,...

Labour Care Guide implementation as a decision-making tool for monitoring labour among healthcare providers in Uganda: protocol for a mixed-methods study

IntroductionThe new WHO Labour Care Guide (LCG), also regarded as the ‘next-generation partograph’, is a core component of 2018 WHO consolidated guidelines on intrapartum care for positive childbirth experience. The...

Protection And Legal Responsibility For Bpjs Patient Medical Records In The Perspective Of Legal Certainty

Medical records as a record are the responsibility and obligation of every medical and health worker to keep the health data of the patients they handle confidential. However, in 2021 there was a data leak from BPJS Health membership patients, where there were 279 million records of BPJS Health patient personal data information spread and traded on Raid Forums. Then it happened again in early 2022. This research aims to analyze and describe the protection and legal responsibility for the medical records of patients of the Social Security Organizing Agency in the perspective of legal certainty and to analyze and describe the implementation of the regulation of patient medical records of the Social Security Organizing Agency based on applicable provisions. This research uses empirical normative legal methods (Socio-Legal). The results of the study show that the implementation of the regulation of medical records of patients of the Social Security organizing agency is technically carried out on the basis of the Minister of Health Regulation Number 24 of 2022 concerning Medical Records. In the regulation, there are conditions that are difficult to distinguish related to the responsibility of the Ministry of Health and the relevant hospitals. The researcher concludes that the policy of protection and legal responsibility for the medical records of patients of the Social Security organizing body in the perspective of legal certainty is currently not fully realized.

Experiences and lessons from using digital technology for noncommunicable disease services during the COVID-19 pandemic in the Eastern Mediterranean Region

Background: Harnessing digital technology for health service provision is inevitable, especially after the dramatic increase in demand during the COVID-19 pandemic and the observed global disruption of health services especially for People Living with Noncommunicable Diseases (PLWNCDs). Aims: To document and share experiences, challenges and lessons learned from the use of digital health interventions (DHIs) for noncommunicable disease (NCD) service delivery during the COVID-19 pandemic in the Eastern Mediterranean Region (EMR). Methods: We conducted a documentary research on the use of DHIs for continuity of NCD services during the COVID-19 pandemic in EMR. We collected our data using a questionnaire that was developed and administered by email to WHO NCD focal persons at the ministries of health of all EMR countries. Using the WHO classification of DHIs we then mapped the various interventions and the stakeholders involved. Results: Seven countries – Islamic Republic of Iran, Jordan, Oman, Qatar, Saudi Arabia, Sudan, and United Arab Emirates – shared their documentations. Documented DHIs used by countries to overcome the disruption of services during the pandemic were mostly on the use of client-to-provider telemedicine for NCD services. The level of implementation varied between countries. NCD and mental health helplines and COVID-19 prevention awareness campaigns for PLWNCDs were the most mentioned interventions. Conclusions: DHIs for NCD service provision were implemented during the COVID-19 pandemic in all settings: highmiddle- and low-income countries in the EMR. There is a high potential for incorporating DHIs within health systems to increase access to health services beyond the pandemic. Documentation, regulation and national capacity-building for mainstreaming DHIs in public health services in the EMR are strongly encouraged, based on each country’s needs.

Prevalence and incidence of multiple sclerosis in Turkey: A nationwide epidemiologic study.

Many studies on multiple sclerosis (MS) reveal different prevalence and epidemiologic results. In this study, we aimed to determine the epidemiologic profile of MS using official health records in Turkey. Patients diagnosed with MS from the official health data of the Ministry of Health, representing the entire population of Turkey, were included in the study. Prevalence and incidence calculations were performed using the data on gender, age, year of birth, city of residence, and year of diagnosis. As a result of the study, the number of patients with the ICD code G35 was determined as 201,061 and the number of patients with this code entered at least three times was determined as 82,225. The prevalence of MS in Turkey was calculated as 96.4 per 100,000 and the female/male ratio as 2.1/1. The incidence of MS in 2022 was 6.2 per 100,000 and the mean patient age was 43.1 ± 13.3 years (female: 43.0 ± 13.1 vs male: 43.2 ± 13.7) while the mean age at first diagnosis was 34.0 ± 13.0 (female: 33.6 ± 12.6 vs male: 34.9 ± 13.7). The research was conducted via Official Database of Turkey, which includes population of 85 million and provides valuable insights into the prevalence and incidence rates of this chronic disease.

HPV Vaccine Issues in Japan: A review of our attempts to promote the HPV vaccine and to provide effective evaluation of the problem through social-medical and behavioral-economic perspectives

In Japan, subsidies from local and national government programs for HPV vaccination of girls aged 13–16 began in 2010. By 2013, HPV vaccines were being used routinely for vaccinating girls aged 12–16 as part of its national immunization program. However, in June of 2013, in response to reports of possible adverse reactions to the vaccine, Japan’s Ministry of Health, Labor, and Welfare (MHLW) announced a ‘temporary suspension’ of its governmental recommendation for HPV vaccination. The vaccination rate quickly dropped from 70 % of age-eligible girls to almost zero. It was not until 2021 that the government’s recommendation suspension finally ended. The efficacy and safety of the HPV vaccine is now well documented, yet Japan has failed to reestablish any credible level of HPV vaccination. The World Health Organization (WHO) warned that Japan’s HPV vaccination debacle was likely to result in real harm to the girls who lacked its protection; something we have already demonstrated with real-world data. To reinvigorate the HPV vaccination program in Japan to its prior levels, in the face of the current high level of HPV vaccine hesitancy, we will have to address the irrationality of human decision-making pointed out by behavioral economics. The Japanese government must act expeditiously to promote stronger cervical cancer control measures.

Effects of multi-month dispensing on viral suppression and continuity in treatment among children living with HIV aged 2 to 9 years: a cohort study in Western Kenya

Background: In Kenya, of the 82,000 children living with HIV; only 59% of these children are receiving ART, and 67% of these are virally suppressed. Early in the COVID-19 pandemic, the Ministry of Health recommended three multi-month dispensing (3MMD) of ART to all people living with HIV, including children. This study assess the association between 3MMD and clinical outcomes among children in Western Kenya. Settings and Methods: We conducted a retrospective cohort study using routinely collected de-identified patient-level data from 43 facilities in Kisii and Migori counties. The study included children 2-9 years old who had been previously initiated on ART and sought HIV services between March 01, 2020, and March 30, 2021. We used generalized linear models with Poisson regression models to assess the association of MMD on retention at 6 months and viral suppression (<1,000 copies/ml). Results: Among the 963 children, 65.2% were aged 5-9 years old, and 50.7% were females. Seventy-eight percent received 3MMD at least once during the study period. Children who received 3MMD were 12% [adjusted risk ratio (aRR) (95% CI) =1.12 (1.01-1.24)] more likely to be retained and 22% [aRR =1.22 (1.12-1.34)] more likely to be virally suppressed than those on < 3MMD. When stratified by viral suppression at entry, the association between 3MMD and retention ([aRR= (95% CI) =1.22 (1.02-1.46)]) and viral suppression [aRR= (95% CI) =1.76 (1.30-2.37)] was significant among individuals who were unsuppressed at baseline. Conclusions: 3MMD was associated with comparable or improved HIV health outcomes among children.

Trends and distribution of external radiation therapy facilities in Japan based on Survey of Medical Institutions from the Ministry of Health, Labour and Welfare.

This study aimed to explore the distribution of external radiation therapy (RT) facilities, the status of related device installations and the adoption of high-precision RT using Survey of Medical Institutions from the Ministry of Health, Labour and Welfare in Japan. Analysis, categorized by the hospital size and prefecture, provides specific insights into the trends in treatment facility healthcare capabilities. Data on the number of RT facilities, high-precision RT facilities, RT devices and treatment planning systems (TPS) categorized by the number of beds and prefecture from 1996 to 2020 were analyzed. In addition, the study examined the correlation between the high-precision implementation rate and the number of TPSs or radiation oncologists and other medical staff. High-precision RT exceeded 95% in large facilities (800+ beds) but remained <50% in medium-sized facilities (300-499 beds). In a prefecture-by-prefecture analysis, calculation of the maximum-minimum ratio of RT facilities per million population and per 30km2 revealed a disparity of 3.7 and 73.1 times in the population ratio and the density ratio, respectively. Although a correlation was found between the number of TPSs per RT device or the number of medical physicists per million population and the rate of high-precision RT implementation, no correlation was found among other professions. Detailed analysis based on the hospital size and prefecture provided more specific information on the medical functions of RT facilities in Japan. These findings can potentially contribute to the future development of RT, including the standardization of treatment techniques and optimal resource allocation.

The role of health surveillance in the face of self-medication in the context of Covid-19: A literature reviewha

The politicization of the disease led to misinformation and the use of unproven treatments, such as the “COVID Kit”. The National Health Surveillance Agency (ANVISA) took important measures, including management and planning, health risk control, regulation, monitoring of suspected and confirmed cases, as well as information, communication and health education. Therefore, the general objective of this research is to demonstrate how the National Health Surveillance Agency (ANVISA) acted in the face of self-medication in the context of COVID-19. To this end, a literature review was carried out over the last five years on self-medication, pandemics, health surveillance, using databases such as PubMed, Google Scholar, Scientific Electronic Library Online (SciELO), Manuals from the Ministry of Health and the World Health Organization Inclusion criteria were adopted, such as articles published in Portuguese or English, primary studies and literature reviews, while studies that did not meet the general objective of the work and publications prior to 2019 were excluded. Regarding the results, ANVISA played an important role in the control and regulation of medicines during the pandemic, classifying chloroquine as a special control medicine and carrying out more than 30 thousand inspections to ensure compliance with clinical protocols to combat the disease. Finally, the pandemic brought challenges for health surveillance professionals, in order to contain the spread of the coronavirus, especially regarding the inappropriate use of medicines and other products subject to health assessment.

Cutaneous adverse events following COVID-19 vaccination: A case series of 30 Japanese patients and a review of 93 Japanese studies.

In Japan, cutaneous adverse events (AEs) following the coronavirus disease 2019 (COVID-19) vaccination have been frequently described; however, a larger case series and literature review are lacking. There is an urgent need for an extensive investigation of new cases and previous reports to provide a thorough body of information about post-COVID-19 immunization cutaneous AEs. We aimed to analyze patients with cutaneous AEs after COVID-19 vaccination in our hospital and review previous studies of cutaneous AEs. We analyzed post-COVID-19 vaccination cutaneous AEs in our department, the Japanese Registry, and previous literature. We enrolled 30 patients with cutaneous post-vaccination AEs in our department over 2 years (April 1, 2021, to March 31, 2023). We also confirmed cases registered in the Ministry of Health, Labor, and Welfare COVID-19 vaccine side effect reporting system (February 17, 2021-March 12, 2023). A total of 587 records were retrieved and 93 articles were included for data extraction. A total of 28 non-injection-site cutaneous AEs and two injection-site AEs were identified. Six (20.0%) patients developed new-onset erythematous eruptions, and five (16.7%) patients developed urticaria. Pruritic eruption, eczema, shingles, and sweating symptoms have also been reported. In previous studies on non-injection-site cutaneous AEs, individuals who received the BNT162b2 vaccine were older than those who received mRNA-1273 (P < 0.01). Cutaneous AEs were mostly nonsignificant and self-limiting reactions; however, rare, severe, or life-threatening AEs were also reported. Physicians should be aware of the various possible cutaneous AEs associated with the COVID-19 vaccination.

Implementation of a pilot checklist for control standardization on fishery goods consignments at the Livorno border control post

To standardize control activities, it is necessary to introduce checklists to support the control of consignments entering the European Union through border control posts (BCPs). This study aimed to develop a pilot checklist for the control of fishery consignments, preliminarily identified as the predominant group of goods entering the Livorno (Italy) BCP. The design of the pilot checklist was preceded by i) a revision of the current European and national legislation on the general and specific objectives of border control activities on fishery products and ii) a comparative analysis of two checklists (one of the Ministry of Health and one of the former Livorno border inspection post) developed on the basis of the repealed legislation. This comparison aimed to define the pilot checklist structure, verification objectives, and selection of assessment scores to be included in defining consignment compliance and acceptability. Once developed, the clarity and ease of use of the first draft of the pilot checklist were verified through its use in a field test during the control of 64 fishery product consignments. 22 regulatory sources (18 European and 4 national) were selected as reference legislation. The pilot checklist was structured as a dynamic “read-do” document based on the workflow of control activities described in the current legislation. The field test was useful in improving the clarity of the verification objectives within the documentary, identity, and physical control sections and in facilitating the use of the checklist and the collection of evidence during the control activity. This study, which focused on fishery products, can provide a practical approach for the development of checklists for all the other goods categories under the responsibility of BCPs.

Clinical and hematological characteristics of complicated and intact otitis media

Purpose: to evaluate clinical and hematological features and identify patterns in hematological indices in patients with complicated and uncomplicated forms of otitis media.&#x0D; Materials and methods: The study included 30 patients with otitis media aged from 18 to 70 years: 24 patients (80%) had an uncomplicated course, 6 (20%) had a complicated course (cholesteatomas, mastoiditis). The diagnosis was established taking into account the clinical recommendations of the Russian Ministry of Health (2022) on the basis of a comprehensive clinical and laboratory examination, otoscopy, and audiological studies.&#x0D; Clinical, anamnestic and statistical methods were used. Calculation of hematological indices was carried out using a computer program. Statistical analysis was carried out using the Statistica 10 package. The critical level of statistical significance when testing scientific hypotheses was p 0.05.&#x0D; Results and conclusions. In the group of patients with complicated otitis media, a more vivid clinical picture and more pronounced changes in hematological parameters were observed. Noteworthy are the features of disturbances in the state of immune homeostasis: with complicated otitis, the ISLE indicator increased 3 times more often, which indicates the predominance of an immediate type reaction in the development of complications. The macrophage system index (MSI) was changed in uncomplicated otitis compared to complicated patients, which indicates a violation of cellular phagocytic protection in otitis media. In all cases, a violation of the effector and affector links of immunity (IAM) was revealed, with a predominance of the effector pathway. In 80% of cases of otitis, disturbances in the interaction of humoral and cellular immunity (LI) were observed.&#x0D; The multidirectionality of the results obtained requires their further study in order to develop an algorithm for personalized diagnosis of patients with otitis media.

Report of the Chief pediatric surgeon of the Ministry of Health of the Russian Federation for 2023. Pediatric surgery: numbers and facts

The study reported on the activities of the chief freelance specialist — pediatric surgeon of the Ministry of Health of the Russian Federation for 2023. Information was provided on the analytical and organizational work of the Institute of Chief Pediatric Surgeons, strategic decisions in pediatric surgical service, interaction with the subjects of the Russian Federation, professional associations of other specialists, and bodies of legislative and executive power of the regions and the Federation. A separate section was devoted to “Pediatric surgery: Numbers and facts”, which is a summary of the main characteristics of the pediatric surgical service of the country through comparative analysis of data from the chief pediatric surgeons of the subjects (n = 80) of the Russian Federation for 2022 and 2023.

Breakdown and reform: the Chilean road to the creation of ministries of hygiene and social welfare 1892-1931.

Doctors have played an important role in the development of health institutions in Latin America. However, they are not the only profession that has had a voice in these matters. There are also other factors influencing the development of ministries of health. This issue has gone unnoticed in the literature. This article suggests that it is possible to identify two distinct trends in the creation of health ministries in Latin America. The first, of an early nature, was seen principally in Central America and the Caribbean in countries dependent on or under the influence of the United States which, from the 1880s, promoted health Pan-Americanism. The second trend, which became apparent from 1924, was characterised by the emergence of ministries in a context of institutional breakdown and the appearance of new actors (military or populist leaders). This second trend was first seen in Chile in 1924. This article analyses the creation of the Ministerio de Higiene, Asistencia y Previsión Social (Ministry of Hygiene, Assistance and Social Security) in Chile in 1924 and its subsequent development through to 1931. The analysis looks at the health measures adopted, the context in which this occurred and the debates triggered by the ministry's process of institutional development, based on parliamentary discussions, presidential speeches, official statistics, legislation, documents prepared by key actors and the press of the time.

Incidence of the musculoskeletal system diseases in children and the organization of specialized care in Saint Petersburg

BACKGROUND: The high prevalence of musculoskeletal system and connective tissue diseases, effects on the quality of life of children, and disability level are among the main medical and social problems.&#x0D; AIM: To assess the morbidity rates and provision of medical care to St. Petersburg children with musculoskeletal diseases between 2017 and 2021.&#x0D; MATERIALS AND METHODS: Data on the incidence of musculoskeletal diseases in children of St. Petersburg were analyzed based on the Federal statistical observation forms submitted by the St. Petersburg State Budgetary Institution Medical Center for Information and Analysis, collections of N.N. Priorov National Medical Research Center for Traumatology and Orthopedics of the Ministry of Health of the Russian Federation “Trauma, orthopedic morbidity, the state of trauma and orthopedic care for the population,” edited by Acad. S.P. Mironov, RAS, and data from the Federal State Statistics Service.&#x0D; RESULTS: In Saint Petersburg, the morbidity rate of musculoskeletal and connective tissue diseases from 2017 to 2021 was 13%, excluding 2020, which was most likely due to the introduction of measures aimed at counteracting the spread of COVID-19 and the suspension of planned outpatient specialized care. The number of orthopedic beds for children decreased by 58, whereas the availability of beds for children remained at the same level and amounted to 4.3 beds per 10,000 children, which exceeded the indicator for the Russian Federation (1.0). The number of children with these disabilities increased 1.4-fold. Deaths of children due to musculoskeletal and connective tissue diseases were recorded in 2019 and 2020.&#x0D; CONCLUSIONS: The results of the 5-year observation period of musculoskeletal and connective tissue diseases in children in St. Petersburg revealed increasing incidence because of the increase in the number of children newly diagnosed with these diseases.

Can Sustainability and Biodiversity Conservation Save Native Goat Breeds? The Situation in Campania Region (Southern Italy) between History and Regional Policy Interventions

The Campania region has a genetic heritage, both vegetal and animal, of great scientific interest, but many genetic resources risk extinction or abandonment. Thus, from a sustainability perspective, their conservation is very important and represents an imperative to allow future generations to satisfy their needs just as we are doing today. The aims of the present paper were to describe the current consistency and importance of goat farming in Italy and in the Campania region and to study its trend from 1861 to understand whether the policies for the sector implemented over time have been sufficient to conserve goat biodiversity. To these ends, the latest available data of the national livestock register of the Italian Ministry of Health, those of the different available Italian agricultural censuses, and historical–cultural documents published over time for the livestock sector were acquired and consulted to describe the goat sector and reconstruct its temporal trend. The results showed that in Italy there are just over 1,000,000 goats (the same consistency as 60 years ago), 50% of which are distributed in the southern regions, and 50,616 farms with goats, 43% of which are extensive. In this contest, the Campania region represents approximately 5% of the national goat population. The continuous decrease in the size of the national and regional goat heritage since the 1920s is the result of the agricultural policy instruments implemented for the livestock sector over time, which have effectively excluded the goat sector. Two small increases in the number of caprines were registered: the first in 1980s, when the Italian scientific community realized that the native goat genetic types, its milk and its organoleptic and dietary qualities could constitute a wealth of endogenous resources that needed to be valorized; the second, in the last decade, due to the actions of sustainability and biodiversity conservation implemented at the national and regional level. At the same time, today the goat sector continues to have a marginal role in the national and regional agricultural economy, and the survival of native goat farming is essentially ensured by sustainable rural communities conceived as the custodians of biodiversity.