World Health Organization Publications Research Articles

Population-based epidemiologic data on brain tumors in German children.

Brain tumors are the most common disease group of solid tumors in childhood, and children with brain tumors have a relatively poor survival rate. Epidemiologic data from a population-based cancer registry provide the necessary information to obtain a full picture of the frequency of this disease, which is a great challenge in pediatric oncology. The German Childhood Cancer Registry (GCCR) is a population-based registry. The level of completeness of patient registration is 95%, but it is somewhat lower for patients with brain tumors. More than 300 children with newly diagnosed brain tumors are reported every year. Analyses of GCCR data are performed according to the International Classification of Childhood Cancer and the recently published World Health Organization classification of tumors of the nervous system. In addition, incidence rates of childhood brain tumors in Germany are compared with those of other countries, as published by the International Agency for Research on Cancer. In the years 1990-1999, a total of 3268 brain tumors were observed (excluding intracranial and intraspinal germ cell tumors). The respective incidence rate for children age < 15 years was 2.6 per 100,000 children and lies between the rates from other countries, which range between 1.7 and 4.1 per 100,000 children. The most common brain tumors were astrocytomas (41.7%), medulloblastomas (18.1%), ependymomas (10.4%), supratentorial primative neuroectodermal tumors (PNETs; 6.7%), and craniopharyngiomas (4.4%). They were located mainly in the cerebellum (27.9%) and the cerebrum (21.2%). The 5-year survival rate for all brain tumors was 64%, with the poorest prognosis for children with PNET. The large data base of the GCCR made it possible to present representative data on patients with childhood tumors of the central nervous system in Germany. The data quality was high, not least because of the strong cooperation with corresponding clinical trials. However, for children with central nervous system tumors, the ascertainment of newly diagnosed patients needs further improvement.

Pain experienced by patients hospitalized at the National Cancer Institute of Milan: research project "towards a pain-free hospital".

According to the data of the literature, the prevalence of pain in cancer patients at various stages of the disease and the settings of care range from 38 to 51%, with an increase of up to 74% in the advanced and terminal stages. Despite published World Health Organization (WHO) guidelines for pain management, 42 to 51% of cancer patients receive inadequate analgesia and 30% receive no analgesics at all. A 3-year Research Project "Towards a Pain-free Hospital", which began one year ago, is ongoing at the National Cancer Institute of Milan. The research is organized in three subsequent steps. In the 1st one, a series of patient- and staff-oriented evaluation tools are used to assess the level of appropriateness of pain communication, assessment, management and control of the in-patients. The 2nd step will implement a number of continuing educational interventions aimed at improving patient awareness and staff knowledge of the appropriate pain assessment and management in order to respond to the patient's pain problem. In the 3rd step, all the assessment tools used in step one will be applied again to establish the prevalence of pain, the causes and intensity and patient satisfaction with pain management and to evaluate the impact of the interventions performed during the 2nd step regarding the overall ability of our hospital to tackle pain emergency in the hospitalized cancer population. The results relative to the 1st step are herein reported, in particular as regards the study on prevalence, causes, severity of pain, the interference of pain with sleep, mood and concentration, the use of pain medications and the relief obtained, the structural validity and internal consistency of the assessment tool used. A total of 258 patients hospitalized for at least 24 h were interviewed by 9 physicians using a brief structured questionnaire prepared ad hoc: 51.5% of the patients presented pain during the previous 24 h caused by surgery (49.6%) or by the tumor mass itself (29.3%). Out of the 133 patients with pain, a high degree (much or very much) of pain at rest was present in 27.1% and pain on movement in 30.8%; 31.6% did not take any analgesic treatment, and 14.3% of the latter reported a high degree of pain at rest and 21.4% on movement. Pain interfered with sleep from much to very much in 28.8% and with irritability and nervousness in 15.9% of the patients. In the 91 patients taking analgesics, 57.2% reported a high degree of pain relief. A high degree of pain and interference, however, was associated with low relief levels. The assessment tool used was shown to have a good structural validity and internal consistency (Chrombach alpha index of interference scale = 0.73). Although the Milan Cancer Institute has the longest tradition in Italy of pain assessment by means of validated tools and pain management according to the WHO guidelines and educational efforts in this field, the results of the study clearly show that it is necessary to persevere with continuing educational and informative programs in order to reduce the frequency and severity of pain and thus improve the quality of life of in-patients.

Primary cutaneous lymphomas.

Primary cutaneous lymphomas have a distinct clinical behavior and prognosis, and therefore require a different therapeutic approach, as compared with their primary nodal equivalents. The European Organization for Research and Treatment of Cancer (EORTC) classification for primary cutaneous lymphomas recognizes a limited number of cutaneous T-cell lymphomas and cutaneous B-cell lymphomas and is at present the best guide to optimal management and treatment of these conditions. Herein, the relationship between the EORTC classification and the recently published World Health Organization classification is discussed, and recent developments regarding the main types of cutaneous T-cell lymphomas and cutaneous B-cell lymphomas recognized in the EORTC classification are presented.

Heal-thy universities

H ealth Promoting Universities I is a recently published World Health Organization document that describes and def'mes the concept, experience, and framework for action involved in promoting healthy The authors of this resource assert that health is everybody's business. As educators of future generations of decision makers, universities can promote an understanding and commitment to health i n their organizational cultures, structures, and working, and their learning, living, and practice contexts. Universities have the responsibility and the potential to enable healthy personal and social development. 1 A health-promoting university creates an environment, a curricula, programs, staff, persons, and a research agenda imbued with the value of health. How would such a goal influence your future and the future of your students, staff, and alumni? How would such a goat be accomplished in your university or practice setting? To what degree is your university committed to health? What would it take for nursing departments within university settings to lead a healthy universities initiative? Such an initiative might indeed heal thy universities. What--specifically--is involved in promoting a healthy University? Health is a core nursing value that has

Growth monitoring in children.

This review is superseded by the published Cochrane Review, Taylor 2023: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014785.pub2/full. Growth monitoring is widely accepted and strongly supported by health professionals, and is a standard component of community paediatric services throughout the world. We sought to evaluate research evidence of its impact. This requires definition, consideration of the setting, and discussion of the intended effects of this activity. In this review, we define growth monitoring as the regular recording of a child's weight, coupled with some specified remedial actions if the weight is abnormal in some way. Although the causes of growth faltering and the responses to it may be region specific, the process is the same, and we consider here growth monitoring in both the deprived and richer populations of the world. Growth monitoring consists of routine measurements to detect abnormal growth, combined with some action when this is detected. As primary care workers worldwide invest time in this activity, we sought evidence of its benefits and harms. The review objectives are to evaluate the effects of routine growth monitoring on: 1. The child, in relation to preventing death, illness or malnutrition; and referrals for medical care, medical specialist assessment or professional social support follow-up. 2. The mother, in relation to nutritional knowledge, anxiety or reassurance about the child's health, and satisfaction with services. Cochrane Controlled Trials Register; MEDLINE; EMBASE; CINAHL; World Health Organization and World Bank publications; specialists in this area; citations in existing reviews and identified studies. Randomised or quasi-randomised trials comparing routine growth monitoring (regular monitoring of growth, plotting on a chart, combined with referral or intervention when growth is abnormal) with no growth monitoring. Trial quality was assessed, and data abstracted by both reviewers. Two studies included, both conducted in developing countries. In one, the nutritional status at 30 months in 500 children showed no difference between those allocated to growth monitoring and those not. The other study examined whether counselling improved mothers' knowledge of the growth chart, and reported better test scores at four months. Given the level of investment in growth monitoring worldwide, it is surprising there is so little research evaluating its potential benefits and harms.

World Health Organization publications

World Health Organization publications

Zoonoses and fertility control in wildlife--requirements for vaccines.

This paper reflects on public health considerations on the voluntary release of anti-fertility vaccines for wildlife in the environment. The World Health Organization (WHO) has established a variety of recommendations on safety and efficacy requirements for the voluntary release of rabies vaccines used for oral immunization of animals. These requirements cover aspects of control of rabies and possible biological consequences in the target population. They also deal with the protection of the health of humans and other non-target species that might come into contact with the different oral rabies vaccines used in various parts of the world. These recommendations are laid down in several WHO publications. They are specific to the disease concerned, the target animal reservoir, the relationship and types of contact between humans and target animals, the vaccines and baits used and the respective conditions of oral immunization of wildlife in densely-populated areas. Many of these recommendations also apply to the development and application of contraceptive vaccines for wildlife carnivores. Additional safety requirements concern the transmissibility of the antigen, the reversibility of the intervention within an individual animal and in animal populations, as well as the species specificity of the antigen used. The management of animal populations that are reservoirs for zoonotic diseases is a possible means by which diseases that are transmissible from animals to humans could be prevented. Oral contraception by means of vaccines is an appealing method, provided that requirements for protecting public and animal health, as well as ensuring environmental safety, are precisely defined and strictly adhered to.

Hypertension and Lead Exposure

To the Editor. —The suggestion by Dr Hu and colleagues 1 that long-term lead accumulation, as reflected by the tibia bone lead level, may be an independent risk factor for developing hypertension in men should be cautiously interpreted. Of the subjects classified as hypertensive, 44% had a blood pressure higher than 160 mm Hg systolic, 95 mm Hg diastolic, or both. 1 These thresholds are 1 mm Hg more than the published World Health Organization (WHO)/International Society of Hypertension (ISH) limits, which Dr Kim and colleagues applied in a second article in the same issue ofTHE JOURNAL. 2 Reclassifying individuals may impact on the association size and its significance. The analyses treating blood pressure as a continuous variable and avoiding the problem of having to define arbitrary cutoff points will be reported elsewhere, but a reference was not provided. According to WHO/ISH guidelines, the diagnosis of hypertension requires that pressure is measured

Book Review

Abstract Abstract Plant Stress From Air Pollution, by Michael Treshow and Franklin K. Anderson, University of Utah, U.S.A., 283 pages (including 18 figures, 17 tables, 31 pages of references (and suggested reading added to the chapters), two appendices on scientific names of plants and on conversion of concentration units, and a good index of 14 pages), format 236 × 157 mm, hard cover, ISBN 0-471-92374-5, John Wiley & Sons, Chichester New York Brisbane Toronto Singapore (1989), £39.00. Reviews of Environmental Contamination and Toxicology, Volume 114, edited by George W. Ware, College of Agriculture, University of Arizona 85721, Tucson, U.S.A., 171 pages (including 1 figure, 33 tables, references added to the four contributions, and an index of 9 pages), hard cover, format 237-156 mm, ISBN 3-540-97207-2, Springer-Verlag New York Berlin Heidelberg London Paris Tokyo Hong Kong (1990), DM 90.00. Polychlorinated Dibenzo-Para-Dioxins and Dibenzofurans Icps/WHO, Environmental Health Criteria No. 88, by a Task Group under the Chairmanship of Prof. A. D. Dayan, St. Bartholomew's Hospital Medical College, London, U.K., 409 pages (no figures, including 73 tables, 79 pages of references, a French summary, but no index), paper back, format 210 × 140 mm, ISBN 92-4-154288-8. World Health Organization Publications, CH-1211 Geneva 27, Switzerland (1989), SFr. 40.00, US$32.00. Advances in Soil Sciences, Volume 9, edited by B. A. Stewart, USDA Conservation and Production Research Laboratory, Bushland, Texas 79012, U.S.A., 219 pages (including 66 figures, 27 tables, references added to each contribution, and an index of five pages), hard cover, format 242 × 162 mm, ISBN 3-540-96781-8, Springer-Verlag New York Berlin Heidelberg London Paris Tokyo (1989), DM 154.00. Immunochemical Methods for Environmental Analysis, ACS Symposium Series No. 442, edited by Jeanette M. van Emon, U.S. Environmental Protection Agency, Las Vegas and by Ralph O. Mumma, Pennsylvania State University, University Park, Pennsylvania, 229 pages (including 65 figures, 36 tables, references added to the chapters, and a subject index of 8 pages), hard cover, format 234 × 159 mm, ISBN 0-8412-1875-7, American Chemical Society, Washington, D.C. 20037 (1990), US$ 49.95. Identifying and Regulating Carcinogens, by the Office of Technology Assessment Task Force, Congress of the United States, Washington, D.C., 249 pages (including 8 figures, 41 tables, four appendices on the Statutory Authority for Regulating Carcinogens, Chemicals Listed in Annual Reports on Carcinogens and NCI/NTP Test Results, Acknowledgements, and Acronyms, and 15 pages of references), hard-bound, format 268 × 211 mm, ISBN 0-87371-152-1, Lewis Publishers, Inc., Chelsea, Michigan, U.S.A. (1988), £29.65.

World Health Organization publications

World Health Organization publications

Lead and chromium concentrations in the potable water of the eastern province of Saudi Arabia.

The World Health Organization (WHO) and United States Public Health Service (USPHS) standards for drinking water recommend an upper limit concentration of 0.05 mg/L for both lead and chromium. The authors studied the cadmium and zinc concentrations in the potable water of the Eastern Province of the Kingdom of Saudi Arabia. They report here the results of the study of lead and chromium concentrations in the potable water of the same area to provide a more complete profile of the levels of heavy metals in the potable water of the Eastern Province.

World Health Organization Publications

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Ethnography and policy: Perspectives on reproduction in anthropology and public health

MacCormack, Carol, ed. Ethnography of Fertility and Birth. New York: Academic Press, 1982. x + 293 pp. including illustrations, notes, references, index. $35.00 cloth. Mangay‐Maglacas, A., and H. Pizurki, eds. The Traditional Birth Attendant in Seven Countries: Case Studies in Utilization and Training. Geneva: World Health Organization Public Health Papers 75, 1981. 211 pp. including appendices, references. Sw. fr. 15.00.

Prevention in Childhood of Health Problems in Adult Life

The title of this World Health Organization (WHO) publication touches on an extremely important part of modern pediatrics. The volume is a collection of nine essays by different authors with an introduction by the editor. For the purposes of this volume, childhood begins at conception, as two of the chapters deal exclusively with fetal problems. Clinical implications (such as increased use of amniocentesis) that stem from those chapters apply even more to obstetricians than to pediatricians; as might be expected, an obstetrician is the coauthor of each of them. As is usually the situation with a multiauthored book, some parts are better organized and more useful than others. The chapters on perinatal disease, obesity, infectious diseases of childhood, and mental health provide particularly good reviews and sufficient background to give the thoughtful reader ideas for planning the next steps. I found the two chapters on malnutrition less imaginative and lacking

Essential Malariology

This book covers all of the basic principles of malaria as a disease and its control in endemic areas. It contains chapters on the history, parasites, clinical course, pathology and immunology, diagnosis, the<i>Anopheles</i>vector, epidemiology, chemotherapy, bases for control, and eradication. Each one of these chapters is written in an authoritative, lucid, concise manner, which only a writer with the experience of Dr Bruce-Chwatt can do. In addition, there is a list of 381 selected references, including most of the World Health Organization publications on malaria, and several appendices with tabulated data on drugs, insecticides, and malaria risk by country. The wealth of information presented in this medium-sized book is very well treated and organized. The eager student of parasitology, public health, or epidemiology, as well as the specialist in infectious or tropical diseases will find it a source of up-to-date information on malaria. However, the main emphasis of

Book Reviews

Book reviewed in this article:Risk Approach to Maternal and Child Health Care: World Health Organization Publication No. 39

World Health Organization Publications

Journal Article World Health Organization Publications Get access International Journal of Epidemiology, Volume 7, Issue 1, March 1978, Page 87, https://doi.org/10.1093/ije/7.1.87 Published: 01 March 1978

Book Reviews

British Journal of DermatologyVolume 97, Issue 3 p. 342-344 Book Reviews First published: September 1977 https://doi.org/10.1111/j.1365-2133.1977.tb15195.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Dermatologic Radiotherapy. OTTO BBAUN-FALCO, STEFEN LUKACS & HERBEBT GOLDSCHMIDT (1977) Burckhardt's Atlas and Manual of Dermatology and Venereology: Third American Edition. Edited by P.J.LYNCH & S.EPSTEIN (1977) Social and Health Aspects of Sexually Transmitted Diseases. Principle of Control Measures. WORLD HEALTH ORGANIZATION (Public Health papers (65)). British Medical Bulletin. Volume 33, No, 2, May 1977, Somatic and Visceral Sensory Mechanisms Principal Drugs. S.J.HOPKINS (1977) Volume97, Issue3September 1977Pages 342-344 RelatedInformation

World Health Organization Publications

World Health Organization Publications

World Health Organization Publications

World Health Organization Publications