International Issues
Leading global institutions come together to address rising death toll on the world's roads
For the first time, representatives from more than 20 of the world's leading road safety organizations representing rich and poor countries, gathered at the World Health Organization (WHO) in Geneva to embark on a global road safety initiative. More than 1·2 million people are killed on the road annually. Millions more are injured or disabled. In some low and middle‐income countries, road crash victims occupy up to 10% of hospital beds. Deaths from all types of injuries are projected to rise from 5·1 million in 1990 to 8·4 million in 2020 – with road traffic injuries as a major cause for this increase.
UN Secretary‐General Kofi Annan noted in his recently released report ‘Global Road Safety Crisis’, that ‘Improving road safety requires strong political will on the part of Governments’, adding that countries should also ‘aim to ensure that sufficient resources are available, commensurate with the size of the road safety problem in their country.’ Globally, estimates suggest that the economic costs of road traffic injuries amount to US$518 billion per year. In developing countries, the costs are estimated to be US$100 billion, twice the annual amount of development assistance to developing countries. To mitigate this global public health and development crisis, Mr Annan recommends that countries develop and implement national strategies on road traffic injury prevention and appropriate action plans.
‘When you lose a child, you die. The mourning never stops. The pain is constant’, says Rochelle Sobel mother of a victim, and founder and president of ASIRT (Association for Safe International Road Travel), a United States based non‐governmental organization. Rochelle Sobel, a participant at the meeting, stresses that ‘while the emotional toll of loss is horrendous and cannot be quantified, the economic toll on families and governments can be calculated and it is devastating.’ Studies suggest that in 2002, some 50% of road traffic fatalities world‐wide involved young adults aged 15–44 years, many of whom were primary breadwinners for their families.
The representatives are preparing a global initiative dedicated to Road Safety, to be launched on World Health Day (7 April 2004). The initiative will include a global report, conferences and discussions in political fora such as the United Nations General Assembly, and other high profile advocacy events. As part of this effort, the alliance will drive a call for action to implement policies and programmes addressing speed reduction; alcohol consumption; re‐enforcing the utilization of seat belts, helmets and child restraints; improving emergency response systems; promoting safe vehicle design; and introducing the implementation of road safety standards.
For more information on WHO's work on World Health Day 2004: Road Safety visit http://www.who.int/world-health-day/2004/en/ or contact Sabine van Tuyll, Communications Officer, Injuries and Violence Prevention, WHO, Geneva; tel.: +41 22 7913342, E‐mail: vantuylls@who.int
Inadequate plumbing systems likely contributed to SARS transmission
Inadequate plumbing is likely to have been a contributor to the spread of SARS in residential buildings in Hong Kong Special Administrative Region of China, a WHO Technical Consultation concluded recently. It also contributes to the spread of a number of other infectious diseases in several other countries. In the absence of proper maintenance and without consistent monitoring, reviewing, enforcing and updating of building standards and practices, inadequate plumbing and sewage systems could continue to enhance the potential of SARS and some other diseases to spread. The meeting concluded that it would be relatively easy to interrupt and avoid some diseases, including SARS if it were to return.
The Consultation developed a checklist of environmental hygiene factors in building design and maintenance that, if followed, could contribute to controlling environmental transmission of SARS Coronavirus (CoV) and other viruses. Viruses that can be transmitted by the ‘faecal droplet’ route also include gastroenteritis virus (such as Norwalk‐like viruses), some adenoviruses and enteroviruses responsible for a number of gastrointestinal and neurological diseases.
‘With this Consultation, WHO is helping its Member States appreciate the need to assess and manage the health risks associated with inadequate plumbing and sewage systems. It has documented lessons learned, it has pointed to risk assessment and management tools to be better prepared in case of future outbreaks and it has listed concrete measures and regulatory frameworks for the prevention of faecal droplet transmission of disease‐causing viruses. This information will be brought together in a guidelines document’, commented Dr Jamie Bartram, Head of WHO's Water, Sanitation and Health Programme at its Geneva headquarters.
It has been suggested that the ‘faecal droplet’ route may have been one of several modes of transmission in Hong Kong during the SARS outbreak in early 2003. In this case, droplets originating from virus‐rich excreta in a given building's drainage system re‐entered into resident's apartments via sewage and drainage systems where there were strong upward air flows, inadequate ‘traps’ and non‐functional water seals.
Meeting in Rome, an international group of WHO experts reviewed the transmission risks related to the current state of plumbing systems around the world and how inadequate construction and maintenance practices could contribute to the spread of SARS. ‘In many countries there will be buildings where keeping sewage separate from building occupants is a critical challenge’, observed Dr Bartram. ‘This could result in harmful viruses, including the SARS CoV, being sucked from the sewage system into the home if, for example, there are strong extractor fans working in a family's bathroom. Fortunately, solutions are simple and already in place in most areas world‐wide, but there remain places where short‐cuts in design, construction and maintenance continue to compromise safety. While the evidence suggests that, under most circumstances, the spread of SARS among people occurred overwhelmingly across a short range of distance through water droplets, there are specific situations where conditions allowed other transmission routes. One of these is through sewage‐associated faecal droplets and this Consultation has therefore recommended measures to reduce sewage‐borne transmission routes of pathogenic viruses.'
The Consultation emphasized that the solution – proper plumbing – is a simple public health measure which is often overlooked but can be addressed at minimal extra cost. Nevertheless, it is a significant tool in stopping faecal droplet transmission of disease.
The Consultation resolved that Governments establish or strengthen intersectoral arrangements and mechanisms to enhance joint efforts of ministries of health, building authorities, local governments and architects/designers to both raise general awareness of the risks from inadequate plumbing and sewage systems, and to take concrete actions to address shortcomings in this area.
For further information contact: Gregory Hartl, Communications Adviser, Sustainable Development and Healthy Environments, WHO, tel.: +41 22 7914458, E‐mail: hartlg@who.int or visit http://www.who.int/.
Research and development News
ANA launches ‘Handle With Care’ campaign
The American Nurses Association (ANA) has launched ‘Handle with Care’, a new initiative aimed at preventing potentially career‐ending back, neck and musculoskeletal injuries in nurses. This new campaign is designed to support the individual nurse in his or her workplace. The campaign seeks to mount a profession‐wide effort to prevent back and other musculoskeletal injuries through greater education and training, and increased use of assistive equipment and patient‐handling devices. The campaign also seeks to reshape nursing education, and federal and state ergonomics policy by highlighting the ways technology‐orientated safe‐patient handling benefits patients and the nursing workforce.
ANA believes the Handle with Care campaign can dramatically improve the health and safety of nurses, increase the safety of patient care and substantially reduce health care costs.
For more information visit http://www.nursingworld.org/handlewithcare/
Aspirin hailed as potential anti‐cancer drug
The humble aspirin, already under trial as a preventative agent for cancer, could also help treat certain types of the disease, researchers report in the journal Nature. Scientists from Cancer Research UK suggest that the drug's anti‐inflammatory effects could combat a family of cancers fuelled by local inflammation.
Working with Greek colleagues, they have found that a rare inherited cancer called turban tumour syndrome is caused when the inflammatory response becomes rampantly over‐active. Turban tumour syndrome is a rare form of inherited skin cancer, known medically as cylindromatosis, in which huge, mushroom shaped tumours grow out of the scalp and other hairy parts of the body. While the tumours are benign, they can cause horrendous disfigurement and discomfort and may eventually turn into life‐threatening malignant cancers.
The authors plan to trial aspirin as a treatment for the syndrome, and believe it could also be effective against other forms of the disease that may be triggered by inflammation, including some types of breast cancer.
Source: Nature 424(6950), 793–796.
Long‐term effects of activity status in the elderly on cardiorespiratory capacity, blood pressure, blood lipids and body composition: a 5‐year follow‐up study
It is generally recognized that physical activity levels in the elderly do not remain constant over time, and typically there is a marked reduction in physical activities in the elderly. The long‐term benefits of regular physical training programmes in the elderly are still not fully understood. A study of 55 elderly healthy subjects (over 65 years old) re‐evaluated for the effects of different physical activity patterns (sedentary, moderately active and highly active) has been conducted using several physiological parameters (pre‐ and post‐training) after a 5‐year period (5·30 ± 1·14 years). Measurements included: body composition, blood lipid profiles, resting systolic and diastolic blood pressure, maximal oxygen uptake, and pulmonary function.
Results indicated a larger decrease in maximal oxygen uptake (VO2max) in the group of elderly sedentary individuals (1·5 ± 0·5 L/min) compared to the moderately active (1·7 ± 0·6 L/min) and the highly active groups (1·9 ± 0·4 L/min). An active lifestyle was not sufficient to increase the physiological function of an individual.
The study could not clearly demonstrate favourable differences for the physically active groups over the sedentary group with regard to several important physiological factors over the 5‐year follow‐up and it appears that the recommendation for, and the initiation of adopting active lifestyles, may not be sufficient on their own to significantly increase an individual's physiological functioning.
Reference
- Carmeil E., Orbach P., Lowenthal D.T., Merrick J. & Coleman R. 2003. Scientific World Journal 3(8), 751–67 Source: http://www.thescientificworld.com [DOI] [PMC free article] [PubMed] [Google Scholar]
New research examines needs of people affected by organ retention
Researchers at the University of Southampton, UK, are examining the needs of family members affected by postmortem organ retention, for a new study commissioned by the Department of Health. The researchers will also be looking at the experiences of NHS staff affected by, or involved in, postmortem organ retention.
Working in collaboration with the Retained Organs Commission, the researchers will explore cases where hearts and other organs were routinely removed during postmortems and stored without explicit consent of the next‐of‐kin, and examine the effect on the families concerned and the health professionals, who supported them.
The research, which is being led by Dr Magi Sque of the University's School of Nursing and Midwifery, aims to identify and prioritize the support needs of families and health professionals affected by organ retention and to identify examples of ‘best practice’ that are responsive to their needs.
‘The lack of consent for the retention of organs, of both children and adults following postmortems by many NHS Trusts, came to public attention during an investigation into the care of children receiving complex cardiac surgery at the Bristol Royal Infirmary’, explains Dr Sque. ‘This practice caused grief and distress for many families. Some have been critical of the way the NHS responded to their need for support in dealing with organ retention and many NHS staff were unprepared for their role and the effects of assisting families.’
‘This new study will describe and explore the kinds of interventions, their effects and the needs of family support groups and services offered by the NHS. The findings are expected to inform planning and policy developments to improve the care of families who consent to postmortem organ retention in the future. It will also provide the basis for a comprehensive support programme linking both the professional and voluntary sector, to help families make decisions that are right for themselves with regard to postmortem examinations and the retention of organs. Additionally, it may help to predict bereavement outcomes so that assistance for families can be targeted more effectively’, adds Dr Sque.
The study is largely qualitative and based on analysis of documents, interviews and focus groups. For further information: Dr Magi Sque, Principal Investigator, School of Nursing and Midwifery, University of Southampton, tel.: +44 (0)23 8059 7970, E‐mail: m.r.sque@soton.ac.uk, or visit http://www.organretention.nursing.soton.ac.uk or visit http://aids2004.org
Forthcoming Events
15th International AIDS Conference, Thailand
This conference will be held 11–16 July 2004 in Bangkok Thailand. For further information, please contact IAS Headquarters, PO Box 4249, Folkungagatan 49, SE‐102 65 Stockholm, Sweden, tel.: +46 8 55 697050, fax: +46 8 55 697059, E‐mail: aids2004@aids2004.org
Practice, Culture and Care, UK
This is the 6th National Conference of the Transcultural Nursing and Healthcare Association, in conjunction with the Foundation of Nursing Studies, and will be held on 29 March 2004 in Glagow, UK. For further information contact Julie Patrige, Conference Organizer, FoNS, 32 Buckingham Palace Road, London SW1W 0RE, UK, tel.: +44 (0)20 7233 5750, E‐mail: admin@fons.org or visit: http://www.fons.org/networks/tcnha
Fitness for Practice: Contributions of Lecturer Practitioners Past, Present and Future, UK
This is the 6th National Conference of the National Lecturer Practitioner Forum, in conjunction with the Foundation of Nursing Studies, and will be held on 12 May 2004 in Bournemouth, UK. For further information contact Julie Patrige, Conference Organizer, FoNS, 32 Buckingham Palace Road, London SW1W ORE, UK, tel.: +44 (0)20 7233 5750, E‐mail: admin@fons.org or visit: http://www.fons.org/networks/nlpf
10th Annual BACP Counseling and Psychotherapy Research Conference, UK
This Conference will be held 21–22 May 2004 in London, UK. For further information please contact Angela Couchman, E‐mail: angela.couchman@bacp.co.uk, or visit http://www.bacp.co.uk/research/general_2004.html