Riviste scientifiche

[Essay] Russian medicine: trying to catch up on scientific evidence and human values

The Lancet - Sa, 30/09/2017 - 00:00
At the beginning of the 20th century, medicine as an academic discipline and a vocational training was quite similar in Russia and in western Europe. Most professors in Russian medical faculties had some international training. Pirogov, Sechenov, Mechnikoff, and Pavlov, just to name a few, were not only exceptional scientists but typical with their international training and research experience. Yet medicine as a service to the public was underdeveloped. The access to a nurse or doctor was very limited, as described depressingly clearly in Anton Checkhov's short stories.

[Essay] Civil society and drugs in Russia: moving towards the conservative agenda

The Lancet - Sa, 30/09/2017 - 00:00
The fall of the Soviet Union in the early 1990s brought about important shifts in Russian economic, social, and political life. Along with economic turmoil emerged a wave of drug abuse.1 Political changes and democratic reforms also led to the growth of civil society, and between the late 1990s and mid-2000s, civil society organisations became a strong force in shaping the response to drug-related problems. These groups are very diverse; some are vigilantes in their approach to cleaning their cities of drugs, whereas others are community-based and organised by people who themselves use drugs and have liberal agendas for drug policy reform.

Chronic disease concordance within Indian households: A cross-sectional study

PLoS Medicine - Ve, 29/09/2017 - 23:00

by Shivani A. Patel, Preet K. Dhillon, Dimple Kondal, Panniyammakal Jeemon, Kashvi Kahol, Sathya Prakash Manimunda, Anil J. Purty, Ajit Deshpande, P. C. Negi, Sulaiman Ladhani, Gurudayal Singh Toteja, Vikram Patel, Dorairaj Prabhakaran

Background

The household is a potentially important but understudied unit of analysis and intervention in chronic disease research. We sought to estimate the association between living with someone with a chronic condition and one’s own chronic condition status.

Methods and findings

We conducted a cross-sectional analysis of population-based household- and individual-level data collected in 4 socioculturally and geographically diverse settings across rural and urban India in 2013 and 2014. Of 10,703 adults ages 18 years and older with coresiding household members surveyed, data from 7,522 adults (mean age 39 years) in 2,574 households with complete covariate information were analyzed. The main outcome measures were diabetes (fasting plasma glucose ≥ 126 mg/dL or taking medication), common mental disorder (General Health Questionnaire score ≥ 12), hypertension (blood pressure ≥ 140/90 mmHg or taking medication), obesity (body mass index ≥ 30 kg/m2), and high cholesterol (total blood cholesterol ≥ 240 mg/dL or taking medication). Logistic regression with generalized estimating equations was used to model associations with adjustment for a participant’s age, sex, education, marital status, religion, and study site. Inverse probability weighting was applied to account for missing data. We found that 44% of adults had 1 or more of the chronic conditions examined. Irrespective of familial relationship, adults who resided with another adult with any chronic condition had 29% higher adjusted relative odds of having 1 or more chronic conditions themselves (adjusted odds ratio [aOR] = 1.29; 95% confidence interval [95% CI] 1.10–1.50). We also observed positive statistically significant associations of diabetes, common mental disorder, and hypertension with any chronic condition (aORs ranging from 1.19 to 1.61) in the analysis of all coresiding household members. Associations, however, were stronger for concordance of certain chronic conditions among coresiding household members. Specifically, we observed positive statistically significant associations between living with another adult with diabetes (aOR = 1.60; 95% CI 1.23–2.07), common mental disorder (aOR = 2.69; 95% CI 2.12–3.42), or obesity (aOR = 1.82; 95% CI 1.33–2.50) and having the same condition. Among separate analyses of dyads of parents and their adult children and dyads of spouses, the concordance between the chronic disease status was striking. The associations between common mental disorder, hypertension, obesity, and high cholesterol in parents and those same conditions in their adult children were aOR = 2.20 (95% CI 1.28–3.77), 1.58 (95% CI 1.15–2.16), 4.99 (95% CI 2.71–9.20), and 2.57 (95% CI 1.15–5.73), respectively. The associations between diabetes and common mental disorder in husbands and those same conditions in their wives were aORs = 2.28 (95% CI 1.52–3.42) and 3.01 (95% CI 2.01–4.52), respectively. Relative odds were raised even across different chronic condition phenotypes; specifically, we observed positive statistically significant associations between hypertension and obesity in the total sample of all coresiding adults (aOR = 1.24; 95% CI 1.02–1.52), high cholesterol and diabetes in the adult-parent sample (aOR = 2.02; 95% CI 1.08–3.78), and hypertension and diabetes in the spousal sample (aOR = 1.51; 95% CI 1.05–2.17). Of all associations examined, only the relationship between hypertension and diabetes in the adult-parent dyads was statistically significantly negative (aOR = 0.62; 95% CI 0.40–0.94). Relatively small samples in the dyadic analysis and site-specific analysis call for caution in interpreting qualitative differences between associations among different dyad types and geographical locations. Because of the cross-sectional nature of the analysis, the findings do not provide information on the etiology of incident chronic conditions among household members.

Conclusions

We observed strong concordance of chronic conditions within coresiding adults across diverse settings in India. These data provide early evidence that a household-based approach to chronic disease research may advance public health strategies to prevent and control chronic conditions.

Trial registration

Clinical Trials Registry India CTRI/2013/10/004049; http://ctri.nic.in/Clinicaltrials/login.php

Banning shark fin soup in the US is bad for shark conservation

New Scientist - Ve, 29/09/2017 - 19:00
A proposed US ban on the sale of shark fins could backfire and make life worse for some of the planet's most imperilled species, says Lesley Evans Ogden

Latest gravitational wave isn’t from neutron stars after all

New Scientist - Ve, 29/09/2017 - 17:00
Recent speculation about the latest gravitational wave experiments suggested they may have seen a neutron star merger, but it’s another black hole smashup

Why Puerto Rico still has no electrical power and how to fix it

New Scientist - Ve, 29/09/2017 - 16:50
Hurricane Maria is long gone but almost all of Puerto Rico has been left without a power supply, and restarting the national grid from scratch will be very difficult

Energy from evaporating water could rival wind and solar

New Scientist - Ve, 29/09/2017 - 15:00
Water evaporating from lakes and reservoirs could provide a huge amount of electricity, but scaling up the technology will be tricky

Genetically modified wheat used to make coeliac-friendly bread

New Scientist - Ve, 29/09/2017 - 14:00
Some glutens are harmful to coeliacs, but others have no effect. A genetically modified wheat lacks only the harmful ones, and can be used to make safer bread

Common antidepressant found to reduce belly fat in older mice

New Scientist - Ve, 29/09/2017 - 10:00
Belly fat becomes much harder to lose when you get older. Inflamed immune cells may be to blame, and an antidepressant seems to help in mice

Elon Musk’s new plans for a moon base and a Mars mission by 2022

New Scientist - Ve, 29/09/2017 - 09:15
SpaceX aims to launch spaceships to Mars within five years with a new rocket design that could also be used on Earth to make rapid around-the-globe trips

Hundreds of Japanese species floated to the US on tsunami debris

New Scientist - Gi, 28/09/2017 - 21:00
The 2011 Tohoku tsunami swept vast amounts of debris out into the Pacific, carrying over 280 species across to America

Extreme gusts of space gas made early black holes enormous

New Scientist - Gi, 28/09/2017 - 21:00
Some of the earliest black holes in the universe are bigger than our current theories can explain, but gas left over from the big bang could be the solution

Plan to slash farm antibiotic use may stop spread of resistance

New Scientist - Gi, 28/09/2017 - 21:00
Bacterial resistance to antibiotics is rising, but a plan to change farming practices and eat less meat could cut use of the drugs and keep them working for us

Ancient ‘sea woodlice’ had surprisingly complicated guts

New Scientist - Gi, 28/09/2017 - 19:55
Fossil trilobites dating back to the dawn of animal evolution had unexpectedly complex and varied digestive systems, hinting that they ate varied and hard-to-digest food

Kidney donors swap organs for transplant vouchers for loved ones

New Scientist - Gi, 28/09/2017 - 18:00
The world’s first voucher system for people who donate kidneys has boosted donations by giving US donors transplant coupons they can give to loved ones in need

Workplace robots have had little impact on jobs in Germany

New Scientist - Gi, 28/09/2017 - 17:35
We’re often told that robots are after our jobs, but an analysis of 20 years of automation in Germany has found that robots can’t be blamed for job losses

Would ‘good gluten’ foods work for people who eat gluten-free?

New Scientist - Gi, 28/09/2017 - 16:54
Bread made from genetically modified wheat that lacks some glutens has been found safe for people with gluten sensitivity in a very small trial

Flying and rolling drone will map underground mines on its own

New Scientist - Gi, 28/09/2017 - 14:31
Underground spaces can be tricky and dangerous for humans to explore, but a new drone is up to the task

Uber’s major pile-up with London’s regulators is no big surprise

New Scientist - Gi, 28/09/2017 - 12:58
Obsessed with their technology's disruptive potential, fast-moving outfits like Uber have long been on a collision course with regulation, says Paul Marks

Lab-grown cells make doping agent EPO and cure anaemia in mice

New Scientist - Me, 27/09/2017 - 21:00
Lab-grown stem cells can make the hormone EPO, which has notoriously been used in sports doping. Transplants of the cells might help some major types of anaemia
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