A meta-analysis of studies covering over 1 million people finds that doing at least one hour of physical activity per day, such as brisk walking or cycling for pleasure, may eliminate the increased risk of death associated with sitting for 8h a day. The findings come in one of the papers in a special series published inThe Lanceton 27 July, ahead of the summer Olympic Games opening in Rio next Friday. Image: Pixabay.com
To look at the impact of activity and inactivity, researchers led by Professor Ulf Ekelund of the Norwegian School of Sports Sciences, Norway and the University of Cambridge, UK, went back to the authors of 13 existing papers and asked all of them to reanalyse their data. The 13 papers were taken from 16 studies selected after a systematic review of six databases, with the 13 final papers providing data on sitting time and all-cause mortality. Of just over 1 million people in these studies, 84,609 (8.4%) died during the follow-up periods of 2-18 years.
The results found that people who sat for eight hours a day, but were physically active, had a much lower risk of premature death compared with people who sat for fewer hours a day, but were not active. This suggests that physical activity is particularly important, no matter how many hours a day are spent sitting. In fact, the increased risk of death associated with sitting for 8 hours a day was eliminated for people who did a minimum of 1 hour physical activity per day. The greatest risk of death was for people who sat for long periods of time and were inactive.
Image: Woman in the West Indies with mycetoma caused by a fungal organism CDC/ Dr. Lucille K. Georg
From Harpur Schwartz, an economics/global health student from Connecticut College, USA, interning with Cabi’s Global Health team.
While tuning in to the live broadcast of the Sixty-ninth World Health Assembly taking place at the World Health Organization (WHO) headquarters in Geneva, Switzerland, mycetoma reached the discussion floor. At the risk of sounding naïve, I’m going to tell you that I had never heard of mycetoma - although a quick google search revealed images resembling elephantiasis. As a student studying global health, I was a little disappointed with myself; I mean I have at least heard of the other neglected tropical diseases (NTDs). But if mycetoma was unfamiliar to me, how many other people had never heard of this disease? I have provided answers to some basic questions I had about mycetoma in case you too are unfamiliar with this disease...
What is mycetoma?
The World health Organization describes mycetoma as, “… a chronic, progressively destructive morbid inflammatory disease usually of the foot but any part of the body can be affected”. This disease is caused by a bacterial (actinomycetoma) or fungal (eumycetoma) infection where the organism enters the body through a minor trauma or a penetrating injury (i.e. commonly a thorn prick). It is believed that the infection enters the body after this pricking occurs, but there are no concrete studies determining transmission. A good video on it can be found here in Global Health Now's Spotlight on Mycetoma by Amy Maxmen.
Is there a cure?
In terms of treatment, curing actinomycetoma using antibiotics has about a 90% success rate. The use of antifungals to treat eumycetoma has a success rate of about 35%, but in 2016 a new antifungal agent, fosravuconazole, will be the subject of the First Clinical Trial in Mycetoma conducted by Drugs for Neglected Diseases Institute (DNDi). Because the disease takes a slow, relatively pain-free progression, mycetoma is at its most advanced stages once it is diagnosed. It is at these later stages when amputation becomes necessary.
What do wellington boots drying in the African sun have to do with blood donation in the post-Ebola era? Tell you later.
But first, as its World Blood Donor Day on June 14th, lets consider the differences between the blood transfusion services in a high income country like the UK with those in Nigeria or Sierra Leone? How has the Ebola epidemic impacted on these services?
Blood transfusion services in the UK
I think we in the UK probably take our well-established national blood service(s) somewhat for granted and only really give it a second thought when either we need to call on its use or something drastic goes wrong.
Established in 1946, the Blood Transfusion Service (BTS) in England and Wales employs over 6000 people to collect & process the blood alone. All sorts of rules and practices surround the preparation and distribution and use of that blood. We are very fortunate that over 3% of people in the UK donate that blood (1% being the figure recommended as a minimum by the W.H.O. to meet a populations needs) but even then we get regular appeals for more blood and we still suffer shortages for particular blood groups and platelets.
But, have you ever asked yourself why we need continuing fresh donations of blood and who are the usual recipients of that blood?
In 2014, in England & Wales, the 3 major “consumers” of blood were:
67%, to treat medical conditions including anaemia, cancer and blood disorders
27%, in surgery, including cardiac surgery and emergency surgery
6%, to treat blood loss after childbirth
The most frequently transfused patient group is over 65 years of age.
100% of the blood donated is voluntary. This is important, as the W.H.O. has declared that the foundation of a safe blood supply is 100% voluntary donation. Blood obtained this way has lower rates of infections and so reduces chances of disease transmission via blood or blood products.
How does this compare with a blood transfusion service in West Africa ?
Our guest blogger this month is Harpur Schwartz, an economics/global health student from Connecticut College, USA. Harpur is interning with Cabi’s Global Health team, learning how information resources can support public health education programmes.
World Blood Donor Day 2016 [June 14th] is quickly approaching, and this year’s theme will be “Blood connects us all”. The goal is to motivate regular blood donors to continue to give blood while motivating new blood donors to start by showing how patients and donors are connected. With the current blood donation crisis, the worry is people do not understand that they qualify to donate. To clear up any blood donation confusion, many countries like the UK have provided specific guidelines [blood donation rules] for who can give blood. Donors have to wait only four months after getting a tattoo or piercing to give blood and a mother only must wait six months after giving birth. Gay and bisexual men [men who have sex with men] who used to face a lifetime ban in the UK, can donate blood if they have not had sex with another man for at least 12 months. This 12 month rule came into force in 2011 in the UK but has only recently done so in the USA (December 21st 2015, FDA revises donor deferral guidelines). It is the reason why many people in Orlando USA, anxious to donate blood to help their injured friends, are not able to do so (Gay Blood Donation Ban Under Fire in Wake of Orlando Shooting).
I have always been interested in how society is responsible for defining disease, and how once a person is labeled as having a certain disease, it frames their very being. In one of my university classes, we discussed how ‘Disease as framed’ is the way in which a person’s image changes as a result of disease. The example we discussed was AIDS and gay men. With the current blood donation policy, my question is if gay men are still being discriminated against because of their association with HIV and AIDS, or if the policy is based on sound evidence?
There has always been a stigma attached to the gay population in regards to HIV and AIDS, mainly because this was where the disease was first identified. [The story of the discovery of the AIDS epidemic is chronicled in the 1993 film “And the Band Played On”. Attitudes began to change in the USA when Mary Fisher delivered her speech, “A Whisper of AIDS”, at the Republican National Convention that took place in Houston in 1992. As a white female, and mother of two, Mary became a new face for HIV and AIDS. She was not a haemophiliac, she was not gay, she did not inject drugs, and yet she still tested HIV positive. Fisher explained to the world how “…HIV asks only one thing of those it attacks. Are you human?”
The gay and bisexual community are still unhappy with being treated differently. A 12 month ban does not take into account if they practiced safe sex, or have been in a committed relationship for 10 years with the same man. However, the 12 month ban policy is based on research evidence and is supported by numerous countries including the UK, the US, and Australia.
25 April is World Malaria Day – a time to reflect on the steps we can take to tackle this terrible disease. Much progress has been made in the fight against malaria over the past 15 years, like the use of bed nets impregnated with pesticides, but 3.2 billion people are still at risk. If we are to achieve a 90% reduction in global malaria incidence and mortality by 2030 we must do more.
The path will not be easy. Mosquitoes are becoming increasingly resistant to pesticides – the front line of defence from malaria today. But there are other aspects we can consider, like the potential link between the incidence of malaria and invasive, non-native weeds.
World Health Day this year focuses on diabetes prevention and treatment with emphasis on what lifestyle changes people can make to stop themselves getting diabetes. There is some intriguing evidence that although lifestyle factors are influential we should also be considering some other environmental factors that could be influencing the risk of disease. One of those factors is air pollution.
Traffic congestion is a public health issue. It increases air pollution which is a known cause of asthma, lung cancer and cardiovascular diseases, and in particular creates "hotspots" of low air quality borne by local residents. It increases the risk of traffic accidents through poor driver behaviour and judgement.
One morning last week, I was stuck in a traffic jam several miles long on the A40 outside Oxford, caused by the super-duper high-flow-thru roundabout at Headington being brought to a halt by roadworks eliminating one lane on one exit and a traffic light failing on another!
Those of you who commute to Oxford will pick up my ironic tone: we have had to endure doubling of commuting times & traffic jams for the past 2 years as Oxford has “improved” each roundabout by turn around the ring road!
Philosophical (I wasn’t going anywhere fast), I found myself wishing the clock turned back to a time when most people lived and worked in the same town, and then I moved on to wishing for a reality where “pass me the floo powder and where is the nearest fireplace?”[Harry Potter], or “beam me up scotty!” [Star Trek] were actual options. These options would improve my quality of life, my health, and my climate. And of course everyone else’s.
It was also not lost on me, in that traffic jam, that this month [March 2016] my colleague and I had made Air Pollution the theme for our free electronic public health newsletter (to receive this, sign up here Global Health Knowledge Base).
I had just written a blog on air pollution caused by traffic jams in India, China, and why it’s the particulates, released by soot & fuel, that we measure for air quality & health. In the blog, Air pollution, can we reduce the impact of cars on urban air quality? , I had hoped that emerging economies were going to learn from the mistakes of the UK and other “developed” countries. And there I was in the mistake.
In January 2016, Delhi, India, improved air quality on its streets when it conducted a 2-week air pollution reduction experiment, with private cars allowed on the streets only on alternate days, depending on license plate numbers. The idea is not new and has been tried elsewhere (Paris and Rome) but I guess its novelty (“who’d have thought” brigade) to the USA explained why it made The New York Times!
Last year, it was all headlines about Bejing [China] and the air quality citizens had to deal with. However it would seem that actually Beijing’s levels of PM10 (particulate matter up to 10 micrometres in size), a measure of air quality, decreased by 40% from 2000 to 2013, whereas Delhi's PM10 levels have increased 47% from 2000 to 2011.
Delhi's PM10 levels are nearly twice as much as in Beijing, and it has the worst PM 2.5 levels of 1600 cities in the world. Thus the need for the license plate experiment. In a BBC article, you can read more about the reasons “Why Delhi is losing its clean air war” and discover the varied & innovative measures China has taken to ameliorate motor car use.
No doubt spurred on by Delhi’s experiment, a health journalist in Bangladesh alerted the HIFA forum to the equally bad situation in India’s neighbour, Bangladesh.
Today, on International Women’s Day, we celebrate the social, economic, cultural and political achievements of women, while calling action for gender parity. The United Nations campaigns for “Planet 50-50 by 2030” referring to the sustainable development goals (SDGs) that are to be achieved in the next 15 years. The goals urge us to, for example, achieve gender equality and empower all women and girls (SDG 5), and to eliminate gender disparities in education (SDG 4). Below, I focus on these goals in more detail and discuss why they are so important for sustainable development, but let’s first look at how gender equality is measured and distributed in the world today.