12 research outputs found

    Mechanisms of control over compliance with international law for the protection of the Mediterranean Sea against pollution.

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    This study is concerned with the legal mechanisms and institutional arrangements established to control compliance with commitments undertaken in treaty form by Mediterranean States, with a view at protecting the marine environment from various sources of pollution. Part I begins with a brief presentation of the state of the Mediterranean environment, both natural and socio-economic. There follows a consideration and assessment of the nature and extent of, and the relationship between, environmental obligations arising under the relevant instruments adopted at the global, regional and sub-regional level, in order to identify the implications thereof for the design and application of the said mechanisms and arrangements. In Part II, the treatment of the core issue begins with an initial review of the evolution of compliance-control mechanisms under general international, and especially environmental, law, followed by a critical examination of the legal arrangements - actually or potentially - used in the Mediterranean to ensure compliance with the said body of law. In this context, a distinction is made between the traditional models, namely the state responsibility and civil liability approach to compliance control and the comprehensive institutional model, and the emerging approaches, namely provision of financial and technical assistance as compliance incentives, and compliance control and enforcement under national law. Finally, this thesis argues that the most constructive way to encourage observance of international marine pollution standards in the region in the long term is through the intervention of international law towards developing appropriate procedural means for follow up and enforcement within domestic legal systems, while, in the short term, efforts should concentrate at establishing - or refining - comprehensive institutional mechanisms that would necessarily accommodate arrangements for financial and technical assistance dependent on effective compliance

    Evaluation of the immunogenicity of a recombinant vaccine against hepatitis B containing S and pre-S2 sequences using two different schedules

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    The immunogenicities of hepatitis B virus vaccines containing S and pre-S2 regions were compared using two different schedules of immunization (A: 0-1-2-12 months and B: 0-1-6 months). Two hundred males and females aged 17-22 years were vaccinated with 20 μg per dose. The follow-up period was extended up to 13 months. One month after the booster dose anti-HBs were detected in 98.9% of those vaccinated with schedule A and 100% of those vaccinated with schedule B. Geometric mean titres (GMT) of anti-HBs were significantly higher with schedule A than schedule B, reaching GMT of 16269.7 mIU ml-1 and 4372.4 mIU ml-1, respectively, one month after the booster dose. Seroconversion rates for the anti-pre-S2 antibodies one month after the booster dose were 89.4% for schedule A and 76.6% for schedule B. GMT were 157.8 mIU ml-1 and 67.5 mIU ml-1, respectively. We conclude that both vaccines elicit high titres of anti-HBs and anti-pre-S2 antibodies. Immunity lasts longer in schedule A than in schedule B. © 1993

    INTRAFAMILIAL CLUSTERING OF HEPATITIS-A

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    The intrafamilial clustering of hepatitis A virus infections (HAV) in families with an index case of sporadic hepatitis A was studied. Four hundred and three family members (84.3%) of 113 children with acute hepatitis A admitted to the Paediatric Department of the West Attica Hospital were included in the study. Epidemiological data and serum samples were collected within 1 week after the patient’s admittance to the hospital. Enzyme-immunoassays were used to detect recent or past HAV infections. The attack rate of HAV infections in susceptible family members was found to be similar in susceptible fathers (16.6%, 1/6), mothers (23.5%, 4/17) and siblings (18.1%, 37/204). The infected family members belonged to 22 families. The attack rate was found to be higher in families with a lower immunity level, while the social class was not found to play an important role. The administration of ISG prevented further spread of hepatitis A among those susceptible. Our data suggest that immunoglobulin for HAV prevention should be given not only to children but also to parents and other adult family members in areas with a low prevalence of anti-HAV among adults

    Reliability and Validity of the Greek Version of Patient Generated-Subjective Global Assessment in Cancer Patients

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    The authors sought to determine the reliability and validity of psychometric properties of the Greek Patient-Generated Subjective Global Assessment (PG-SGA) in cancer patients attending a palliative care unit. The scale was translated into Greek. The study took place in an outpatient palliative care unit and 238 cancer patients completed the nutrition assessment. For treatment effect, the index was administered to 164 patients, whereas for the test of the instrument's robustness to 100 patients. Both assessments took place 15 days after the baseline assessment. Ninety-three patients were well-nourished, 104 were moderately malnourished, and 41 were severely malnourished. Reliability was assessed by the internal consistency and test-retest of the instrument. Validity was assessed with construct validity using the PG-SGA items, treatment effect, and criterion validity. Weight loss, physical examination, activities and function, and symptoms were predictors to the classification. Mean values in male patients classified as severely malnourished had the lowest values in all objective parameters except serum albumin, whereas severely malnourished female patients had the lowest values in all objective parameters except serum albumin and arm muscle circumference (AMC). Values of serum transferrin, AMC, and body mass index were significantly lower in patients classified as severely malnourished. The Greek PG-SGA is a psychometrically sound assessment in Greek cancer patients. © 2015, Taylor & Francis Group, LLC

    KNOWLEDGE, ATTITUDES AND PRACTICES OF GREEK HEALTH-PROFESSIONALS, IN RELATION TO AIDS

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    In order to improve educational programmes directed at health care workers we investigated their knowledge, attitudes and practices in relation to HIV/AIDS. An anonymous self-administered questionnaires was distributed to 609 health care workers. Of these, 59.6% agreed to participate (42.4% of the medical doctors, 74.3% of the nurses and 79.6% of the laboratory technicians, health visitors and other health care workers). All studied groups believed that their knowledge of HIV modes of transmission (84.3%) was sufficient. In contrast, a relatively small percentage reported knowledge of the clinical spectrum of HIV infection (48.8%) and the diagnostic assays (57.6%). Nearly all the study participants believe (92.8%) that there is a risk of acquiring HIV infection during the hospitalization of HIV/AIDS patients. Obligatory screening of all patients was reported by nearly all participants (90.6%) as a chance to minimize their occupational risk. Although health care workers reported satisfactory knowledge of safety measures (87.0%), only 56.7% used gloves and 38.8% accept the hospitalization of HIV/AIDS patients. In spite of the educational programmes for AIDS in Greece, this study demonstrates that health professionals’ knowledge and precautionary measures are not sufficient. As a result, a small percentage of them treat AIDS patients without discrimination. There is an urgent need to implement specific educational programmes for health professionals so that they will safely provide high quality care to people affected by HIV/AIDS

    Immunological and molecular detection of human immunodeficiency virus in saliva, and comparison with blood testing

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    In order to test the detection feasibility of human immunodeficiency virus (HIV) in saliva, a three-method blind screening analysis was conducted. Sixty-eight individuals were studied, comprising 34 HIV carriers and 34 noncarriers (controls) of matched gender and age. An oral examination preceded saliva and blood sampling of studied individuals. All samples were tested blind for HIV by using two immunological methods [Oraquick-compatible enzyme-linked immunosorbent assay (ELISA) and a fluorescent immunoenzymatic method (ELFA)], confirmed by western blotting, and a simple molecular method (polymerase chain reaction amplification of a relatively constant viral DNA region), confirmed by DNA hydridization. Compared with the controls, about twice as many HIV carriers had oral health problems, including periodontal disease. ELFA resulted in 33/34 positives and 34/34 negatives in saliva, while it detected 34/34 positives and 34/34 negatives in blood. ELISA performed even better, with correct assignment of all positives and negatives in both saliva and blood. The PCR method, at three annealing temperatures, surprisingly detected all positive samples, while it gave no false-positive result. In conclusion, the detection of anti-HIV in saliva may achieve accuracy of 97.1-100%, comparable with that in blood. Furthermore, this study suggests that a highly accurate molecular method of HIV detection may be feasible, although the studied carriers had rather homogeneous characteristics. © 2006 The Authors
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