Supportive Environments for Health

The environment influences our health in many ways through exposures to physical, chemical and biological risk factors, and through related changes in our behavior in response to those factors. Globally, nearly one quarter of all deaths and of the total disease burden can be attributed to the environment. These findings have important policy implications, because the environmental risk factors can be modified by established, cost-effective interventions. The process of building an intersectoral approach, which recognizes all facets of a community, helps in both making and implementing a LEHAP. Coordinated actions can promote development strategies with multiple social and economic co-benefits, in addition to global health gains, both immediate and long term. Repositioning the health sector to act more effectively on preventive health policies, while enhancing intersectoral partnerships, is thus critical to addressing the environmental causes of disease and injury, and achieving better health for all. Our case study presents an example of intersectoral approach that resulted in a successful implementation of measures at different levels in local community to reduce air pollution in the urban area of Celje

Mathematical Nanotoxicoproteomics: Quantitative Characterization of Effects of Multi-walled Carbon Nanotubes (MWCNT) and TiO2 Nanobelts (TiO2-NB) on Protein Expression Patterns in Human Intestinal Cells

Background: Various applications of nanosubstances in industrial and consumer goods sectors are growing rapidly because of their useful chemical and physical properties. Objectives: Assessment of hazard posed by exposure to nanosubstances is essential for the protection of human and ecological health. Methods: We analyzed the proteomics patterns of Caco-2/HT29-MTX cells in co-culture exposed for three and twenty four hours to two kinds of nanoparticles: multi-walled carbon nanotubes (MWCNT) and TiO2 nanobelts (TiO2-NB). For each nanosubstance cells were exposed to two concentrations of the material before carrying out proteomics analyses: 10 μg and 100 μg. In each case over 3000 proteins were identified. A mathematically based similarity index, which measures the changes in abundances of cellular proteins that are highly affected by exposure to the nanosubstances, was used to characterize toxic effects of the nanomaterials. Results: We identified 8 and 25 proteins, which are most highly affected by MWCNT and TiO2-NB, respectively. These proteins may be responsible for specific response of cells to the nanoparticles. Further 14 reported proteins are affected by either of the two nanoparticles and they are probably related to nonspecific toxic response of the cells. Conclusion: The similarity methods proposed in this paper may be useful in the management and visualization of the large amount of data generated by proteomics technologies

Strengthening the primary health care response to COVID-19: an operational tool for policymakers

Aims: The aim of this paper is to introduce an operational checklist to serve as a tool for policymakers in the WHO European Region to strengthen primary health care (PHC) services and address the COVID-19 pandemic more effectively and to present the results from piloting the tool in Armenia. Backgrounds: PHC has the potential to play a fundamental role in countries’ responses to COVID-19. However, this potential remains unrealized in many countries. To assist countries, the WHO Regional Office for Europe developed a guidance document – Strengthening the Health Systems Response to COVID-19: Adapting Primary Health Care Services to more Effectively Address COVID-19 – that identifies strategic actions countries can take to strengthen their PHC response to the pandemic. Based on this guidance document, an operational checklist was developed to serve as a tool for policymakers to operationalize the recommended actions. Methods: The operational checklist was developed by transforming key points in the guidance document into questions in order to identify potentially modifiable factors to strengthen PHC in response to COVID-19. The operational checklist was then piloted in Armenia in June 2020 as part of a WHO mission to provide technical advice on strengthening Armenia’s PHC response to COVID-19. Two WHO experts performed semi-structured, face-to-face interviews with nine key informants (both facility managers and clinical staff) in three PHC facilities (two in a rural and one in an urban area). The data collected were analyzed to identify underlying challenges limiting PHC providers’ ability to effectively and efficiently respond to COVID-19 and maintain essential health services. Findings: The paper finds that making adjustments only to health services delivery will be insufficient to address most of the challenges identified by PHC providers in the context of COVID-19 in Armenia. In particular, strategic responses to the pandemic were missed, due, in part, to the absence of COVID-19 management teams at the facility level. Furthermore, the absence of PHC experts in Armenia’s national pandemic response team meant that health system issues identified at the facility level could not easily be communicated to or addressed by policymakers. The checklist therefore helps policymakers identify critical challenges – at both the facility and health system level – that need to be addressed to strengthen the PHC response to the COVID-19 pandemic

Basal lamina formation at the site of spinal cord transection

The pia-glial basal lamina (BL) at the site of spinal cord injury could be an important physical impediment to central nervous system regeneration. We used an epithelial BL-specific immunohistochemical stain to determine the location of the pia-glial BL after spinal cord transection. Small segments of BL were found at the margin of the lesion 5 days after transection. After 10 days, longer and more numerous segments were seen. At 20 days, the entire transected end of the spinal cord was capped by a layer of BL.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50298/1/410080204_ftp.pd

Supportive Environments for Health

The environment influences our health in many ways through exposures to physical, chemical and biological risk factors, and through related changes in our behavior in response to those factors. Globally, nearly one quarter of all deaths and of the total disease burden can be attributed to the environment. These findings have important policy implications, because the environmental risk factors can be modified by established, cost-effective interventions. The process of building an intersectoral approach, which recognizes all facets of a community, helps in both making and implementing a LEHAP. Coordinated actions can promote development strategies with multiple social and economic co-benefits, in addition to global health gains, both immediate and long term. Repositioning the health sector to act more effectively on preventive health policies, while enhancing intersectoral partnerships, is thus critical to addressing the environmental causes of disease and injury, and achieving better health for all. Our case study presents an example of intersectoral approach that resulted in a successful implementation of measures at different levels in local community to reduce air pollution in the urban area of Celje

Multivariate Chemometric Analysis of a Polluted River of a Megalopolis

A chemometrical study regarding a 10-years water quality monitoring plan at 15 sampling points along a section of the Reconquista River and its stream channels, which embraces 21 campaigns, is presented. The original data were pre-treated in order to eliminate missing data and outliers, obtaining a final data matrix of 270 samples by 26 physical-chemistry variables. Multivariate statistical methods like multi curve resolution, canonical correlation analysis and factor analysis methods, as well as current univariate statistics were applied. The interpretation was simplified when variables were separated in groups containing environmentally and chemically related variables instead of analyzing them all together. These methods have shown that the presence of metals likely come from at least 3 different type of sources. Although the stream channels arriving to the main river course are highly polluted, their flow rates are so low that do not significantly decrease its water quality. They mainly contribute to the high levels of biochemical-oxygen demand and chemical-oxygen demand as well as nitrogen-content species. Furthermore, regarding metals, the pollution of the river coming from the upstream is higher than those introduced by all channels.Fil: Garcia Reiriz, Alejandro Gabriel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Química Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Química Rosario; ArgentinaFil: Magallanes, Jorge Federico. Comisión Nacional de Energía Atómica; ArgentinaFil: Vracko, Marjan. National Institute of Chemistry; EsloveniaFil: Zupan, Jure. National Institute of Chemistry; EsloveniaFil: Reich, Silvia Leonor. Universidad Nacional de San Martín. Instituto de Investigación en Ingeniería Ambiental; ArgentinaFil: Cicerone, Daniel. Comisión Nacional de Energía Atómica; Argentina. Universidad Nacional de San Martín. Instituto de Investigación en Ingeniería Ambiental; Argentin

Health and well-being for all: an approach to accelerating progress to achieve the Sustainable Development Goals (SDGs) in countries in the WHO European Region

Background Forty-three out of 53 of the WHO European Member States have set up political and institutional mechanisms to implement the United Nations (UN) 2030 Agenda for Sustainable Development. This includes governance and institutional mechanisms, engaging stakeholders, identifying targets and indicators, setting governmental and sectoral priorities for action and reporting progress regularly. Still, growing evidence suggests that there is room for advancing implementation of some of the Sustainable Development Goals (SDGs) and targets at a higher pace in the WHO European Region. This article proposes the E4A approach to support WHO European Member States in their efforts to achieve the health-related SDG targets. Methods The E4A approach was developed through a 2-year, multi-stage process, starting with the endorsement of the SDG Roadmap by all WHO European Member States in 2017. This approach resulted from a mix of qualitative methods: a semi-structured desk review of existing committal documents and tools; in-country policy dialogs, interviews and reports; joint UN missions and discussion among multi-lateral organizations; consultation with an advisory group of academics and health policy experts across countries. Results The E—engage—functions as the driver and pace-maker; the 4 As—assess, align, accelerate and account—serve as building blocks composed of policies, processes, activities and interventions operating in continuous and synchronized action. Each of the building blocks is an essential part of the approach that can be applied across geographic and institutional levels. Conclusion While the E4A approach is being finalized, this article aims to generate debate and input to further refine and test this approach from a public health and user perspective

The time-dependent rearrangement of the epithelial basement membrane in human skin wounds

In 62 human skin wounds (surgical wounds, stab wounds and lacerations after surgical treatment) we analyzed the immunohistochemical localization of collagen IV in the epithelial basement membrane. In 27 of these wounds the distribution of collagen VII, which represents a specific component of the basement membrane of stratified epithelia, was also analyzed. We were able to demonstrate a virtually identical co-distribution of both collagen IV and VII in the wound area with no significant time-dependent differences in the appearance of both collagen types. Fragments of the epithelial basement membrane could be detected in the wound area from as early as 4 days after wounding and after 8 days a complete restitution of the epithelial basement membrane was observed. In all cases with a wound age of more than 21 days the basement membrane was completely reformed over the former lesional area. The period between 8 and 21 days after wounding was characterized by a wide variability ranging from complete restitution to deposition of basement membrane fragments or total lack of the epidermal basement membrane