Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People.

The Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People is the result of the meeting held at the Rockefeller Foundation Bellagio Center in Lake Como, Italy 30 October-1 November, 2012. The meeting was science-based but policy-oriented. The role and amount of healthy and unhealthy fats, with attention to the relative content of omega-3 and omega-6 fatty acids, sugar, and particularly fructose in foods that may underlie the epidemics of non-communicable diseases (NCDs) worldwide were extensively discussed. The report concludes that sugar consumption, especially in the form of high energy fructose in soft drinks, poses a major and insidious health threat, especially in children, and most diets, although with regional differences, are deficient in omega-3 fatty acids and too high in omega-6 fatty acids. Gene-nutrient interactions in growth and development and in disease prevention are fundamental to health, therefore regional Centers on Genetics, Nutrition and Fitness for Health should be established worldwide. Heads of state and government must elevate, as a matter of urgency, nutrition as a national priority, that access to a healthy diet should be considered a human right and that the lead responsibility for nutrition should be placed in Ministries of Health rather than agriculture so that the health requirements drive agricultural priorities, not vice versa. Nutritional security should be given the same priority as food security.

Dermatoscopy of facial actinic keratosis, intraepidermal carcinoma, and invasive squamous cell carcinoma: a progression model.

BACKGROUND: Little is known about the dermoscopic features of keratinocyte skin cancer. OBJECTIVE: We sought to determine the dermoscopic features of facial actinic keratosis (AK), intraepidermal carcinoma (IEC), moderately to poorly differentiated invasive squamous cell carcinoma (SCC), and well-differentiated SCC of the keratoacanthoma type. METHODS: This was a retrospective analysis of dermoscopic images of histopathologically diagnosed keratinocyte skin cancer. RESULTS: A total of 243 (70 AK, 71 IEC, 78 SCC, and 24 keratoacanthomas) tumors of the face from 243 patients (mean age: 71.1 years; range: 44-94 years) were analyzed. The majority of patients had a fair skin type, history of melanoma or nonmelanoma skin cancer, and multiple AK. A red pseudonetwork was significantly associated with AK (P < .001), whereas dotted/glomerular vessels, diffuse yellow opaque scales, and microerosions were significantly more prevalent among IEC (P < .001). Hairpin vessels, linear-irregular vessels, targetoid hair follicles, white structureless areas, a central mass of keratin, and ulceration were significantly associated with invasive SCC (P < .001 for all criteria). Similar patterns as in SCC were observed among keratoacanthomas. LIMITATIONS: The retrospective design of our study and the lack of assessment of sensitivity and specificity of the dermoscopic criteria are limitations. CONCLUSIONS: Based on our findings we propose a progression model of facial AK developing into IEC and invasive SCC.

Bellagio report on healthy agriculture, healthy nutrition, healthy people.

The Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People is the result of the meeting held at the Rockefeller Foundation Bellagio Center in Lake Como, Italy, 29 October-2 November 2012. The meeting was science-based but policy-oriented. The role and amount of healthy and unhealthy fats, with attention to the relative content of omega-3 and omega-6 fatty acids, sugar, and particularly fructose in foods that may underlie the epidemics of non-communicable diseases (NCD's) worldwide were extensively discussed. The report concludes that sugar consumption, especially in the form of high energy fructose in soft drinks, poses a major and insidious health threat, especially in children, and most diets, although with regional differences, are deficient in omega-3 fatty acids and too high in omega-6 fatty acids. Gene-nutrient interactions in growth and development and in disease prevention are fundamental to health, therefore regional Centers on Genetics, Nutrition and Fitness for Health should be established worldwide. Heads of state and government must elevate, as a matter of urgency, Nutrition as a national priority, that access to a healthy diet should be considered a human right and that the lead responsibility for Nutrition should be placed in Ministries of Health rather than agriculture so that the health requirements drive agricultural priorities, not vice versa. Nutritional security should be given the same priority as food security.

[Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People]. / Informe de Bellagio sobre Agricultura Saludable, Nutrición Saludable, Población Saludable.

The Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People is the result of the meeting held at the Rockefeller Foundation Bellagio Center in Lake Como, Italy, 29 October-2 November 2012. The meeting was science-based but policy-oriented. The role and amount of healthy and unhealthy fats, with attention to the relative content of omega-3 and omega-6 fatty acids, sugar, and particularly fructose in foods that may underlie the epidemics of non-communicable diseases (NCD's) worldwide were extensively discussed. The report concludes that sugar consumption, especially in the form of high energy fructose in soft drinks, poses a major and insidious health threat, especially in children, and most diets, although with regional differences, are deficient in omega-3 fatty acids and too high in omega-6 fatty acids. Gene-nutrient interactions in growth and development and in disease prevention are fundamental to health, therefore regional Centers on Genetics, Nutrition and Fitness for Health should be established worldwide. Heads of state and government must elevate, as a matter of urgency, Nutrition as a national priority, that access to a healthy diet should be considered a human right and that the lead responsibility for Nutrition should be placed in Ministries of Health rather than agriculture so that the health requirements drive agricultural priorities, not vice versa. Nutritional security should be given the same priority as food security.

El informe del Bellagio sobre Agricultura Saludable, Nutrición Saludable, Población Saludable es el resultado de la reunión mantenida en el Centro Bellagio de la Fundación Rockefeller en el Lago de Como en Italia, entre el 29 de Octubre y el 2 de Noviembre de 2012. La reunión basada en la ciencia, fue orientada hacia la política. Se discutió extensamente el papel y la cantidad de grasas saludables y perjudiciales, con atención al contenido relativo de los ácidos grasos omega-3 y omega-6, el azúcar, y particularmente la fructosa en los alimentos que pueden conllevar la epidemia de enfermedades no transmisibles (EnT) a través del mundo. El informe concluye que el consumo del azúcar, especialmente en forma de fructosa de alta energía utiizada en bebidas refrescantes, posee una amenaza muy importante de la salud, especialmente en niños, y la mayoría de las dietas, aunque con diferencias regionales, son deficientes en ácidos grasos omega-3 y demasiado altas en ácidos grasos omega-6. Las interacciones gen-nutriente en el crecimiento y desarrollo y en la prevención de la enfermedad son fundamentales para la salud, por lo que deberían establecerse a través de todo el mundo Centros regionales de Genética, Nutrición y Condición Física para la Salud. Los jefes de estado y gobierno deben priorizar dentro de sus nacionales de forma urgente la Nutrición, cuyo acceso a una dieta saludable debería considerarse un derecho humano y dirigir la responsabilidad para que la Nutrición tenga un lugar en los Ministerios de Salud, más que la agricultura de modo que los requerimientos de salud conduzcan a prioridades agrícolas, y no viceversa. La seguridad nutricional debería ser considerada como prioridad como lo es la seguridad alimentaria.

BLINCK-A diagnostic algorithm for skin cancer diagnosis combining clinical features with dermatoscopy findings.

BACKGROUND: Deciding whether a skin lesion requires biopsy to exclude skin cancer is often challenging for primary care clinicians in Australia. There are several published algorithms designed to assist with the diagnosis of skin cancer but apart from the clinical ABCD rule, these algorithms only evaluate the dermatoscopic features of a lesion. OBJECTIVES: The BLINCK algorithm explores the effect of combining clinical history and examination with fundamental dermatoscopic assessment in primary care skin cancer practice. PATIENTS/METHODS: Clinical and dermatoscopic images of 50 skin lesions were collected and shown to four primary care practitioners. The cases were assessed by each participant and lesions requiring biopsy were determined on separate occasions using the 3-Point Checklist, the Menzies method, clinical assessment alone and the BLINCK algorithm. RESULTS: The BLINCK algorithm had the highest sensitivity and found more melanomas than any of the other methods. However, BLINCK required more biopsies than the other methods. When comparing diagnostic accuracy, there was no difference between BLINCK, Menzies method and clinical assessment but all were better than the 3-Point checklist. CONCLUSIONS: These results suggest that the BLINK algorithm may be a useful skin cancer screening tool for Australian primary care practice.

Measuring performance in skin cancer practice: the SCARD initiative.

BACKGROUND: The Skin Cancer College of Australia and New Zealand (SCCANZ) has developed a unique project named SCARD - the Skin Cancer Audit and Research Database. Designed initially as a self-audit tool for primary care skin cancer practitioners, SCARD acts as a tracking tool to enhance practice safety, and it also creates practice performance reports. Pooling of de-identified data enables participating practitioners to confidentially compare their own practice to that of their peers. Additionally, this creates a large database with significant research potential, as SCARD records for every lesion de-identified practitioner and patient data, and extensive details of location, provisional and histological diagnosis, and the procedure(s) performed in its treatment. METHODS: Preliminary data collected in the database have been presented in this study. RESULTS: An initial pool of data from 177 practitioners contains 77,553 specimens from 41,006 individual patients. CONCLUSIONS: The data presented are being analyzed for further studies, and additional data continues to be collected from this ongoing project. SCARD is a useful tool at practice level, and substantial uptake by Australian primary care skin cancer practitioners has provided a unique opportunity for research into skin cancer and its management. SCCANZ, a professional college of predominantly primary care medical practitioners, with a commitment to the management of skin cancer in Australia and New Zealand, has formed a partnership with the School of Medicine at the University of Queensland to ensure that these data are managed and analyzed appropriately.

Informe de Bellagio sobre agricultura saludable, nutrición saludable, población saludable / Bellagio report on healthy agriculture, healthy nutrition, healthy people

El informe del Bellagio sobre Agricultura Saludable, Nutrición Saludable, Población Saludable es el resultado de la reunión mantenida en el Centro Bellagio de la Fundación Rockefeller en el Lago de Como en Italia, entre el 29 de Octubre y el 2 de Noviembre de 2012. La reunión basada en la ciencia, fue orientada hacia la política. Se discutió extensamente el papel y la cantidad de grasas saludables y perjudiciales, con atención al contenido relativo de los ácidos grasos omega-3 y omega-6, el azúcar, y particularmente la fructosa en los alimentos que pueden conllevar la epidemia de enfermedades no transmisibles (EnT) a través del mundo. El informe concluye que el consumo del azúcar, especialmente en forma de fructosa de alta energía utiizada en bebidas refrescantes, posee una amenaza muy importante de la salud, especialmente en niños, y la mayoría de las dietas, aunque con diferencias regionales, son deficientes en ácidos grasos omega-3 y demasiado altas en ácidos grasos omega-6. Las interacciones gen-nutriente en el crecimiento y desarrollo y en la prevención de la enfermedad son fundamentales para la salud, por lo que deberían establecerse a través de todo el mundo Centros regionales de Genética, Nutrición y Condición Física para la Salud. Los jefes de estado y gobierno deben priorizar dentro de sus nacionales de forma urgente la Nutrición, cuyo acceso a una dieta saludable debería considerarse un derecho humano y dirigir la responsabilidad para que la Nutrición tenga un lugar en los Ministerios de Salud, más que la agricultura de modo que los requerimientos de salud conduzcan a prioridades agrícolas, y no viceversa. La seguridad nutricional debería ser considerada como prioridad como lo es la seguridad alimentaria (AU)

The Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People is the result of the meeting held at the Rockefeller Foundation Bellagio Center in Lake Como, Italy, 29 October-2 November 2012. The meeting was science-based but policy-oriented. The role and amount of healthy and unhealthy fats, with attention to the relative content of omega-3 and omega-6 fatty acids, sugar, and particularly fructose in foods that may underlie the epidemics of non-communicable diseases (NCD's) worldwide were extensively discussed. The report concludes that sugar consumption, especially in the form of high energy fructose in soft drinks, poses a major and insidious health threat, especially in children, and most diets, although with regional differences, are deficient in omega-3 fatty acids and too high in omega-6 fatty acids. Gene-nutrient interactions in growth and development and in disease prevention are fundamental to health, therefore regional Centers on Genetics, Nutrition and Fitness for Health should be established worldwide. Heads of state and government must elevate, as a matter of urgency, Nutrition as a national priority, that access to a healthy diet should be considered a human right and that the lead responsibility for Nutrition should be placed in Ministries of Health rather than agriculture so that the health requirements drive agricultural priorities, not vice versa. Nutritional security should be given the same priority as food security (AU)

Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People / Informe Bellagio sobre la actividad agropecuaria y la nutrición para la salud de las personas

The Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People is the result of the meeting held at the Rockefeller Foundation Bellagio Center in Lake Como, Italy 30 October-1 November, 2012. The meeting was science-based but policy-oriented. The role and amount of healthy and unhealthy fats, with attention to the relative content of omega-3 and omega-6 fatty acids, sugar, and particularly fructose in foods that may underlie the epidemics of non-communicable diseases (NCDs) worldwide were extensively discussed. The report concludes that sugar consumption, especially in the form of high energy fructose in soft drinks, poses a major and insidious health threat, especially in children, and most diets, although with regional differences, are deficient in omega-3 fatty acids and too high in omega-6 fatty acids. Gene-nutrient interactions in growth and development and in disease prevention are fundamental to health, therefore regional Centers on Genetics, Nutrition and Fitness for Health should be established worldwide. Heads of state and government must elevate, as a matter of urgency, nutrition as a national priority, that access to a healthy diet should be considered a human right and that the lead responsibility for nutrition should be placed in Ministries of Health rather than agriculture so that the health requirements drive agricultural priorities, not vice versa. Nutritional security should be given the same priority as food security.

El Informe Bellagio sobre la actividad agropecuaria y la nutrición para la salud de las personas es el resultado de la reunión celebrada del 30 de octubre al 1 de noviembre del 2012 en el Centro Bellagio de la Fundación Rockefeller, ubicado a orillas del lago de Como (Italia). La reunión se basó en datos científicos, pero estuvo orientada a cuestiones de política. Se trataron ampliamente los temas de la función y la cantidad de las grasas saludables y las grasas poco saludables en los alimentos, con atención especial a su contenido relativo de ácidos grasos omega-3 y omega-6, y de azúcar, en particular fructosa, que pueden ser la causa de la epidemia de enfermedades no transmisibles en el mundo. El informe concluye que el consumo de azúcares, sobre todo en la forma de fructosa de alto contenido energético contenida en las bebidas gaseosas, supone una amenaza grave e insidiosa para la salud, especialmente en la niñez, y que la mayoría de los regímenes alimentarios, aunque con diferencias regionales, contienen cantidades insuficientes de ácidos grasos omega-3 y cantidades demasiado elevadas de ácidos grasos omega-6. Dado que las interacciones entre los genes y los nutrientes durante el crecimiento y el desarrollo, así como en la prevención de las enfermedades, son fundamentales para la salud, deben establecerse en todo el mundo centros regionales de genética, nutrición y buena condición física para promover la salud. Los jefes de Estado y de gobierno deben elevar la nutrición, con carácter de urgencia, al nivel de prioridad nacional, lograr que el acceso a un régimen alimentario saludable se considere un derecho humano, y hacer que la responsabilidad principal en materia de nutrición recaiga en los ministerios de salud, en lugar de en los ministerios de agricultura y ganadería, a fin de que las necesidades de salud orienten las prioridades agropecuarias, y no a la inversa. Debe asignarse a la seguridad nutricional la misma prioridad que a la seguridad alimentaria.

Skin cancer medicine in primary care: towards an agenda for quality health outcomes.

The number of skin cancer clinics functioning within Australia's primary care environment is increasing rapidly, and significant concerns have been raised about the type and quality of work done by some doctors in some clinics. Mainstream general practice is threatened by perceived fragmentation, and specialist practice in dermatology and plastic surgery is threatened by encroachment into their domains of practice. We propose an agenda of training, standards, accreditation, audit and research to ensure that skin cancer clinics provide optimal health outcomes for patients.