Last update:
12-May-2011

The measurement of children's health in a society is important for two main reasons: Firstly, children are citizens, with all the social and economic rights of that society, but they are unable to act by themselves and of their own volition; secondly, their current health levels influence the future health of the population. The indicators used for the measurement of children's health must be carefully chosen, in order to determine the policies for the growth and development of a society, to reveal the health and social problems and to guide decision-making for the initiatives and actions necessary for combating these problems, and, finally, to monitor the epidemiological, health, social, and economic changes, with a view to designing actions and initiatives aimed at safeguarding children's health. This article reports the indicators used for health measurement in general and those used for the measurement of children's health, relating the indices to the changes in the epidemiological standards in contemporary society and to the social and economic indicators. The importance of children's health in social development and welfare is acknowledged, and it is recognized that the worsening of children's health has adverse effects on the future of a society. The article concludes with examples of initiatives for the safeguarding of children's health, with an emphasis on nutrition and life style, i.e., measures related to information-promotion-advertising, education, and the development of preventive and reactionary measures. These include complete prohibition of smoking in public places, and health initiatives for the protection of children from diseases and epidemics, such as vaccinations and preventive medicine.Hepatocellular carcinoma (HCC) is the third cancer-related cause of death worldwide and the first in people with liver cirrhosis. The incidence varies between countries and is estimated at 5−15 new cases per 100,000 population per year in the Mediterranean countries. Genetic predisposition plays a key role. Overexpression of epidermal growth factor (EGFR) is related with HCC in animal models. Certain metabolic diseases increase the risk for HCC. Chronic hepatitis B virus (HBV) infection may lead to HCC with or without cirrhosis, and HBV vaccination or therapy with interferon or nucleot(c)ides may reduce the risk for HCC. Hepatitis C virus (HCV) infection carries a 27-fold increase in risk for HCC. Patients with HBV coinfection or other chronic liver diseases are at higher risk. Cirrhosis is in itself an independent risk factor, and 4 in 5 patients with HCC have pre-existing cirrhosis. Alcohol abuse is a co-factor for liver carcinogenesis, operating by direct and indirect mechanisms; consumption of >80 g alcohol per day for more than 10 years increases the HCC risk 5-fold. The impact of cigarette consumption is still ambiguous. Obesity, diabetes mellitus and non-alcoholic steatohepatitis may lead to cirrhosis and HCC. Certain toxins increase the risk for HCC: Αflatoxins, microcystins and red betel chewing related toxins are the best known. There is evidence that B6 and choline depletion and high plasma levels of ethionin participate in HCC development, and certain organic or inorganic substances have been related with HCC. Anabolic steroids are known to contribute to liver carcinogenesis. Radiation may also contribute to the HCC molecular mechanism, although the role of non-ionizing radiation remains to be clarified. Patients who have received liver transplantation are at higher risk for HCC. Finally, there is evidence that caffeine may protect against HCC development. Recent research has focused on the role of heat-shock proteins and HBx protein in molecular pathogenesis and risk of HCC and in the impact of vaccination programs and antivirxcus therapy on the reduction of HCC frequency.

Key words: Children's health, Epidemiological standards, Health measurement indicators, Social and economic indicators.