Biomedical subjects

S Flessa

Publications and source records attributed to S Flessa.

9 recordsLinked to original sources

PubMed2001

Processing effects on lycopene content and antioxidant activity of tomatoes.

Consumption of tomato products has been associated with decreased risk of some cancer types, and the tomato antioxidant, lycopene, is thought to play an important role in the observed health effects. In this study, four carotenoids, trans-lycopene, phytofluene, phytoene, and zeta-carotene, were quantified in tomato products. Samples of raw tomatoes, tomato juice after hot break scalder, and final paste were obtained from two different processing plants over two years. Comparison of carotenoid levels throughout processing indicated that lycopene losses during processing of tomatoes into final paste (25-30 degrees Brix) ranged from 9 to 28%. The initial Brix level of the raw tomatoes appeared to influence the amount of lycopene loss that occurred, possibly due to the differences in processing time required to achieve the final desired Brix level of the paste. In general, no consistent changes in the other carotenoids were observed as a function of processing. The antioxidant activity of fresh tomatoes, tomato paste, and three fractions obtained from these products (i.e., aqueous, methanol, and hexane fractions) was also determined. In both a free radical quenching assay and a singlet oxygen quenching assay, significant antioxidant activity was found in both the hexane fraction (containing lycopene) and the methanol fraction, which contained the phenolic antioxidants caffeic and chlorogenic acid. The results suggest that in addition to lycopene, polyphenols in tomatoes may also be important in conferring protective antioxidative effects.

Antioxidants↗

PubMed2001

MOSHI: a culture-tailored management game for African hospital managers.

The computer-based management game MOSHI (management of small hospitals) was developed in Tanzania and became an integrated component of a training programme for East African hospital managers. Players are in charge of a 120-bed hospital in rural Tanzania and have to make strategic and tactical decisions according to their own traditions and values. Thus, it becomes possible that the cultural gap between western management philosophy and traditional African values is bridged.

Cultural Characteristics↗

PubMed2000

Identification of three triterpenoids in almond hulls.

Three triterpenoids, betulinic acid, oleanolic acid, and ursolic acid, were isolated as their methyl esters (treatment with diazomethane) from diethyl ether extracts of almond hulls (Nonpareil variety) using flash chromatography and preparative high-performance liquid chromatography. The triterpenoids, which comprised approximately 1% of the hulls, were characterized using chromatographic and spectroscopic methods. These studies demonstrate that almond hulls are a rich source of these triterpenoids, which have reported anti-inflammatory, anti-HIV, and anti-cancer activities.

Chromatography, Gas↗

PubMed2000

Where efficiency saves lives: a linear programme for the optimal allocation of health care resources in developing countries.

Morbidity and mortality are directly influenced by the available health care budget. In addition, the optimal allocation of this scarce resource to the different strata of the health care system depends on the health care priorities. This paper presents a linear programming model in order to analyse the impact of changes of the health care budget and the goal system of the health care system on the optimal allocation to preventive and curative medicine. The model demonstrates that the current resource allocation in developing countries is inefficient. This calls for a new emphasis on preventive medicine and primary care in the political processes in developing countries.

Adolescent↗

PubMed2000

[Sustainability and the relevance of poverty: an unresolvable contradiction? The example of the Evangelical Lutheran Church in Tanzania].

Public Health systems in developing countries are in a field of tension between two poles: sustainability and accessibility. A several months check on hospitals run by the Lutheran Church in Tanzania led us to conclude, however, that the great majority of these institutions have neither a survival chance nor have they made any substantial contribution to the status of public health care for the poor. Basing on the results of this check we discuss a few measures to transform church-run public health systems in developing countries in accordance with the goals of sustainability and accessibility. It is, however, evident that it will not be enough just to increase the technical efficiency of existing hospitals. What is needed--and this seems indeed to be the only feasible way--is to effect a complete reorganisation in the sense of Primary Health Care. It is only then that church-run Public Health Care may survive in these countries and that provision of adequate health care can be ensured for many patients.

Christianity↗

PubMed1999

Decision support for malaria-control programmes--a system dynamics model.

Although malaria claims millions of casualties every year there are hardly any recent efforts to model its epidemiology in order to support decision-makers of malaria-control programmes. There have been ample attempts to develop analytical models during the era of WHO malaria eradication programmes (1950-1970), but none of them was detailed enough to honour the high complexity arising from the interdependencies of the environment, the parasite, vector and host system. This paper presents a multi-group system dynamics model of the spread of malaria in an African country. Epidemiological details are included so that the impact of several intervention programmes can be simulated and analysed. The model's basic structure is fully described and some examples of the simulations are presented. It becomes obvious that detailed multi-group system dynamics models are valuable to assess the effectiveness and efficiency of anti-malaria campaigns.

Adolescent↗

PubMed1998

The costs of hospital services: a case study of Evangelical Lutheran Church hospitals in Tanzania.

The health care systems of many developing countries are facing a severe crisis. Problems of financing services leads to high patient fees which make institutions of Western health care unaffordable for the majority of the rural poor. The conflict between sustainability and affordability of the official health care system challenges both local decision-makers and health management consultants. Decisions must be made soon so that the existing health care systems can survive. However, these decisions must be based on sound data, especially on the costs of health care services. The existing accounting systems of most hospitals in developing countries do not provide decision-makers with these data. Costs are generally underestimated. The leadership of the 16 hospitals of the Evangelical Lutheran Church in Tanzania is currently analyzing how the existing health care services should be restructured. Therefore, reliable estimates of the costs of hospitals services are required. A survey on 'Costing of health services of the Evang. Luth. Church in Tanzania' was prepared, which summarizes the results of seven months of field investigations in Lutheran hospitals. The major findings are that the costs of providing adequate services are much higher than expected. The most important factors determining these costs are the administrative efficiency of the hospital and the scope of services offered. The paper closes with some recommendations on how to improve the services in order to make them both affordable for the rural poor and financially sustainable for the Church. It is concluded that even the best improvement of technical efficiency will not safeguard the survival of the hospital-based health care services of the Lutheran Church in Tanzania. These findings call for a reallocation of health care resources to lower levels of the health care pyramid.

Christianity↗

PubMed1998

[Health insurance in Africa: a straw for the health care system].

Health Care Systems Clutch at a Straw: The health care systems of sub-Saharan Africa are facing a global crisis which is severely challenging their survival. Currently, alternatives to the traditional financing of health care by government grants and/or "fee for service" are sought. Otherwise the vast majority of poor rural inhabitants of these countries will lose access to Western medicine at the end of this century, making appropriate medical care a privilege of a small number of rich urbans. One approach to solving this crisis is the introduction of a health insurance system. However, the culture of African people must also be considered if one attempts to design and implement an insurance scheme. This paper reflects some of the problems of health insurance in an African context. Since the author contributed to the design of a "Community Based Health Insurance" of the Evangelical Lutheran Church in Tansania, this scheme is used here as an example.

Africa↗

PubMed1991

[AIDS--dynamics in Tanzania: a strategy simulation].

This paper presents computed core results obtained from a PC-based multigroup simulation of the AIDS epidemic in Tanzania. A basic projection as well as several strategic scenarios illustrate the dynamics of AIDS prevalence, mortality, and cost if alternative strategies are assumed. Our model forecasts that in 2010 A. D. HIV prevalence will be between 37 and 46 per cent and AIDS prevalence between 7 and 11 per cent. Around the year 2000 all health care resources will be fully occupied with caring for AIDS patients only.

Acquired Immunodeficiency Syndrome↗