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PubMedDate not supplied

[A microepidemic of severe tuberculosis in a hospital for chronic neuropsychiatric patients].

Details and considerations on a microepidemic of severe tuberculosis occurring in a hospital for chronic neuro-psychic patients are presented. This episode presents a practical interest by the knowledge of the circumstances of occurrence and progression, clinical-epidemiological features, associated favouring factors (immunodeficiency, absence of a sustained program for tuberculosis investigation) and biologic prophylaxis by BCG vaccinations and revaccinations. Several measures for avoiding such epidemics and, in prospect, of AIDS in the institutions at high risk are discussed.

Age Factors↗
PubMed2003

[Decentralization of health care and medical teaching: the Chilean experience].

In Chile there has been a close interaction between medical teaching and health care. In 1943, the University of Chile School of Medicine (founded in 1833) created Chairs in several public hospitals. The University of Chile School of Public Health (founded in 1943) played a key role in the creation in 1952 of a centralized National Health Service (NHS). The NHS had outpatient clinics and hospitals all over the country and was responsible for health care and for the promotion of health and disease prevention programs. In 1954, the NHS and the School of Medicine set up Residencies and General Practitioners programs aimed at improving the distribution of specialists and general practitioners throughout the country. In 1979, the NHS was replaced with 27 autonomous Health Services headed by the Ministry of Health, while the administration of primary care outpatient clinics was transferred to the municipal government. However, sanitary programs were still managed at the central level. Higher education also expanded and was decentralized. There are currently 60 universities and 17 medical schools, compared to eight and six, respectively, in 1981. The number of students in higher education has increased by 370% in 20 years. At the present time, the Chilean health case system is a predominantly public system with a strong and sizeable private system. Sixty two percent of the population is covered by public health insurance, while 27% is covered by private insurance. New and well equipped private clinics have multiplied. Private non profit institutions manage the prevention and treatment of work related injuries and diseases. Chile's outstanding health indicators (fertility rate: 17.2 x 1,000; mortality: 5.4 x 1,000; maternal mortality: 2.3 x 10,000; neonatal mortality: 4.5 x 1,000; life expectancy: 76 years) are a direct consequence of the improved social, cultural and economic condition of the general populations as well as of the sanitary programs sustained over the past half century.

Certification↗
PubMed2004

[Malaria at the time of "Roll Back Malaria"].

Only within the last 4 years has worldwide political awareness of the impact of malaria made it possible to envision significant initiatives in malaria control and research within the framework of an ambitions and sustained program called the "Role Back Malaria (RBM) Partnership" coordinated by the WHO. The purpose of this article is to describe the current main objectives of the RBM partnership. This program implies a transfer of responsibilities and research technologies, which will require adaptation. Up to now French expertise has played little part.

Biomedical Research↗
PubMed1991

General theory of paradigms in health.

In Costa Rica, three sequential health paradigms have been identified over the last 50 years. The first began to develop during the 40's and has been called that of the deficiency diseases, since with a diachronic approach it placed excessive emphasis on malnutrition. The second began in 1970 and it is known as that of the infectious diseases, since through a holistic or synchronic approach, it underlined the importance of infections in high rates of morbidity and mortality. The third and last is the paradigm of the chronic diseases, it appeared in the 80's and is presently in process, doing battle with the chronic ailments, life styles, and environment, and it also utilizes a holistic approach. The recognition of these three paradigms has permitted Costa Rica a rapid advance in improving the health of its population, to the point that with a per capita outlay of $130 (US dollars), it has indices similar to those of the industrialized nations. This particular experience could be useful for other less-developed countries that are still applying the paradigm of the deficiency diseases.

Adult↗
PubMed1980

The methodology of home-based intervention studies: problems and promising strategies.

Research on home-based interventions directed toward promoting positive interaction between mothers and their young children has become a less active field in spite of evidence that some programs sustain meaningful improvements in the lives of mothers and children. The purpose of this paper is to clarify some of the methodological problems of home-based intervention research and to suggest future directions. Several major projects are discussed to illustrate different perspectives, trade-offs, and promising strategies for dealing with key issues: (a) congruence between goals and methods, (b) sample selection and retention, and (c) measurement and design. The authors suggest that designing home-based interventions as longitudinal development research (rather than outcome evaluations) can provide valuable knowledge about ecological factors that affect the development of competence in parents and children and about effective ways to support families.

Child Behavior Disorders↗
PubMedDate not supplied

Eradication of vitamin A deficiency with 5 cents and a vegetable garden.

1. It is estimated that 10 million children are vitamin A deficient. Of these children, over 1 million needlessly die, go blind, or suffer lesser degrees of visual impairment every year. This problem--along with all forms of malnutrition--is likely to be seriously magnified by the year 2000. The scope of the problem is immense, and the need to address it is urgent. 2. Interventions for the prevention of vitamin A deficiency and its consequences are considered to be some of the most cost-effective and health-productive in the Third World--and yet the problem remains immense, representing one of the greatest failures in global public health planning. 3. As ophthalmic professionals, we are at the center of this urgent public health concern. We have an important responsibility in the initiation and development of sustainable programs for health promotion and disease prevention.

Agriculture↗