Comprehensive health planning: learning by example.
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The acceptability of family planning services was studied at 12 federally funded clinics in the poor, inner-city area of Detroit by means of a questionnaire given to 535 patients selected at random. The majority of respondents judged clinic care acceptable, but ratings varied among individual clinics, types of clinics (hospital or community-based, single-purpose or multipurpose), and characteristics of patients. Ratings also varied among the factors identified from the 24 questionnaire items as the criteria of acceptability: (1) doctor's care and (2) nurse's care, which were found to be closely correlated with patient's satisfaction with their clinic experience, and (3) waiting time, (4) accessibility, and (5) comfortableness, which were not correlated with overall satisfaction. Overall clinic acceptability was positively correlated with revisits for some of the clinics.
Sanitary prognostication of the quality of urban environment covers a complex of problems, among which problems, associated with the charecter of the rational utilization of natural environment and ultraviolet microclimate regulation. Knowledge on this microclimate will help to elaborate criteria for assessment of environment, pledged in the biological effectiveness of the natural short-wave sun radiation reaching the earth surface a useful, but still poorly known environmental factor. After detailed acquaintance with the economical, physico-geographical and climatic characteristics of the big settlements in Bulgaria, 7 towns were chosen, representatives of the three basic economical regions in this country. A study was undertaken in these towns with compilation of physical characteristics of the natural ultraviolet irradiation, assessment of its biological activity and estimation of the degree of its losses in urban environment and evaluation of ultraviolet microclimate changes, in view of the possibilities to formulate an environment constituting a danger to health. The results may be helpful for a broad circle of specialists, occupied with environment protection problems and with the aspects of rational urban planning.
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OBJECTIVES: This study evaluates New York City's Child Immunization Day (1993), with emphasis on the cost and effects of a mass campaign and the use of strategies from developing nations in an inner-city context. METHODS: The methodology was designed to (1) document the planning and implementation process, (2) analyze the number and characteristics of children in the target group, and (3) estimate costs. RESULTS: Neither the social mobilization nor the political will that characterize successful campaigns in developing nations occurred in New York City's campaign. Despite substantial time and effort from both private and public agencies, turnout for the event was low. In total, 2647 families and 5237 children were assessed for health care and insurance needs, 2949 children were immunized at a cost of about $279 per immunized child, and 7236 vaccines were administered. CONCLUSIONS: The differences between inner cities and developing nations have a bearing on strategies used in planning and implementing mass campaigns. New strategies need to be forged from a blending of these contexts to create effective campaigns in industrialized inner cities.
The formation of an university institute of pathology at the Hanseatic city of Lübeck preceded a long, changeful planning, accompanied by a chain of historical events. In the 19th century, Lübeck owned seven different places for clinical or forensic autopsies. Thus, in the first years of the 20th century it was generally called for the formation of a "Central Institute of Pathology" that was completed after all in the year 1927. Two years later, Eberhard von Praun became head of the institute and was immediately confronted with the "Lübeck-disaster". He was followed 1935 by Ernst Jeckeln, who identified the "Enteritis necroticans" which appeared in North Germany in the first years after the "Second World War". He called the disease "Darmbrand", a term that is since then internationally used. Jeckeln became the first "Ordinarius for Pathology" at the "Medical Academy Lübeck", which was associated to the "University of Kiel". His long-time colleague was Alfred Wegener, who identified the "Wegener's granulomatosis". In the year 1972 Alfred Gropp became head of the institute, an all-round scientist and pathologist, e.g. well-known in the field of developmental pathology. During his term, the "Medical Academy" got the university status and was named "Medizinische Hochschule Lübeck".