Research training in the biomedical aspects of human reproduction and family planning in developing countries.
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Between 1967 and 1969 the New York City capital budget listed monies for the planning and construction of 15 new ambulatory care centers to provide comprehensive medical care to medically underserved areas of the city. Because of the urgent need, an effort was made in planning the centers to minimize the number of agency approvals. By adopting this approach, the appropriateness of the centers to their target populations became secondary to the process of negotiating the bureaucracy. In spite of this tactical decision, by 1970 construction had begun on only 1 center. This case study discusses the events from 1967 through 1969 that relate to the effort to expedite bureaucratic processing of the facilities.
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There is an urgent need for a quick inexpensive and reliable method for identifying groups and individuals most in need of primary health care. The Rapid Rural Appraisal (RRA) is the most appropriate approach. It is a method by which resources can be quickly deployed to alleviate the problems of the poor. If properly used it can play a major role in identifying community health needs thereby aiding the health planning process and improving the health of the people. Nevertheless, RRA techniques should not be regarded as separate and apart from other research methodologies but complementary to them.
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The view of the tympanic membrane of the ear provides the specialist with important information for the assessment of ear disease and for treatment planning. In rural and remote areas, the incidence of ear disease is high but access to ear specialists is limited. As part of a project to deliver tele-otoscopy services to remote Western Australia, we have investigated various aspects of a tele-otoscopy system. We found that the MedRX video-otoscope is relatively safe to use and produces images of very good quality. A confident diagnosis could be made from still images compressed to 20 kByte. Video sequences could be compressed to a ratio of 1:300. Furthermore, a software package has been developed, and we are developing a training course for health-care workers in remote areas.
The view of the tympanic membrane of the ear provides the specialist with important information for the assessment of ear disease and for treatment planning. In rural and remote areas, the incidence of ear disease is high but access to ear specialists is limited. As part of a project to deliver tele-otoscopy services to remote Western Australia, we have investigated various aspects of a tele-otoscopy system. We found that the MedRX video-otoscope is relatively safe to use and produces images of very good quality. A confident diagnosis could be made from still images compressed to 20 kByte. Video sequences could be compressed to a ratio of 1:300. Furthermore, a software package has been developed, and we are developing a training course for health-care workers in remote areas.
In developing the national occupational health programme in Thailand it was necessary to obtain information on workers' health to enable proper planning and implementation of the programme. A stratified sample of different types of small (up to 50 workers) and medium-sized factories (51-150 workers) located in one geographical area was selected. In all, 98 plants were surveyed and a total of 1449 workers were examined. The prevalence of diseases, many of which were work-related, was higher in the small than in the medium-sized plants. Additional information confirmed the need for controlling the multitude of health problems of these under-served workers. The Ministry of Health used this data in training primary health care workers in the small workplaces, controlling the health problems discovered, developing laboratories and drafting legislation.
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In many animal species, the early development of the embryo follows a stereotypic pattern of cell cleavage, lineage allocation and generation of tissue asymmetry leading to delineation of the body plan with three primary embryonic axes. The mammalian embryo has been regarded as an exception and primary body axes of the mouse embryo were thought to develop after implantation. However, recent findings have challenged this view. Asymmetry in the fertilised oocyte, as defined by the position of the second polar body and the sperm entry point, can be correlated with the orientation of the animal-vegetal and the embryonic-abembryonic axes in the preimplantation blastocyst. Studies of the pattern of morphogenetic movement of cells and genetic activity in the peri-implantation embryo suggest that the animal-vegetal axis of the blastocyst might presage the orientation of the anterior-posterior axis of the gastrula. This suggests that the asymmetry of the zygote that is established at fertilisation and early cleavage has a lasting impact on the delineation of body axes during embryogenesis.