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PubMedDate not supplied

[Decentralized focus of the campaign against AIDS in Quebec].

The aim of this article is to describe the operation of a local health system within the social and public health context in the Province of Quebec, Canada. Following a review of the local health system concept, a description is given of the resources that have been used to combat acquired immunodeficiency syndrome (AIDS) in the city of Quebec and the surrounding region. Some of the results obtained and difficulties encountered are presented, as are prospects for this work in the future.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Prenatal diagnosis in the county of Viborg before and after decentralization of sample taking].

On account of an increase in the frequency of amniotic fluid samples (AFS), the need for further decentralisation of sampling developed. Viborg Amt (Viborg County) was able to offer this service to all pregnant women in the county after 01.VIII.1985 who fulfil the indication for prenatal diagnosis (PD). Among 902 registered AFS divided over a period of two years before and two years after the decentralisation there was no significant deterioration of the service measured by the number of spontaneous abortions and unsuccessful AFS. The indications for prenatal diagnosis altered in such a way that the unofficial indication of anxiety rose significantly while the indication of maternal age greater than or equal to 35 years decreased. Furthermore, a positive correlation was registered between a reduction of distance from the pregnant woman to the centre of sampling and the percentage of referrals made by the local practitioner. The paper also shows that more pregnant women, referred for AFS on account of advanced age, accepted PD than was registered in an earlier research, but this pattern declined in the research period.

Amniocentesis↗
PubMed1990

[Measurement of blood cholesterol, decentralized, using a Reflotron, or centralized in a laboratory. A comparison].

In connection with an extensive screening programme for blood cholesterol, the cholesterol values in 105 participants were measured on a sample of capillary blood employing a Reflotron and, simultaneously, samples of venous blood were examined by conventional enzymatic analysis in a laboratory. Whereas the day-to-day variation and the scatter involved were quite limited in the laboratory, the variation scatter between the two methods of measurement was 0.65 mmol/l. This figure was, however, no greater than that described between different laboratories in USA. Nevertheless, it is an important problem with the Reflotron method that even slight deviations from the recommended procedure of withdrawing blood involve a systematic risk for erroneously low cholesterol results.

Blood Chemical Analysis↗
PubMed1990

Establishment of an inservice training program for rural health workers in a decentralized system.

The maintenance of the effective functioning of peripheral health workers in isolated working environments has long been a subject of contemplation by health planners and managers. It depends on training, motivation and skill. This paper describes the development of an inservice training program for rural health workers based on the establishment of a core group of trainers in each province. Training of trainers utilized a combination of formal training, workshops, distance-learning techniques and regular on-site consultation.

Allied Health Personnel↗
PubMedDate not supplied

Rigid contact lens decentration: a risk factor for corneal warpage.

Clinically significant contact lens induced corneal warpage is seen in a small proportion of soft and rigid contact lens wearers. Previous studies using the keratometer have found no correlation between the fit of the lens and the induced topographic changes. In this study, using computer-assisted topographic analysis, seven eyes (four patients) with rigid contact lens-induced corneal warpage were noted to have topographic abnormalities that correlated with the decentered resting position of the contact lens on the cornea. The warpage topography for each of these corneas was characterized by a relative flattening of the cornea underlying the resting position of the contact lens. Lenses that rode high, for example, produced flattening superiorly and resulted in a relatively steeper contour inferiorly that simulated the topography of early keratoconus patients who had not worn contact lenses. After discontinuing contact lenses the corneal topography returned to a normal pattern in five eyes. Two eyes retained asymmetry that is not characteristic of normal corneas. Up to 6 months was required for the corneas to return to a stable topography after contact lens wear was discontinued.

Adult↗
PubMed1989

Organization and decentralization of the Malawi National Bilharzia Control Programme.

The Bilharzia Control Project, supported by GTZ in collaboration with the Ministry of Health, began in late 1981 with two pilot areas, namely Nkoma and Pirimiti. The aims of the programme are to decrease the level of morbidity due to schistosomiasis through health facilities, chemotherapy, sanitation and health education. The glass sandwich diagnostic technique is used for the diagnosis of S. mansoni infection. The Nytrel urine syringe filtration technique, with Lugol's solution to stain eggs, and urine test strips are used for diagnosis of S. haematobium infection. Chemotherapy using the "test and treat" (TAT) approach, is carried out in a community, whether at a school or in a village. It is possible to treat between 100 and 300 people per day for S. mansoni infection using this approach with three bilharzia assistants (health surveillance assistants). This is also possible in S. haematobium areas. The "test and treat" teams can spend more than 3 weeks in a village and can treat up to 300 persons per day (using a microscope). Mapping and census of a village is done on the afternoon before the day of treatment. Health education talks are conducted on this same afternoon. Health education is to be the number one priority in the schistosomiasis control programme in Malawi. The role of man in the cycle of the infection will have to be emphasized in the informational component of schistosomiasis control. The Bilharzia Control Programme needs to join forces with other ministries or organizations through the primary health care approach, to motivate and mobilize the communities in its control activities.

Animals↗