Showing papers by "World Health Organization published in 1981"

Health for all by the year 2000.

Abstract: The World Health Assembly in launching the movement for health for all by the year 2000 has identified health for all as the attainment by all the people of the world of a level of health that will allow them to lead socially and economically productive lives. The definition implies that the level of health of all individuals should be such that they are capable of working productively and of actively participation in the social life of the community in which they live. To bring this about will necessitate reforms in the health sector as well as reforms of a political social and economic nature. A more equitable distribution of resources for health can be the 1st of several of such reforms in all sectors. The health infrastructure needs to be reorganized in order to play a leading role in forging together the different health programs into a single unified system. The International Conference of Primary Health Care held in Almata of the Union of Soviet Socialist Republics in 1978 issued a Declaration. This Declaration stated that primary health care is the key to realizing health for all by the year 2000. Also identified were 8 essential elements of primary health care. These include the following: education concerning prevailing health problems and the methods of preventing and controlling them; promotion of food supply and proper nutrition; an adequate supply of safe water and basic sanitation; and maternal and child health care including family planning and immunization against the major infectious diseases.

Characteristics of depressive patients contacting psychiatric services in four cultures. A report from the who collaborative study on the assessment of depressive disorders.

Abstract: The paper is a report on results obtained in the course of a multi-centre international study on depressive disorders in four countries, which was sponsored and co-ordinated by the World Health Organization. A screen form was developed and tested in order to select depressive patients among psychiatric in-patient and out-patient populations. The patients selected in this way were assessed clinically by experienced investigators using the WHO schedule for Standardized Assessment of Depressive Disorders (SADD). A total of 53 patients were evaluated in the five research centres, and the data were utilized in uni- and multivariate statistical analyses aiming to establish whether similar cases of depression could be found in different cultures, to describe their characteristics and to ascertain the extent to which diagnostic concepts and classification categories could be applied in different settings. The results point to a considerable degree of similarity in depressive symptomatology across the cultures if particular selection criteria are applied, and suggest that broad diagnostic groupings such as 'endogenous' and 'psychogenic' depressions could be used consistently by clinicians working in different cultures.

Evaluation of A/Alaska/6/77 (H3N2) cold-adapted recombinant viruses derived from A/Ann Arbor/6/60 cold-adapted donor virus in adult seronegative volunteers.

Abstract: The influenza A/Ann Arbor/6/60 (H2N2) cold-adapted (ca) virus was evaluated as a donor of attenuating genes to new variants of influenza A virus. This ca donor virus was mated with the A/Alaska/6/77 (H3N2) wild-type virus, and three A/Alaska/6/77 (H3N2) ca recombinant viruses were produced. The parental origin of the genes in the three ca recombinants had been determined previously (2), and their virulence for adult seronegative volunteers was assessed in the present study to identify the genes present in the ca donor virus that confer attenuation. Each of the recombinants received the hemagglutinin and neuraminidase genes from the A/Alaska/6/77 (H3N2) wild-type parent. One ca recombinant (CR-29) received all six transferable genes from the ca parent and was found to be satisfactorily attenuated in the volunteers. The two other ca recombinants received five of the six transferable genes with a wild-type gene at the M or NS locus. The pattern of infection in humans with these latter two ca recombinants was similar to the CR-29 ca recombinant. These findings demonstrate that inheritance of a gene in ca recombinants at the M or NS locus segregates independently of attenuation and suggest that the M and NS genes present in the ca donor virus are not the major determinants of attenuation conferred by this virus.

Life events and schizophrenia: The “triggering” hypothesis

Abstract: The present paper reviews the life event research specific to schizophrenia with the goal of assessing the extent to which recent empirical studies have implicated life stress variables as precipitants of acute episodes of the disorder (i.e. the “triggering” hypothesis). Different methodological strategies used in life events research are reviewed along with the substantive findings from quasi-experimental and controlled studies of schizophrenic patients. It is concluded that stressful life events have been found to be part of the pool of factors associated with the onset of acute schizophrenic episodes, but evidence is still lacking to indicate that this association is a necessary or direct one. Recommendations are made regarding the types of future studies required to fill the gaps in the existing literature.

The Epidemiology of Acute Myocardial Infarction in Young Age Groups

Abstract: The steady increase of mortality due to coronary heart disease (CHD) in the 1940s and 1950s was followed by a declining trend in the United States, Australia, New Zealand, and several European countries since the late 1960s. During the period of increase, a menacing shift of coronary mortality towards younger age groups and a diminishing male/female ratio were also observed. These were slowly corroborated by clinical morbidity data, showing more and more frequently the occurrence of acute myocardial infarction (AMI) in young males and even females.

Field diagnosis of sleeping sickness in the Ivory Coast. I. Comparison of the miniature anion-exchange/centrifugation technique with other protozoological methods

Abstract: The miniature anion-exchange/centrifugation (m-AEC) technique for the detection of trypanosomes in blood was tried out as a field diagnostic method for African sleeping sickness among populations exposed to natural infection in the vicinity of Daloa, Republique de la Cote d'Ivoire. It was compared with the two other protozoological techniques in common use in Africa, namely, the microhaematocrit buffy-coat microscopy (MBCM) method and the thick blood film (TBF). A laboratory study on a small number of known infected subjects and two field-survey studies, all showed the m-AEC method to be more sensitive than the MBCM and very much more sensitive than the TBF. The m-AEC method detected many cases that were missed by one or other, or both, of the other tests. The m-AEC method has, also, other advantages. The duration of critical microscopy required is limited. It is faster in operation when large numbers of subjects are concerned than is the MBCM. It offers, with no additional operation beyond filling the eluates into suitable tubes, samples of diluted plasma which may be used for serology. Thus a very efficient survey procedure can be envisaged: first the m-AEC test, selecting infected subjects for immediate treatment; second, re-examining, by the m-AEC method, on a subsequent visit, those other subjects suspect on the basis of the serological examination of the eluates. The complexities of the preparation of materials and procedures, which hitherto have inhibited general application in the field of techniques involving anion-exchange, have been avoided by miniaturization and by the pre-preparation of apparatus and materials at a base laboratory.

The experimental application of insecticides from a helicopter for the control of riverine populations of Glossina tachinoides in West Africa. Part VIII

Abstract: The results of discriminative spraying of endosulfan and decamethrin from a Bell 47G-4A helicopter to fringing riverine forest habitats of Glossina tachinoides in the Komoe Valley, Upper Volta, are described. The insecticides, diluted with diesel oil were applied from the helicopter through a unilateral (left-side) arrangement of four rotary atomisers. Three experimental blocks were each sprayed twice at an interval of about one month, one with endosulfan at individual swath dosages of 100 g (a.i.)/ha, the second with endosulfan at 200 g (a.i.)/ha and the third with decamethrin at 12.5 g (a.i.)/ha. In spite of aerially applied dieldrin barriers there was extensive reinvasion by G. tachinoides during the inter-spray period, consequently conclusions were largely drawn from the data collected before and after the second cycle of insecticide applications. The reinvasion problem is discussed. Endosulfan at 200 g/ha was the most effective in controlling G. tachinoides. Other treatments were less, but p...

Facial scarring after varicella a comparison with variola major and variola minor

Abstract: To assess the prevalence of persistent facial scars after recovery from chickenpox (varicella), 250 subjects in Somalia in whom the diagnosis had been confirmed by electron microscopic identification of varicella virus were examined in 1979, a year after their illness; 2.4% had five or more facial scars indistinguishable from those seen among smallpox (variola major or variola minor) victims, with a higher percentage among males (2.7%) than females (1.9%). The highest proportion of those with five or more residual facial scars (8.3%) was found among young adults 20-29-years-old. The low proportion of varicella cases who had five or more facial scars contrasts with the 6.8% of cases of variola minor who were similarly scarred one year later (Somalia, 1978), and to an even greater degree with the situation after variola major, where the proportion varied from 65% for vaccinated subjects to 85% among unvaccinated persons (India, 1976). Pockmark surveys are a valid method for determining the past occurrence of variola major but cannot be relied on in areas were variola minor has occurred. However, varicella must be considered when making such a retrospective diagnosis.

Social control of deviants in six countries.

Abstract: Descriptive information on the social control network for deviants in 6 countries with diverse social, economic and cultural backgrounds has been collected and compared. In each country it was possible to identify a sequence by which deviant behaviour is controlled and managed, consisting of 5 stages: discovery, official screening, disposal, release and after-care. It was also possible to make a clear distinction between the mental health systems and the criminal justice systems in each country. Differences were apparent in the extent of community involvement in the discovery stage and in the role of the primary level of health services. In some instances, differences were also apparent between rural and urban areas and between the way in which rich and poor people were handled. In all countries community after-care services are insufficient, particularly for offenders released from the prison system. This report is based on the first phase of a WHO collaborative study. It forms the basis for further work currently in progress which includes: (a) a review of laws to identify situations in which dangerousness is used as a criterion; (b) a study of consecutive cases of patients admitted against their will to mental hospitals and of individuals on whom the courts request psychiatric reports; and (c) a study of the reliability and reasons for dangerousness assessment made by various professional groups and based on a standard set of case histories.

Statistical analysis of interdependence of country health resource variables, with special regard to manpower-related ones

Abstract: The analysis reported here was the latest in a series of efforts to clarify the relative importance of the health system and of socioeconomic factors to a nation's general level of health. The study has also quantified national and regional deviations from the general pattern as a basis for selective investigation of the effects of planned interventions.The analysis was unusually comprehensive in that it included 131 WHO Member States. As in a number of other studies, socioeconomic factors were found to account for much of the national variation in life expectancy. Inclusion of health resource variables added a special lagged effect which ultimately accounted for 90% of life expectancy variation. Evidence was also obtained that socioeconomic factors may operate partially through the development of health resources. It appears, therefore, that though socioeconomic factors are necessarily linked to health improvement, they are not sufficient in the absence of corresponding development of a viable health services infrastructure.Residual deviations from the general pattern varied systematically by WHO region in 30% of the cases. Most notably, in the African Region the number of physicians is well below even the modest level expected on the basis of the socioeconomic situation in the region. There is, however, considerable variation within individual countries, and it was not possible to find any significant relationship between the WHO manpower development programme and the national health resource parameters. It is therefore concluded that statistical analysis is of limited applicability in this field.

A community-based hypertension register as a part of a systematic hypertension control project: experiences from the North Karelia project.

Abstract: A community control programme for hypertension was instituted during 1972 and 1977 as a major subprogramme of the North Karelia project. The aim was to reduce the high blood-pressure levels prevalent among the whole population of the county of North Karelia. A community-based hypertension register, established according to the recommendations of the WHO, served as a central information system and ensured the continuous follow-up of the hypertensive patients. During the period May 1972 to April 1977 17 014 hypertensive subjects were registered (9-7% of the total population). The registered subjects were followed-up annually. The build-up of the registration system took two to three years, the system proved to be feasible, the percentage of non-participants during the follow-up was between 14 and 16% and the amount of missing data was insignificant.Un programme de surveillance de la population pour l'hypertension fut mis en place de 1972 a 1977 dans le cadre du projet de Carelie du Nord. Le but etait dedimi...

Rapid assessment of air, water, and land pollution sources

Abstract: A procedure is outlined to make a rapid across-the-board estimate of the quantities of air, water and land pollution in a given region or country. Such inventories, though not as detailed as one would eventually need, provide a first integrated view of the magnitude and quantity of pollution and can contribute to effective and comprehensive pollution control planning.

Medical Education in Indonesia

Abstract: Excerpt Indonesia has 13 government medical schools and 10 in the private sector. They produce more than 1200 new graduates each year, of whom more than 90% come from the government schools. In 197...

Esters of 17 α-ethynyl 19-nor-testosterone and 17 α-ethynyl-18-homo-19-nor-testosterone and pharmaceutical compositions containing the same

Abstract: Esters of 17 α-ethynyl 19-nor-testosterone and 17 α-ethynyl-18-homo-19-nor-testosterone and the 3-oximes thereof having long-active contraceptive activity.

Inhibition of Lymphocyte Proliferation With Hepatocellular Carcinoma: Lack Serum Alpha-Fetoprotein Levels

Abstract: Sera from 23 hepatocellular carcinoma (HCC) patients were studied for their effects on lymphocyte proliferation during polyclonal mitogen stimulation and one-way mixed lymphocyte culture (MLC). The effect of 25% HCC serum on tritiated thymidine uptake of cultures varied from slight augmentation to 95% inhibition; however, no relationship was found between the potency of inhibition and serum alpha-fetoprotein (AFP) concentration. Purified AFP from the ascitic fluid of an HCC patient had no effect on MLC or cultures containing pokeweed mitogen; but at a concentration of 200 micro g/ml, AFP inhibited up to 30% of the proliferative responses in cultures containing phytohemagglutinin or concanavalin A. Results strongly suggest that the AFP in HCC sera is not inhibitory in itself.

Brief Reports on All Topics

Abstract: S. typhi strains harboring R plasmids are a common finding in Mexico City hospitals. The predominant R plasmids share the following properties: they belong to the same incompatibility group (H1)’ have a molecular weight of 135 Mdal, carry a temperature sensitive transfer system, and code for the resistance to Cm, Sm, Su, Hg and Tc. The general organization of the resistance genes resembles that of RlOO, since homogenic derivatives which have lost the r-determinants, Tn1O or all the resistance genes can be isolated in vitro by several methods. Furthermore, naturally occurring a-plasmids deleted for the r-determinants or Tn1O have been found, although at low frequency. Complementation experiments indicated that the ts transfer system of the mexican plasmids is not related to that of Flac, Rl-19 or Col Ibdrd.

The relative benefits and risks of hormonal contraception with particular reference to developing countries

Abstract: Publisher Summary This chapter discusses the relative benefits and risks of hormonal contraception with particular reference to developing countries. The actual and perceived relative benefits and risks of hormonal contraception affect the formulation of national policy and regulations, the professional practices of the providers of contraceptive services, and the acceptance and continuation of use of contraceptive methods by couples. In terms of mortality risk, all methods of contraception are safer than unwanted pregnancy until the age group 35–39 years. Beyond the age of 35, women who smoke have a greater risk of dying from the cardiovascular effects of oral contraceptives than as a result of childbirth. The maternal mortality and mortality associated with induced abortion is much higher in most developing countries than in developed countries. Many of the contributing risk factors—such as prolonged oral contraceptive use and smoking—are not important in the developing world. The effect of oral contraceptives on breast milk and their possible effects by transmission to the suckling infant are of growing concern, as many governments are considering initiation of programs of hormonal contraception in the postpartum period.