Primary school health education: a practical project for a small hospital community health department

A pilot project in a rural district of Tamil Nadu, India in which health is taught as a subject in primary schools by hospital-based staff is described.     

Prevaccination serologic screening for measles in health care workers

A model was developed from which the cost-effectiveness of prevaccination serologic screening for measles could be estimated, for any combination of antibody screening costs and prevalence of antibody to measles. This model was tested using sera obtained prospectively from 222 health care workers, including 181 born in or after 1957 who had no history of measles, no measles vaccine after 1980, and no documentation of immunity to measles. In addition, 41 subjects born before 1957 who had no history of measles were studied. A rapid, reliable, and inexpensive ($5 per test) commercial ELISA was used to test for antibodies to measles; its seroprevalence in the subject population was 86%. From the model, it was estimated that prevaccination serologic testing would be cost-effective if antibody screening cost less than or equal to $12.75 per test. In this subject population, prevaccination serologic screening for measles was cost-effective.     

Primary health care as an instrument of development in Mexico

A Primary Health Care (PHC) score is obtained by averaging thirteen indicators of PHC of each state of Mexico with data of 1985. Some correlations between the PHC score with other indicators of development, such as education and urbanism, are analyzed. The socioeconomic and educational status of women impinge directly in the processes of PHC. Based upon results of basic research some features of coverage and selectivity of PHC strategies are analyzed.     

Wolbachia-induced cytoplasmic incompatibility as a means for insect pest population control

Biological control is the purposeful introduction of parasites, predators, and pathogens to reduce or suppress pest populations. Wolbachia are inherited bacteria of arthropods that have recently attracted attention for their potential as new biocontrol agents. Wolbachia manipulate host reproduction by using several strategies, one of which is cytoplasmic incompatibility (CI) [Stouthamer, R., Breeuwer, J. A. J. & Hurst, G. D. D. (1999) Annu. Rev. Microbiol. 53, 71-102]. We established Wolbachia-infected lines of the medfly Ceratitis capitata using the infected cherry fruit fly Rhagoletis cerasi as donor. Wolbachia induced complete CI in the novel host. Laboratory cage populations were completely suppressed by single releases of infected males, suggesting that Wolbachia-induced CI could be used as a novel environmentally friendly tool for the control of medfly populations. The results also encourage the introduction of Wolbachia into pest and vector species of economic and hygenic relevance to suppress or modify natural populations.     

Perceived control as a buffer in the use of health care services.

Gerontologists are increasingly interested in the notion of perceived personal control because such perceptions can be threatened by age-related changes such as declining health and the loss of loved ones. Although a great deal is known about the central role of perceived control in healthy, successful aging, less is known about its potential role in specific contexts such as the use of health services. Our study examined the link between perceived control and patterns of health service use among older individuals with arthritis. We assessed perceived control during an interview, using both a domain-specific and a global measure, and considered health service use in the subsequent year. Even after statistically adjusting for age and morbidity, individuals who perceived low levels of control subsequently were found to use more health services than their high-control counterparts; they visited their physicians more often, had more laboratory tests, and stayed longer in the hospital. This was true, however, only for individuals who had also reported that their arthritis restricted the things they were able to do. Various interpretations are considered, including the possibility that patients with low perceived control are inefficient users of health services or that patients with high perceived control experience a deficiency in health care.     

Primary health: handle with care

The concept of primary health care is inherently vulnerable. It seems ironic that the very needs that necessitate the proposal of PHC solutions may also inhibit the effective implementation of those solutions. The reasons are numerous. Such villages may have poor cash economies, supervision and supply are more difficult, and workers are more difficult to find. The expectation had been that relative isolation would imply a greater need for health services, and that once offered, acceptance of village health posts would be highest in areas most dependent on them. This would not appear to be so. Community involvement is arguably the most difficult part of PHC to put into effect. Since 1974, the Lardin Gabas Rural Health Program of the Church of the Brethren Mission has been training village health workers from 119 villages in northeastern Nigeria. From 1976, the scheme was introduced, with few modifications, to the central plateau region by the Church of Christ in Nigeria Rural Health Program, in a further 33 villages. The ingenious teaching techniques--using parables and local stories, drama, songs and riddles to convey health messages--have received considerable international exposure in the literature, but little attention has been given to the pratical difficulties experienced in actually establishing and maintaining the program. The purpose of this paper is not to detract from the worth of village health schemes; the teaching methods are both sound and appropriate, the aims are worth pursuing, the need for such services great. However, it is necessary to point out that the primary health care approach, by its very nature, needs to be sensitive to the individual social and cultural situation in which it is to be implemented.