Maternal and child health care in Ecuador: Obstacles and solutions

This report analyzes the obstacles to improving maternal and child health care in Ecuador and examines the steps that have been followed to alleviate these problems. The principal factors hindering maternal‐child health program effectiveness are the lack of a grassroots program and insufficient organization development. Several recommendations are made for alleviating these problems in Ecuador's health system, most notably reorganization strategies that support local initiative. This analysis has value for developed and developing countries interested in improving the delivery of maternal‐child health services.     

Community health nursing in an urban day care center.

This paper has endeavored to depict some of the student achievements during community health nursing practice in a less traditional clinical setting, a day care center for infants and toddlers. There appear to have been a number of advantages to such a clinical placement. For one thing, students had the opportunity to devise a package of preventive/maintenance health services for a specific group of healthy children. This they were able to implement in collaboration with the day care center staff and the children's families. In the course of delivering the health services, they learned firsthand the strategies inherent in planning and negotiating among one another. In recognition of the integrity of child health as a component of family health care, they accounted regularly to the parents in both individualized and group fashion. Through the experiences over the course of the quarter, there seemed to be a heightened awareness of the potential for innovative nursing practice in urban communities.     

Interactions of partial LSD analogs with behavioral disrupting effects of LSD and DMT in the rat.

Adult male Holtzman rats were trained to barpress on a schedule whereby every fourth press earned a reward of 0.01 ml of sugar-sweetened milk (FR4). After an i.p. injection of LSD (0.1 mg/kg) or DMT (3.2 or 10 mg/kg) such barpressing is abolished completely and resumed, usually within an hour, at a rate near the preinjection control rate of pressing. It continues at a steady, uninterrupted pace until the animals are removed from the operant chamber one-half hour later. A series of N,N-diethylnipecotamide derivatives were synthesized and tested for their ability to modify the disruptive effect of these hallucinogens. N,N-diethylbutyramide (DBA) and 1-methyl-1,2,5,6-tetrahydropyridine-3-(N,N-diethylcarboxamide) (THPC) were also tested. Pretreatment with a single i.p. injection of any of these compounds (5--40 mg/kg) either had no effect on or else prolonged the duration of hallucinogen-induced cessation of barpressing.     

Males have larger skeletal size and bone mass than females, despite comparable body size.

Gender differences in fractures may be related to body size, bone size, geometry, or density. We studied this in 18-year-old males (n = 36) and females (n = 36) matched for height and weight. Despite comparable body size, males have greater BMC and BMD at the hip and distal tibia and greater tibial cortical thickness. This may confer greater skeletal integrity in males. INTRODUCTION: Gender differences in fractures may be related to body size, bone size, geometry, or density. We studied this in males (n = 36) and females (n = 36; mean age = 18 years) pair-matched for height and weight. MATERIALS AND METHODS: BMC, bone area (BA), and BMD were measured in the spine and hip using DXA. Distal tibia was measured by pQCT. RESULTS AND CONCLUSIONS: Males had a higher lean mass (92%) compared with females (79%). No gender differences were observed for vertebral BMC or vertebral height, although males had greater width and thus BA at the spine. Males had greater BMC and BA at the femoral neck and total femur (p < 0.02). Geometric variables of the hip including neck diameter and neck-axis length were also greater in males (p < 0.02). There was greater cross-sectional moment of inertia, safety factor, and fall index in males (all p < 0.02). Males had greater tibial BMC, volumetric BMD, and cortical area and thickness compared with females (p < 0.01), with both greater periosteal circumference (p = 0.011) and smaller endosteal circumference (p = 0.058). Statistically controlling for lean mass reduced gender differences, but males still had 8% higher hip BMD (p = 0.24) and 5.3% higher total tibial BMD (p = 0.05). A subset of males and females were matched (n = 14 pairs) for total hip BA. Males in this subset still had greater BMC and BMD at the total hip (p < 0.05) than females, despite similar BA. In summary, despite comparable body size, males have greater BMC and BMD than females at the hip and distal tibia but not at the spine. Differences in BMC and BMD were related to greater cortical thickness in the tibia. We conclude that differences in bone mass and geometry confer greater skeletal integrity in males, which may contribute to the lower incidence of stress and osteoporotic fractures in males.     

Intradural-extramedulläre Raumforderung thorakal

Ohne Zusammenfassung