Experience of Finnish women with Norplant insertions and removals

Objective Norplant® and Norplant-2® have been available for use by Finnish women since 1984 and 1986, respectively. The objective of this study was to explore Norplant users' experiences of insertions, removals and medical treatments.
Design A questionnaire was sent to women who had received Norplant® or Norplant-2® implants one to two years earlier ( n = 262) in normal clinical settings; the response rate was 79%.
Results At insertion, problems were experienced by 9% and at least some pain by 23% of women. During the first year 20% of all users (14% of Norplant® and 33% of Norplant-2® users) had their implants removed. Problems were experienced at removal by 33% of women and pain was experienced by 40%; nevertheless most users were satisfied with the device. Findings were similar for the two types of Norplant. Forty-two percent of the women had received minipills containing levonorgestrel before Norplant insertions in an attempt to assess Norplant's suitability, and 8% had received drugs for adverse effects caused by Norplant.
Conclusions Studies including perspectives of Norplant users and the whole lifespan of Norplant (including removal) should be conducted in all clinical settings where Norplant is provided.     

Northwest African and Middle Eastern food and dietary change of indigenous peoples

This paper describes cultural and ecological characteristics of Northwest African and Middle Eastern food patterns and discusses the forces contributing to rapid dietary change. Focus is given to indigenous/tribal/ethnic/minorities in these areas with contributions to definitions of these groups, the extent of their diversity, and the importance of their traditional knowledge of local food resources. Urbanization, particularly for those facing extreme poverty in the urban environment, is recognized as a significant force to dietary change and consequent poor nutrition, especially for children. Examples of food systems are given for the coastal zone of West Africa and the semi-arid and desert zones of North Africa and the Middle East, also including the food system of Pharaonic times. Trends in dietary change are presented as data derived from FAO Food Balance Sheets.     

Assessment of an on-line computerized perinatal data collection and information system

Summary. An on-line maternity data collection system has been designed to provide the information required for perinatal audit and to allow many of the letters and forms required for effective communication in pregnancy to be produced automatically. The system meets the requirements of the Korner Committee on Health Services Information and has been approved by the Computer Policy Committee. Pregnancy is followed prospectively from the first antenatal clinic visit until the file is closed 28 days after delivery. Data are entered by midwives and secretaries onto a network of microcomputers placed at convenient points in the maternity unit. The system has been fully operational with no significant problems since the beginning of 1984 and has led to improved communication between hospital and the community. Analysis of 253 consecutive case notes showed a high level of accuracy of the data recorded on computer. Reports and clinical audit are readily available both from the system locally, from standard programmes on the regional mainframe computer and via a mainframe computer at London University     

医院信息化与卫生信息立法的思考

随着医院信息系统的不断发展与完善，卫生信息立法问题亟待解决。作者阐述了卫生信息立法在当前医院信息化实践中的迫切性和重要性，指出了医院信息化中涉及法律依据的具体表现。建议：首先要建立健全局域网管理法规；其次要建立健全卫生信息法规体系；第三，加大网络安全保障技术的研制、认证和推广应用；第四，做好过渡时期电子病历的规范应用和管理。