Community-based research for promoting the new public health

The rhetoric of the new public health urges a focus on healthpromotion achieved through policy and structural change, andplaces emphasis on primary health care services based on communityinvolvement. Research should contribute to the implementationof such policies at the local level. Methods for community-basedresearch, however, are not well developed. This article, drawingon the experiences of a South Australian community health researchunit, describes approaches that can make research (especiallyneeds assessment and evaluative research) more relevant anduseful. The factors discussed include the relationship betweenresearchers, service providers and service consumers, and appropriateresearch methodologies for community research.     

Hypotension--does it Make Sense in Family Practice?

In general practice many diagnostic labels are used that arerelated to cultural background rather than a scientific basis.To estimate the use of diagnoses like ‘hypotension’and depression, a cross-sectional survey in German and BritishGPs' surgeries was performed. Prevalence of related symptoms,socio-demographic and medical data were recorded as well asactual and previous blood pressure levels. In German generalpractice, where ‘hypotension’ is an establishedentity, 17% of all patients attending were reported as hypotensiveeither by their doctor or by themselves. The proportion wastwice as high among women than among men. It was more commonamong the young. One-quarter of these patients were on medicationto raise their blood pressure. Actual and previous blood pressurelevels failed to explain the occurrence of symptoms like tiredness,dizziness, headache etc. Demographic characteristics of patientsdiagnosed as depressed were similar in both countries. Presumablyfor economic reasons there is a tendency for German GPs to usemore diagnostic labels of any kind. It was concluded that diagnosticlabels attached to vague but frequently presented symptoms varyconsiderably between countries. They often lack a physiologicrationale. Nevertheless they often support the tendency to somatizecommon problems.     

Compensation for jaw fixation by aphasic patients under conditions of increased articulatory demands: a follow-up study

This investigation explored the ability of eight non-fluent aphasic patients and 10 normal control speakers to compensate for fixation of the jaw by a bite block in the productionof vowels and fricative consonants.The articulatory demands were increased relative to production of isolated syllables by eliciting stimuli five times in succession at a rapid rate of speech. Acoustic analyses of the vowels and fricatives revealed comparable patterns in both speaker groups, demonstrating (incomplete) compensation for the bite-block perturbation. The results confirm earlier findings of relatively normal articulatory compensation in non-fluent aphasic patients, extending them to conditions of increased articulatory demands. Implications for the role of left hemisphere cortical structures in speech adaptation are briefly considered.     

The neural bases of prosody: Insights from lesion studies and neuroimaging

This paper reviews the major findings and hypotheses to emerge in the literature concerned with speech prosody. Both production and perception of prosody are considered. Evidence from studies of patients with lateralized left or right hemisphere damage are presented, as well as relevant data from anatomical and functional imaging studies.     

DONOR BREAST MILK

Baum, J. D. (University Department of Paediatrics, John Radcliffe Hospital, Oxford, U.K.). Donor breast milk. Acta Paediatr Scand, Suppl. 299:51, 1982.—A simple system for the collection and storage of human milk, as a voluntary community activity, is described. The case is made for prefering drip breast milk as the main source of human milk for the milk bank. The central place of precise pasterurisation is emphasised as the essential feature for maintaining bacteriological quality control and simplicity of organisation. The suitability of donor breast milk for the nutrition of the low birthweight infant is discussed and evidence presented to indicate that low birthweight infants fed exclusively on donated human milk are of similar size to control term infants when assessed at 18 months corrected postnatal age. Emphasis is placed on the importance of controlled trials in relation to all innovations in feeding of low birthweight infants.