Beliefs about worry and intrusions: the Meta-Cognitions Questionnaire and its correlates

In 1995 the World Health Assembly voted to launch a global program for the eradication of malaria. The program lasted fourteen years. Though it was successful in a number of countries, eradication failed in most of the developing world. Studies that have examined the failure of malaria eradication have focused on the various technical, organizational, and financial problems which hampered the program. While these critiques are valid, they lose sight of the wider political, economic and cultural context within which eradication was conceived and executed. Malaria eradication was a product of a postwar vision of economic and social development and needs to be examined in this context. Many of the problems that plagued eradication efforts flowed from this intense association between eradication and "development".     

A land filled with mosquitoes: Fred L. Soper, the Rockefeller Foundation, and the anopheles gambiae invasion of Brazil

The success of Fred Soper and the Rockefeller Foundation's International Health Division in eradicating the anopheles gambiae mosquito from Northeast Brazil was a significant watershed in the history of malaria control. It revived faith in vector control strategies and paved the way for the application of eradication methods in the fight against malaria following World War II. Yet Soper's achievement needs to be re-examined from a wider analytical perspective that takes account of the longer epidemiological history of malaria in northeast Brazil and the wider social and economic context within which malaria occurred. This wider perspective suggests that the origins of the 1938/39 malaria epidemic were much more complex than Soper acknowledged. By focusing narrowly on the anopheles gambiae mosquito and its eradication. Soper failed to understand this broader context. This myopia, in turn, permitted Soper to make claims for both the scale of his achievement and its importance for the future of malaria control which were unjustified.     

Cognition and the global Malaria Eradication Programme

When making a decision involves the analysis of complex cause-effect relationships, experts are normally consulted to describe the best options available. The global Malaria Eradication Programme relied upon the advice of a small group of experienced malariologists; their counsel directed the most ambitious endeavour in the history of the World Health Organisation. In this essay 1 week to show how that group behaved with a single purpose and ultimately grew to be greater than the sum of its parts because of the control of knowledge. Each member of this epistemic community was willing to battle against malaria as soon as possible--forsaking research, traditional tools, and risking disastrous epidemics--because they believed that residual insecticides could progressively eradicate a disease that killed millions and sapped the lives of countless more. Alternative methods were ridiculed; and the epistemic community used their individual prestige to insert the DDT gospel into the technical forums of the WHO, and the power (and money) forums of the USA. Particular knowledge structures of the post-war decade nurtured a technical solution to malaria, and we shall explore how the WHO and the epistemic community could grow within this environment so compatible to their praxes.     

For WHO or for whom?

The World Health Organization (WHO) is moving forward in its drive to eradicate poliomyelitis and it believes that dracunculiasis can be eliminated by the year 2000. Leprosy, river blindness, Chagas disease, and filariasis can also be eliminated as public health problems within 10 years given the requisite additional investment. While WHO's international public health goals and achievements are both laudable and necessary, WHO's success in changing people's thinking is most likely the organization's most valuable influence. WHO has fostered a shift away from secondary and tertiary care to more primary health care, the provision of safe water, and intersectoral health promotion. The next director general of the World Health Organization must address the need to decentralize WHO and delegate control to regions. Moreover, greater organization and efficiency must be brought to the World Health Assembly so that conference delegates, the press, and attending nongovernmental organizations can have more fruitful interaction.     

Community dentistry: rationale

The present curricula in dentistry are biased in favor of cure and technical capability ... individualism rather than promotive, preventive and community orientation. The team "approach" and "total patient care" concepts must be given emphasis in these curricula. Dentistry, being a profession, should accentuate service, rather than materialism and profit. The Philippine situation demands than adoption of a "New Horizon in Health" which emphasized positive health as part of human development. The educational system, organized dentistry, the licensing board, the legislators, policy makers, oral health providers and research formulators will have important roles to perform in the successful implementation of this "new horizon in health" concept. "Primary Health Care" is another strategy adopted to realize the global goal of "Health for all by Year 2000". This is a positive approach for both individual and community oral health intervention programs.     

Mosquitoes or malaria? Rockefeller campaigns in the American South and Sardinia

Most members of the International Health Division of the Rockefeller Foundation remained convinced that diseases were the fundamental cause of human poverty and underdevelopment and that destruction of the larval stages of vector mosquitoes was the cheapest and most effective way to eliminate one of the most important of such diseases, malaria. But the validity of both their assumptions remains in question despite campaigns in the American South and elsewhere during the 1920s and 1930s and an unsuccessful attempt at "species eradication" in Sardinia immediately after World War II.     

Toward ICD-11: Improving the clinical utility of WHO's International Classification of mental disorders.

This article describes the current revision by the World Health Organization (WHO) of the International Classification of Diseases and Related Health Problems (ICD-10). ICD-10 is the basis for ICD-10-CM, which will be introduced in 2013 as the official U.S. system. U.S. psychologists will be required to use ICD-10-CM for all third-party billing and reporting, but are generally not familiar with the ICD or WHO's role in global health classification. Although the U.S. lags behind other countries on the implementation of WHO's international classification systems, psychologists and other health professionals will be affected by ICD-11, so it is important to understand its development. WHO views the current revision as an important opportunity to improve the clinical utility of the classification system for mental disorders. Serious problems with the clinical utility of both the ICD and the DSM are widely acknowledged. Clinical utility affects the daily lives of practitioners and is also a global public health issue. Most people with mental disorders worldwide receive no treatment. A diagnostic system with greater clinical utility can be a tool to improve identification and treatment, helping WHO member countries to reduce the disease burden of mental disorders. Consistent with this goal, WHO's revision process is global, multilingual, and multidisciplinary and will produce different versions of the classification for clinical use, research, and primary care. A systematic program of studies being undertaken by WHO aimed at improving clinical utility is described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Modulation of the induction of ornithine decarboxylase by some opioid receptor agonists in immune cells and cardiomyocytes

The use of synthetic antimalarial compounds played a secondary role to the use of residual insecticides in post World War II antimalarial control and eradication campaigns. The discovery of chloroquine-resistant malaria in South East Asia and South America prompted an intensification of antimosquito measures, rather than a thorough investigation of resistance. It was the failure of the antimosquito measures which primarily called a halt to malaria eradication and a return to control. A focus on the role of synthetic antimalarials in Thailand thus aims to provide a complementary view to those histories being constructed around the antimosquito measures.     

Mathematical modeling of platelet survival with implications for optimal transfusion practice in the chronically platelet transfusion-dependent patient

Even now 50% of the world population are still living in malaria endemic areas and every year 200 million new cases with 2 million deaths are reported. Most of the malaria deaths are children under 5 years old. Although malaria endemicity currently exists mainly in tropics, before the human started its efforts to eradicate malaria in large scale in 1950s, malaria was more widely distributed in the world. At this time Japan and malaria together with North America and European countries. However some areas were precluded from malaria endemicity: i.e., high mountains and deserts. Also Polynesian islands in the Pacific have never been malarious, even though Melanesian Papua New Guinea, Solomon, and Vanuatu are highly malarious even now. Human disease malaria is caused by Plasmodium parasites and transmitted by Anopheles mosquitoes. Human is classified into the malaria donor and recipient. The environment is supporting this system: for example, temperature and rainfall are important factors together with vegetation, or housing, health infrastructure, war situation, and poverty status. In 1950s, the WHO malaria eradication program focused its efforts on vector control, using DDT-residual spraying. But the program completely failed with mainly operational reasons and we already learned it is almost impossible to control malaria only killing mosquitoes. In 1992 the new Global Malaria Control Strategy adopted by Malaria Summit at Amsterdam says the primary objective is early diagnosis and treatment to prevent malaria death. In this context malaria chemotherapy is a key issue. Also we understand more and more the environmental management is very important. Malaria vaccine may be a conceptually important tool, but may be available soon.     

Disease eradication as a public health strategy: is measles next?

Following the failure of disease eradication efforts in the first half of this century, the success of smallpox eradication and the ongoing initiatives against poliomyelitis and dracunculiasis are re-establishing eradication as a viable disease control strategy. The perpetual benefits of eradication, together with the positive impact that such initiatives can have on health services in general, are changing the world's perception of these endeavours. Among the most obvious examples of this changing trend is the recent enthusiasm in both industrialized and developing countries for re-exploring the eradicability of measles. Increasingly, it appears that measles, the single leading cause of vaccine-preventable childhood morbidity and mortality worldwide, may be the next major organism targeted for global eradication.     

Conforming strategies of public health campaigns to disease specificity and national contexts: Rockefeller Foundation's early campaigns against hookworm and malaria in Brazil

The early experience of Rockefeller Foundation in Brazil, starting in 1915, reflected the idea of extending learned experience in Southern US to a wide international context. Health education and the creation of permanent local health services were expressed as main guidelines for cooperation with State and federal Brazilian agencies. Translating to the shaping of public health models the terms of scientific hygiene associated with the pastorian revolution, RF pictured different actions as part of a three step rationale of survey, experiment and demonstrations. In this paper we focus on Lewis Hackett's campaign, designed as a demonstration campaign of the "intensive method" of hookworm control, with the final purpose of enlisting local agencies in long-term action (1919-1924) and the malaria campaign in Rio de Janeiro State Lowlands (1922-1928) led initially by Mark Boyd as an "experimental control work" of field observation, campaign, control and maintenance to set guidelines to malaria control in tropical areas. The course and ultimate results of these experiences showed the need to adapt formal models to complex national and State-building context and to disease specificity, leading to pragmatic adaptations in the issue of control and eradication and on the shaping of vertical and horizontal health services. The failure of these two experiences in terms of disease control helped to strengthen the move, predominant in the next two decades, to vertical campaigns with least dependency on local social and political dynamics, as in the exemplar case of Frederick Soper's Anopheles gambiae eradication campaign (1938-1942).     

Micro-sequencing strategies for the human A33 antigen, a novel surface glycoprotein of human gastrointestinal epithelium

At the end of the XIXth Century the attitude towards malaria changed dramatically from fatalism and resignation to an active policy that made the eradication of the disease a possible objective. This dramatic change in the scientific political and cultural attitudes towards malaria was the result of two main phenomena: i) the impact of the scientific medicine and Pasteurian revolution on medicine and health policies, and ii) the discovery of the theoretical simplicity of the cycle of malaria transmission and of the possibility to interrupt it, by avoiding the contacts between people and the Anopheles mosquitoes. However, scientifically based strategies against malaria were in place before the discovery of the real causative agents and of the transmission cycle at the end of the XIXth century, as the origin of the scientific medicine had already produced a 'rationale' for local and national campaigns against malaria. According to Tommasi-Crudeli, for example, the cause of malaria was not a 'chemical compound', a 'miasma', but a 'living ferment', specific and autonomous. As a consequence, the aim of antimalarial measures was to eliminate the conditions indispensable to the multiplication of the specific ferment contained in the soil. The theory of malaria aetiology changed after the discovery of the transmission cycle by Ross and Grassi, but the general strategy remained the same: to eliminate one of the factors indispensable to the multiplication and diffusion of the agent. The detailed knowledge of the malaria transmission cycle made it possible to define the exact conditions which were alone responsible for the propagation of the disease and its persistence in the endemic areas. The theoretical linearity and the specificity of the 'Grassi's law' was decisive and produced a fundamental paradigmatic shift in the antimalarial policies. The essential point for the epidemiology and prophylaxis of malaria became to clarify the conditions which contribute to facilitate or to prevent the infection of the Anopheles.     

Identification of volatile organic compounds emitted in the field by oilseed rape (Brassica napus ssp. oleifera) over the growing season

There is currently a trend gaining acceptance that explicitly recognizes the need to set priorities for making rational decisions in health policy, respecting at the same time the underlying purpose of health care - to improve people's health. This trend in health policy is referred to as "health targets" although definitions vary considerably. Having been initiated by the World Health Organization in the late 1970s, the international policy on health targets is in the process of renewal to become Health for All in the Twenty-First Century. The new program highlights 10 global targets, from the reduction of worldwide burden of diseases to improvement of access to comprehensive, essential quality care. Countries such as the United Kingdom and Australia have adopted and implemented such programs which basically include cardiovascular, cancer, accidents, and mental health targets. For many countries, however, there are several difficulties in establishing similar programs. One of them is the unavailability of reliable data, although political factors and structure of health systems also play a key role in the creation of health targets. Overall, health targets appear to be a key element in building a strong public health policy, taking into consideration not only the cost of healthcare, but also the outcomes in improving health which is the ultimate goal of health care systems.     

Aging, research on aging, and national policy: A conversation with Robert Butler.

Reports on an interview with R. N. Butler (August 10, 1982), who was the first director of the National Institute on Aging (NIA), from 1976 to 1982. Butler speaks about the federal role on aging research in the "post-Butler" era (following his resignation from NIA), stressing the importance of behavioral science. He suggests that the National Institute of Health may support more behavioral research than the Alcohol, Drug Abuse, and Mental Health Administration. Butler also expresses views on the 1981 White House Conference on Aging and the 1982 United Nations World Assembly on Aging; the national social, economic, and health policies related to a 4-generational society; nursing home training sites where health care providers can get first-hand experience with the aged; and the role of Medicaid and Medicare in meeting health care cost of the elderly. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Functional outcome assessment of adults with dementia

The demands from health care funding sources for treatment outcome data that will document the benefits of treatment relative to its cost have resulted in the widespread adoption of the World Health Organization International Classification of Impairments, Disabilities, and Handicaps as a useful model for gathering and providing such data. This article examines the literature on functional assessment and the outcomes of interventions for patients with dementia, then discusses current assessment instruments and procedures, the outcome data now available, and the research needs and challenges facing speech-language pathology in documenting the impairments, disabilities, and handicaps of patients with dementia.     

Strategies of the Pan American Health Organization/World Health Organization for the control of iron deficiency in Latin America

Iron deficiency anemia is one of the major micronutrient deficiencies in the world. Its etiology is well understood, and inexpensive solutions to the problem have been identified. Nevertheless, the problem persists. This paper estimates the magnitude of iron deficiency anemia and presents strategies suggested by the Pan American Health Organization of the World Health Organization (PAHO/WHO) for adoption by individual countries.     

The new child health insurance expansions: how will school-based health centers fit in?

In June 1998, the Making the Grade National Program Office and the National Assembly on School-Based Health Care sponsored a workshop on the relationship between the State Child Health Insurance Program (SCHIP) and school-based health centers. Workshop participants used the health centers' experience with Medicaid managed care as a window for understanding their prospects for negotiating contracts with health plans under SCHIP. Speakers representing the federal perspective, state agencies, health plans, and local school-based health centers offered their views on the challenges of developing contracts, incentives, and disincentives that health plans have to contract with school-based health centers, and what has accounted for success where relationships are moving forward. Experiences in Colorado and Connecticut were presented as case studies on these evolving issues.     

An evaluation of surveillance of malaria at primary health care level in Kenya

As less than twenty five per cent of persons suffering from malaria seek formal treatment in most of sub-Saharan Africa, Facility-based morbidity statistics are inadequate for monitoring malaria control programmes. This explorative study assessed whether a health centre equipped with a microscope and trained personnel could monitor malaria transmission within its catchment area. The study was conducted at Chemase Health Centre in Nandi District in Kenya, an area holoendemic for malaria with Anopheles gambiae as the main vector and Plasmodium falciparum as the commonest cause of malaria. From first August to 31 October 1991, first seven children under five years of age on each working day accompanied by their mothers to the maternal and child health clinic were studied. A general examination was performed by a Registered Clinical Officer (Medical Assistant) and thin and thick blood smears made, stained with Giemsa stain and examined for malaria parasites by a Medical Laboratory Technologist. Mothers were interviewed by enrolled community nurses on antimalarial measures they were using in their homes. Four hundred and fifty five children mostly under five years of age, consisting of 48.1% males and 51.9% females, were studied. Malaria parasites were present in 209 (45.9%) blood smears of the children. The percentage of blood smears positive for malaria parasites was high in children below 36 months of age. There was a tendency for low percentage of blood smears positive for malaria in children whose mothers reported using mosquito nets or insecticide sprays. The study did not interrupt the routine of the health centre. Periodic monitoring of new malaria illnesses. and percentage of blood smears positive for malaria parasites in children aged 0 to 35 months should be introduced into health centre practice in Kenya. This catchment area approach could be used to monitor malaria control programmes as well as predicting malaria epidemics.     

Background and prospects of the Community Health Act

Japan was defeated in World War II and almost all of the nation was demoralized by the destruction and damage to much of the nation. The medical and health care system during and before World War II needed to be reformed radically and fundamentally since almost all medical and health institutes were destroyed. On the other hand, many health personnel came back from overseas after the war. Japanese modern medicine had developed on the basis of German medicine; however, many aspects of American medicine, including public health and democracy, were rapidly introduced following the end of World War II. The American type of health center was established and many laws concerning medical and health care were enacted in 1947-1948. One of them was "The Health Center Law." The National Health Insurance Act was enacted in 1958 and the total population has been covered by health insurance plans since 1961. Many physicians quit the health centers and they have worked as clinicians under the National Health Insurance scheme, because health centers were introduced before adequate education and research existed in the field of public health. On the other hand, the health insurance scheme was in its golden age during the high economic growth period of the 1960s. Japan has succeeded in all forms of modern technology and economy for the past 30 years and is now one of the top nations in the field of medical and health care, such as the numbers of clinics and hospitals and beds, the frequency of consulting with a doctor, length of hospital stay, examinee rates in mass health examinations in the community and workplace and so on. Health conditions have changed drastically from the 1950s to the present. Therefore, health centers do not fit current health needs. For example, mortality from tuberculosis, acute infections diseases and also stomach and uterus cancers and apoplexy have decreased rapidly while mortality from chronic diseases, especially lung, breast and rectal cancers, and myocardial infarction have increased gradually. Changes of life style resulting from rapid economic growth are suspected to be important causes of the change in the prevalence of these diseases. Mass health examination was important and effective as a preventive measure against tuberculosis, especially as a means of early detection and early treatment. However, it is not now effective against chronic diseases. The screening examination has resulted in identifying many patients suspected of being ill. Every examiner must be able to distinguish pathologic findings from physiologic changes of aging. Every patient must, therefore, understand his/her individuality and evaluate the result of his/her efforts to improve life style by receiving a health examination. Accordingly, the aim of health examination has changed from early detection to health support for the examinee. During the decades when life expectancy was less than 50 years of age, it was not necessary for people to plan for retirement. Moreover, there was little burden on younger generations to provide care for the aged people because there were few old people more than 70 years of age and the birth rate was high. Nowadays, elderly people face many years of life after retirement and there are too many aged people in relation to the number of younger persons. As for medical care services, many new medical needs have emerged in recent years, including "quality of life," "palliative medicine in terminal care," "establishment of a primary care system" and "comprehensive care connecting health and medical care with welfare" etc. Improved living standards resulting from economic growth, called the "economic miracle" internationally, have helped to bring about a rapid and wide range of change in daily lifestyle, such as eating habits, working conditions and environment. The Ministry of Health and Welfare has made every effort to revise the laws in relation to health and medical care systems, in order to adjust to recent