Objectives: To eval uate a South Ausueaan ca mpai gn to prom ote and implemen t knowled ge that takmg adeq uate totateztonc ace in tho perrconcephona l per iod can red uce the risk 01ha ving a baby wll h a neu ral lube detect . Des ign s nd s etting:The ca mpaign, co nd ucted In Octo be r 1994 -Aug us1 1995.tar geted women 01repr od uctive age and health prote ssronars. Evaluat ion was by computer-assisted telephon e interviews undertak en by random dIalling th roug hout the State before and alter the cam paign, and by sett-a dmenste red que snc nnaircs 10 heall h prctess.onars and women ," the postnatal per iod .Partic ipants: Women 01reprod uctive ag e and four group s 01heallh profe ssionals. Ma in outcome measures : Know ledge about folate . tcrete-nch l ood s and the cencc ncepncnar per iod : oerncpanon of health prof essionals in advising wom en abo ut tcrete: usc at peric onceptiona l folic acid s upplements; sales ot lolic acid tab let s; and prevalence of neural l ube defect s , Resuffs : Signi fica nt increas es in know ledge about tota te followed the ca mpaign . Heallh professiona ls and women in the pos tnata l period had highe r in itial leve ls of know ledge about fo late , whic h also Increased signlli canUy. The propo rtion s of womon lak ing penconcap trcnal tone acid supplements , and of healt h professiona ls adVISing women pl ann ing a pregnancy abou t folate , also increased signi fican tly, and tone acid taoiet sales dou bled Total p revalence 01neural tube det ects declined between 1966 a nd 1999 1rom a ba seli ne 012.0 per 1000 births to 1.1 per 1000 births (Po isson regression, P= 0 .03 ; ave rag e decline of 1.0%, per year). Conclusi on s : A sho rt educ atio nal campaign with a Iimifed budg et ($40000) can promote rotate success l ully, but eue rnauve st rateqies such a s lood tc ruucanon ale like ly to be needed to ac hieve adeq uate oe rtccn ceo uc nar tctat e intake lo r a very high propo rtion of women.
Objectives To evaluate a South Australian campaign to promote and implement knowledge that taking adequate folate/folic acid in the periconceptional period can reduce the risk of having a baby with a neural tube defect. Design and setting The campaign, conducted in October 1994 – August 1995, targeted women of reproductive age and health professionals. Evaluation was by computer‐assisted telephone interviews undertaken by random dialling throughout the State before and after the campaign, and by self‐administered questionnaires to health professionals and women in the postnatal period. Participants Women of reproductive age and four groups of health professionals. Main outcome measures Knowledge about folate, folate‐rich foods and the periconceptional period; participation of health professionals in advising women about folate; use of periconceptional folic acid supplements; sales of folic acid tablets; and prevalence of neural tube defects. Results Significant increases in knowledge about folate followed the campaign, Health professionals and women in the postnatal period had higher initial levels of knowledge about folate, which also increased significantly. The proportions of women taking periconceptional folic acid supplements, and of health professionals advising women planning a pregnancy about folate, also increased significantly, and folic acid tablet sales doubled. Total prevalence of neural tube defects declined between 1966 and 1999 from a baseline of 2.0 per 1000 births to 1.1 per 1000 births (Poisson regression, P=0.03; average decline of 1.0% per year). Conclusions A short educational campaign with a limited budget ($40 000) can promote folate successfully, but alternative strategies such as food fortification are likely to be needed to achieve adequate periconceptional folate intake for a very high proportion of women.
A 6-month course for training general practitioners (GPs) in surgical emergencies was developed and piloted in Ethiopia. The course was designed after an assessment of the surgical manpower needs in Ethiopia. Seven GPs were selected by the Ministry of Health (MOH) from rural hospitals that had no surgical specialists but had operating facilities. The course consisted of 1 week of lectures followed by 11 weeks each in obstetrics/gynaecology and general surgery. The GPs trained in district hospitals under the supervision of surgical specialists. Emphasis was placed on practical experience in managing a limited number of previously identified surgical emergencies. Follow up 9 months after completion of the course showed that five of the seven GPs had completed significant numbers of life saving procedures. Complications occurred largely in advanced disease. Difficulties remain with the recognition of the GPs' training and their supervision. We conclude that GPs can be trained to provide life saving surgery in a short training programme at a modest cost, but mechanisms for ensuring ongoing support need to be established.
Recently rediscovered material from the collections and archives of the Oxford University Museum throws new light on the disappearance of the endemic rat Rattus macleari from Christmas Island (Indian Ocean), thought to have gone extinct between 1898 and 1908 as a result of diseases introduced by infected individuals of R. rattus. A collection of rats made by H.E. Durham in 1901-1902 reveals that R. macleari was present on Christmas Island at this time, although in lesser numbers than had been the case when the species was described in 1887. Also present in the collection are specimens of R. rattus, together with a number of rats which exhibit a mixture of characters from both R. rattus and R. macleari. Durham's notes on blood parasites in the Christmas Island rats reveal that in 1901-1902 both R. rattus and some specimens of R. macleari were heavily infested with trypanosomes. Notes deposited in the University Museum archives by Hanitsch (1923) show that R. macleari was no longer present on Christmas Island after 1904. As a result of the authors' observations on the Durham collection and the Hanitsch manuscript, it is proposed that the extinction of R. macleari occurred between 1901 and 1904. During this period, there is evidence for extensive interspecific hybridisation between R. macleari and R. rattus. The selective pressure for such hybridisation may have been parasitisation, resulting from the introduction of trypanosome-infected individuals of R. rattus in a cargo of hay in 1899.
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