Systematics of species referred to the genus Angiostrongylus

Based on morphological criteria of the male bursa, angiostrongylid nematodes often placed in the genus Angiostrongylus Kamensky (1905) were found to be heterogeneous, comprising species which are relegated to 5 distinct genera: Angiostrongylus Kamensky, 1905 (syn. Haemostrongylus Railliet and Henry, 1907); Parastrongylus Baylis, 1928 (syn. Pulmonema Chen, 1935, Rattostrongylus Schulz, 1951, Morerastrongylus Chabaud, 1972, Chabaudistrongylus Kontrimavichus and Delyamure, 1979); Angiocaulus Schulz, Orlov and Kutass, 1933; Gallegostrongylus Mas-Coma, 1977 (syn. Thaistrongylus Ohbayashi, Kamiya and Bhaibulaya, 1979 n. syn); and Stefanskostrongylus Drozdz, 1970. These genera all contain species located primarily in specific host groups: Angiostrongylus in carnivores; Parastrongylus in rodents (Muridae), Angiocaulus in mustelids; Rodentocaulus in rodents (Cricetinae), Gallegostrongylus in rodents (Muridae), and Stefanskostrongylus in insectivores. Species in each genus include: Angiostrongylus (A. vasorum, A. raillieti, A. chabaudi); Parastrongylus (P. tateronae, P. cantonensis, P. mackerrasae, P. sandarsae, P. sciuri, P. petrowi n. comb., P. dujardini, P. schmidti, P. costaricensis n. comb., P. malaysiensis n. comb., P. ryjikovi n. comb., P. siamensis n. comb.); Angiocaulus (A. gubernaculatus, A. ten n. comb., A. sp. Caballero, 1951); Rodentocaulus (R. ondatrae) and Gallegostrongylus (G. ibicensis, G. andersoni, G. harinasutai n. comb.). Angiostrongylus pulmonalis is likely similar to Stefanskostrongylus soricis and is transferred to this genus. Angiostrongylus minutus is removed to Stefanskostrongylus.     

Epilogue. Establishment of the Center for Chronic Disease Prevention and Health Promotion

The establishment of the Center for Chronic Disease Prevention and Health Promotion (CCDPHP) at the Centers for Disease Control (CDC) following the Conferences on the State of the Art in Quality Control Measures for Diagnostic Cytology Laboratories is briefly discussed. The CCDPHP is expected to play a major role in the CDC's cancer control program, including participation in establishing effective screening programs and assuring the quality of such methodologies as the Papanicolaou test and mammography.     

Analysis of motivation to contraceptive use applying the weighting procedure

This paper presents a technique for scaling contraceptive use motivation for the sample population of the Family Planning Health Services Project in Matlab. The project, which began in 1977, is conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh. The hypothesis of the research is that through the use of a scaling algorithm the power of demographic characteristics, attitudes, and intentions for predicting contraceptive use can be enhanced. The analysis shows that two factors explain use motivation. Scale 1 is weighted for demographic variables and desire for additional children, while Scale 2 is comprised of education and intentions of contraceptive use. Both scales have a pronounced independent predictive power. We conclude that scaling has improved upon the predictive power of indicators of reproductive motivations.     

Immunity to rubella in women of childbearing age in the United Kingdom.

In the first three years of a surveillance scheme for susceptibility to rubella in women aged 15-44 the results of over 1.3 million serological tests were collected by 80 laboratories throughout the United Kingdom. Seventy eight per cent of the results, or an average of 340,000 a year, were from pregnant women, so that just under half of all pregnant women in the United Kingdom were reported on. Eighteen per cent of results were from women tested before vaccination and the remainder were from diagnostic and other tests. Pregnant women showed an overall downward trend in susceptibility to rubella (from 4.2% at the beginning of 1984 to 3.0% at the end of 1986), and a similar decline was seen in the two other categories. Regional data showed a significant negative correlation between the proportion of pregnant women aged 15-19 who were susceptible to the virus and rate of uptake of vaccine in 14 year old schoolgirls. Women aged 25-29 were least susceptible. This form of laboratory surveillance is feasible and representative; it should be continued to monitor the effect of introducing the measles, mumps, and rubella vaccine.     

Malignant hypertension in women of childbearing age and its relation to the contraceptive pill.

Eleven of 34 women aged 15-44 with malignant phase hypertension were taking oral contraceptives at presentation. All had had normal blood pressure before starting to take the pill. In four the interval between the start of oral contraception and the diagnosis of malignant hypertension was less than four months, and in eight no other cause for the hypertension was found. Underlying renal disease and renal failure were less common among pill users than among non-users with malignant hypertension who were of similar age. No pill user became normotensive after withdrawal of the pill, but blood pressure was well controlled (diastolic less than 90 mm Hg) in three patients taking only one drug. By contrast, all 23 non-users needed two or more antihypertensive drugs to control blood pressure. Ten year survival was 90% among pill users and 50% among non-users. These results suggest that oral contraceptives may be a common cause of malignant hypertension in women of child-bearing age. If the pill is stopped and underlying renal disease excluded the long term prognosis for such patients is excellent.     

Measuring Health System Strengthening: Application of the Balanced Scorecard Approach to Rank the Baseline Performance of Three Rural Districts in Zambia

Introduction

There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia.

Methodology

The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan.

Results

Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children''s clinical observation scores were negatively correlated with drug availability (coeff −0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03).

Conclusion

The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery performing poorly in all study districts. This tool could be valuable in monitoring and evaluation of health systems.     

DAP12 couples c-Fms activation to the osteoclast cytoskeleton by recruitment of Syk

We examined the mechanism by which M-CSF regulates the cytoskeleton and function of the osteoclast, the exclusive bone resorptive cell. We show that binding of M-CSF to its receptor c-Fms generates a signaling complex comprising phosphorylated DAP12, an adaptor containing an immunoreceptor tyrosine-based activation motif (ITAM) and the nonreceptor tyrosine kinase Syk. c-Fms tyrosine 559, the exclusive binding site of c-Src, is necessary for regulation of DAP12/Syk signaling. Deletion of either of these molecules yields osteoclasts that fail to reorganize their cytoskeleton. Retroviral transduction of null precursors with wild-type or mutant DAP12 or Syk reveals that the SH2 domain of Syk and the ITAM tyrosine residues and transmembrane domain of DAP12 mediate M-CSF signaling. Our data provide genetic and biochemical evidence that uncovers an epistatic signaling pathway linking the receptor tyrosine kinase c-Fms to the immune adaptor DAP12 and the cytoskeleton.     

Population programs for the detection of couples at risk for severe monogenic genetic diseases

Population genetic screening programs for carrier detection of severe genetic disorders exist worldwide, mainly for beta-thalassemia. These screening programs are either mandatory or voluntary. In several Arab countries and Iran, the state has made thalassemia carrier detection mandatory, while tests for detecting carriers are required by the religious authorities in Cyprus. In all the existing mandatory genetic screening programs, the couples have to get the information about the tests before marriage, but the decision whether or not to marry is left to them. Voluntary programs exist for instance in several Mediterranean countries for the prevention of thalassemia and for several genetic diseases among Jews. While voluntary programs leave the decision to be screened or not to the individual, a major problem is that in many cases awareness about the existence of screening tests is very sparse. Some programs, for instance in Canada or Australia, therefore provide education about genetic tests and screening at school in order to allow the individuals to be able to make an informed decision about their reproductive choices. This article represents the opinions of the author and not necessarily those of the Ministry.