Rural health care looks to the future. Issues in the institutionalization and management of rural health care: making technology appropriate

Experimental projects have demonstrated the technical feasibility of systems of accessible, affordable health care. These projects have relied extensively on non-professional community health workers. However, large-scale implementation of these schemes will require new management procedures that are both responsive to rural health needs and congruent with national institutions. This paper identifies the need to establish institutional mechanisms to mobilize essential inputs, promote acceptance by beneficiaries, maintain quality standards, recruit and retain field staff, and achieve accountability for resources. It then outlines methods for developing these institutions. It stresses the need for both formal, bureaucratic organizations and informal organizations of clients. It also identifies the need to consider administrative and institutional resources in determining the appropriateness of a health care technology.     

An optical method for the determination of the isotopic composition of 1H2O/2H2O mixtures: Eu3+ luminescence lifetimes

A spectroscopic method employing pulsed dye laser instrumentation is described for the determination of the 1H2O/2H2O composition of aqueous solutions by the measurement of reciprocal excited state lifetimes of EuEDTA-. The reciprocal lifetimes, gamma-1, of the 1H2O/2H2O mixtures increase linearly with the mole fraction of 1H2O. For EuEDTA- the relationship between gamma-1 and the mole fraction, chi H, of 1H2O in 1H2O/2H2O mixtures is expressed by the equation chi H = 0.37 gamma-1-0.152, with a sensitivity in chi H of +/- 0.02. The reciprocal lifetimes are independent of pH in the range 5.1 to 10.5, changes in ionic strength, and the type of buffer used in EuEDTA- containing solutions.     

Zingiberanamalayanum sp. nov. (Zingiberaceae) from India

Zingiber anamalayanum (Zingiberaceae), a new species from the southern western Ghats, India is described and illustrated. A phenetic analyses to assess the similarity indices and the uniqueness of the new species have been performed. A diagnostic key to Zingiber spp. in south India is provided.     

Sequence Determinants of GLUT1 Oligomerization: ANALYSIS BY HOMOLOGY-SCANNING MUTAGENESIS*

The human blood-brain barrier glucose transport protein (GLUT1) forms homodimers and homotetramers in detergent micelles and in cell membranes, where the GLUT1 oligomeric state determines GLUT1 transport behavior. GLUT1 and the neuronal glucose transporter GLUT3 do not form heterocomplexes in human embryonic kidney 293 (HEK293) cells as judged by co-immunoprecipitation assays. Using homology-scanning mutagenesis in which GLUT1 domains are substituted with equivalent GLUT3 domains and vice versa, we show that GLUT1 transmembrane helix 9 (TM9) is necessary for optimal association of GLUT1-GLUT3 chimeras with parental GLUT1 in HEK cells. GLUT1 TMs 2, 5, 8, and 11 also contribute to a less abundant heterocomplex. Cell surface GLUT1 and GLUT3 containing GLUT1 TM9 are 4-fold more catalytically active than GLUT3 and GLUT1 containing GLUT3 TM9. GLUT1 and GLUT3 display allosteric transport behavior. Size exclusion chromatography of detergent solubilized, purified GLUT1 resolves GLUT1/lipid/detergent micelles as 6- and 10-nm Stokes radius particles, which correspond to GLUT1 dimers and tetramers, respectively. Studies with GLUTs expressed in and solubilized from HEK cells show that HEK cell GLUT1 resolves as 6- and 10-nm Stokes radius particles, whereas GLUT3 resolves as a 6-nm particle. Substitution of GLUT3 TM9 with GLUT1 TM9 causes chimeric GLUT3 to resolve as 6- and 10-nm Stokes radius particles. Substitution of GLUT1 TM9 with GLUT3 TM9 causes chimeric GLUT1 to resolve as a mixture of 6- and 4-nm particles. We discuss these findings in the context of determinants of GLUT oligomeric structure and transport function.