Searching for solutions: health concerns expressed in letters to an East African newspaper column

This study examined health care questions from an unusual data set: 1252 unsolicited letters written over a three–year period to an advice column in an East African newspaper. Analysis of the letters was a non-intrusive method of ascertaining prevalent health questions and opinions. People wrote seeking information, advice, solutions, and reassurance about health problems. Emotions expressed in the letters ranged from hope to fear and frustration. The written format allowed questions which are generally too embarrassing or stigmatized to present in other public or interpersonal settings. More than half the total letters raised questions about sexual behaviour, sexually transmitted diseases, and HIV/AIDS. The letters present not only personal health concerns, but also expectations of health-care quality and reflections on the medical options presently available in Uganda. As a whole, the letters express dissatisfaction not only with the outcomes of health encounters, but with the process. Of the letter writers with specific physical complaints, more than one-third had already sought medical care and were dissatisfied with the results. The letters were seeking solutions, especially for alleviation of symptoms and discomfort. Almost equally prevalent was a plea for accurate and relevant health information; people not only want to feel better, but they also want to understand their own health

Paris on the Mekong: using the aid effectiveness agenda to support human resources for health in the Lao People's Democratic Republic

Background: This study examines the potential of aid effectiveness to positively influence human resources for health in developing countries, based on research carried out in the Lao People's Democratic Republic (Lao PDR). Efforts to make aid more effective-as articulated in the 2005 Paris Declaration and recently reiterated in the 2008 Accra Agenda for Action-are becoming an increasingly prominent part of the development agenda. A common criticism, though, is that these discussions have limited impact at sector level. Human resources for health are characterized by a rich and complex network of interactions and influences-both across government and the donor community. This complexity provides a good prism through which to assess the potential of the aid effectiveness agenda to support health development and, conversely, possibilities to extend the impact of aid-effectiveness approaches to sector level

Severe Intracranial Hypertension Associated with Tetracycline Use in Non-Small Cell Lung Cancer

Introduction: Erlotinib has become an established treatment for patients with non-small cell lung cancer harbouring an epidermal growth factor receptor (EGFR) mutation.  Tetracycline antibiotics are commonly prescribed for erlotinib-induced acneiform rash.  A rare but morbid complication of tetracycline use is intracranial hypertension, an association which has not been reported in the oncology literature.Presentation of Case: We report a case of severe intracranial hypertension in a patient with non-small cell lung cancer.  Risk factors were prolonged tetracycline use and leptomeningeal carcinomatosis.  Initial investigations were unhelpful, necessitating a high index of suspicion.Conclusion: Tetracycline antibiotics, which are commonly prescribed for erlotinib rash, are an important risk factor for intracranial hypertension.  Our patient developed severe vision loss from papilloedema, despite normal neuroimaging and relatively low opening pressure on lumbar puncture.  Continuous intracranial pressure monitoring can be a valuable investigation in such circumstances

Paris on the mekong: Using the aid effectiveness agenda to support human resources for health in the lao people’s democratic republic

Background This study examines the potential of aid effectiveness to positively influence human resources for health in developing countries, based on research carried out in the Lao People’s Democratic Republic (Lao PDR). Efforts to make aid more effective-as articulated in the 2005 Paris Declaration and recently reiterated in the 2008 Accra Agenda for Action-are becoming an increasingly prominent part of the development agenda. A common criticism, though, is that these discussions have limited impact at sector level. Human resources for health are characterized by a rich and complex network of interactions and influences-both across government and the donor community. This complexity provides a good prism through which to assess the potential of the aid effectiveness agenda to support health development and, conversely, possibilities to extend the impact of aid-effectiveness approaches to sector level. Methods The research adopted a case study approach using mixed research methods. It draws on a quantitative analysis of human resources for health in the Lao People’s Democratic Republic, supplementing this with a documentary and policy analysis. Qualitative methods, including key informant interviews and observation, were also used. Results The research revealed a number pathways through which aid effectiveness is promoting an integrated, holistic response to a range of human resources for health challenges, and has identified further opportunities for stronger linkages. The pathways include: (1) efforts to improve governance and accountability, which are often central to the aid effectiveness agenda, and can be used as an entry point for reforming workforce planning and regulation; (2) financial management reforms, typically linked to provision of budget support, that open the way for greater transparency and better management of health monies and, ultimately, higher salaries and revenues for health facilities; (3) commitments to harmonization that can be used to improve coherence of donor support in areas such as salary supplementation, training and health information management. Conclusion If these opportunities are to be fully exploited, a number of constraints will need to be overcome: limited awareness of the aid effectiveness agenda beyond a core group in government; a perception that this is a donor-led agenda; and different views among partners as to the optimal pace of aid management reforms. In conclusion, we recommend strategic engagement of health stakeholders in the aid effectiveness agenda as one means of strengthening the health workforce

Treatment of Russian Rules for Metallic Constructions

260 σ.Μετάφραση των Ρωσικών κανονισμών για μεταλλικές κατασκευές και η σύγκρισή τους με τον Ευρωκώδικα.Translation of the Russian rules for metallic constructions and their comparison to the Eurocode.Δημήτριος Σ. Αντωνιάδη

Effects of rootstock on avocado fruit quality – assessment of postharvest disease, major cations and biochemical traits

Growth and yield performance of ‘Hass’ and ‘Shepard’ grafted to several commercial and proprietary rootstocks has been assessed annually in field trials established around Australia between December 2004 and May 2005. Since 2008 fruit has been assessed for postharvest anthracnose and stem end rot after ripening at 23°C to favour disease development. Peel and/or flesh samples have been analysed for calcium and nitrogen, and for activities of peroxidase and catalase. There were significant rootstock effects on disease and skin cations in some cases, for example, at Hampton in 2010, ‘Hass’ fruit from clonal SHSR-03, ‘A10’ and ‘Velvick’ had less anthracnose than from ‘Reed’ and ‘Hass’. At the Walkamin field site in 2011 fruit skin calcium levels were highest in fruit from ‘Shepard’ trees on clonal ‘Velvick’ and seedling ‘SHSR-03’. These rootstocks have typically performed well in terms of conferring resistance to anthracnose, thus re-affirming the importance of calcium in disease resistance