Multimedia materials for education, training, and advocacy in international health: experiences with the Schistosomiasis Control Initiative CD-ROM

We describe an innovative use of multimedia materials to support training and advocacy within a schistosomiasis control programme. The Schistosomiasis Control Initiative (SCI) at Imperial College London works with selected sub-Saharan African countries to develop schistosomiasis control programmes. Two elements of the SCI programme were supported by multimedia materials developed at the Wellcome Trust in collaboration with the SCI: (1) training of programme managers, district health officers, and those delivering practical elements of the programme; and (2) advocacy targeted at decision-makers and donors. Evaluation of the materials revealed high reported ratings for both user satisfaction and impact from use of the product. From this experience we draw out several general messages about development of multimedia materials and how these will play a growing future role in promoting training within international health.

Health education, recent and future trends

During the past, Health Education has been taking place in a variety of ways: prevention, monitoring and control of potentially epidemic diseases. New trends have been arising (such as 'health corners', interdisciplinary activities, exhibit, 'mini-university' for children, etc.). But it is important to discuss what 'Health Education' means, and define 'health' and rethink educational strategies. Several evaluations have highlighted the limited impact that communication activities, or one-off awareness campaigns, may have.

Integrating professional education, research and extensionin irrigated agriculture technology centers

With the objective to stimulate the use of irrigation and the electric energy fee reduction during night time program granted by the 2004 Federal law, the Government of the state of Paraná, Brazil launched the Night Irrigation Program - NPI. Beyond this discount, the farmer that adheres to NPI will get additional benefits, as completion of the electric grid without cost, subsidized financing of equipment, technical assistance, support with environmental farm compliance, and the possibility of replacing the entire pump energy matrix. As part of the NPI strategy of action, installation of learning centers for irrigation technology was planned in agricultural schools, thus contributing both to improve technical professional training in agriculture, and for the dissemination of knowledge in irrigated agriculture, in order to increase agricultural productivity.

Long-term efficacy of a rural community-based integrated intervention for prevention and management of chronic obstructive pulmonary disease: a cluster randomized controlled trial in China's rural areas

This study aimed to assess the efficacy of a rural community-based integrated intervention for early prevention and management of chronic obstructive pulmonary disease (COPD) in China. This 18-year cluster-randomized controlled trial encompassing 15 villages included 1008 patients (454 men and 40 women in the intervention group [mean age, 54 ± 10 years]; 482 men and 32 women in the control group [mean age, 53 ± 10 years]) with confirmed COPD or at risk for COPD. Villages were randomly assigned to the intervention or the control group, and study participants residing within the villages received treatment accordingly. Intervention group patients took part in a program that included systematic health education, smoking cessation counseling, and education on management of COPD. Control group patients received usual care. The groups were compared after 18 years regarding the incidence of COPD, decline in lung function, and mortality of COPD. COPD incidence was lower in the intervention group than in the control group (10% vs 16%, <0.05). A decline in lung function was also significantly delayed in the intervention group compared to the control group of COPD and high-risk patients. The intervention group showed significant improvement in smoking cessation compared with the control group, and smokers in the intervention group had lower smoking indices than in the control group (350 vs 450, <0.05). The intervention group also had a significantly lower cumulative COPD-related death rate than the control group (37% vs 47%, <0.05). A rural community-based integrated intervention is effective in reducing the incidence of COPD among those at risk, delaying a decline in lung function in COPD patients and those at risk, and reducing mortality of COPD.

Parasites of commercial shrimps and fishes in Argentine sea: on the adult and metacercaria of Opecoeloides feliciae n. sp. (Digenea: Opecoelidae)

Opecoeloides feliciae n. sp., first record of opecoelid metacercariae in commercial shrimps of South Atlantic Ocean, parasitizing Cynoscion striatus (adults) and Artemesia longinaris (metacercariae), is described, illustrated and compared with related species of the genus. Adults, immature worms and metacercariae are compared, and rates of prevalence and intensity of infection are also given.

Adult and nymphs of Microtriatoma trinidadensis (Lent, 1951) (Hemiptera: Reduviidae) caught from peridomestic environment in Bolivia

This is the first report of adult and nymphs (20 nymphs of all stages and 4 adults) of Microtriatoma trinidadensis (Lent 1951) (Hemiptera: Reduviidae: Triatominae) collected in peridomestic environment, in the department of La Paz, Bolivia. These specimens were associated to Rhodnius stali Lent, Jurberg & Galvão 1993. The exceptional finding of M. trinidadensis in peridomestic environment, illustrates the general tendency of triatominae to adapt to human dwellings and dependences.

Proteolytic activity in the adult and larval stages of the human roundworm parasite Angiostrongylus costaricensis

Angiostrongylus costaricensis is a nematode that causes abdominal angiostrongyliasis, a widespread human parasitism in Latin America. This study aimed to characterize the protease profiles of different developmental stages of this helminth. First-stage larvae (L1) were obtained from the faeces of infected Sigmodon hispidus rodents and third-stage larvae (L3) were collected from mollusks Biomphalaria glabrata previously infected with L1. Adult worms were recovered from rodent mesenteric arteries. Protein extraction was performed after repeated freeze-thaw cycles followed by maceration of the nematodes in 40 mM Tris base. Proteolysis of gelatin was observed by zymography and found only in the larval stages. In L3, the gelatinolytic activity was effectively inhibited by orthophenanthroline, indicating the involvement of metalloproteases. The mechanistic class of the gelatinases from L1 could not be precisely determined using traditional class-specific inhibitors. Adult worm extracts were able to hydrolyze haemoglobin in solution, although no activity was observed by zymography. This haemoglobinolytic activity was ascribed to aspartic proteases following its effective inhibition by pepstatin, which also inhibited the haemoglobinolytic activity of L1 and L3 extracts. The characterization of protease expression throughout the A. costaricensis life cycle may reveal key factors influencing the process of parasitic infection and thus foster our understanding of the disease pathogenesis.

Effect of medroxyprogesterone acetate on thyrotropin secretion in adult and old female rats

Steroid hormones have been implicated in the modulation of TSH secretion; however, there are few and controversial data regarding the effect of progesterone (Pg) on TSH secretion. Medroxyprogesterone acetate (MPA) is a synthetic alpha-hydroxyprogesterone analog that has been extensively employed in therapeutics for its Pg-like actions, but that also has some glucocorticoid and androgen activity. Both hormones have been shown to interfere with TSH secretion. The objective of the present study was to investigate the effects of MPA or Pg administration to ovariectomized (OVX) rats on in vivo and in vitro TSH release and pituitary TSH content. The treatment of adult OVX rats with MPA (0.25 mg/100 g body weight, sc, daily for 9 days) induced a significant (P<0.05) increase in the pituitary TSH content, which was not observed when the same treatment was used with a 10 times higher MPA dose or with Pg doses similar to those of MPA. Serum TSH was similar for all groups. MPA administered to OVX rats at the lower dose also had a stimulatory effect on the in vitro basal and TRH-induced TSH release. The in vitro basal and TRH-stimulated TSH release was not significantly affected by Pg treatment. Conversely, MPA had no effect on old OVX rats. However, in these old rats, ovariectomy alone significantly reduced (P<0.05) basal and TRH-stimulated TSH release in vitro, as well as pituitary TSH content. The results suggest that in adult, but not in old OVX rats, MPA but not Pg has a stimulatory effect on TSH stores and on the response to TRH in vitro.