Five-day plan for smoking cessation using group behaviour therapy.

The "Five-Day Plan to Stop Smoking" (FDP) is an educational group technique for smoking cessation. We studied a cohort of 123 smokers (55 men, 68 women, mean age 42 years) who participated in 11 successive FDP sessions held in Switzerland between 1995 and 1998 and who were followed up for at least 12 months by telephone or direct interview. Overall, 102 of the 123 subjects (83%) had stopped smoking by the end of the FDP, and self-declared smoking cessation rate was 25% after one year. The following factors potentially associated with outcome were studied: age, sex, smoking habit duration, cigarettes per day, Fagerström Test for Nicotine Dependence (FTND), group size, and medical presence among the group leaders. Smoking habit duration was the only variable which showed a statistically significant association with success: the rate of smoking cessation was higher among patients who had smoked for less than 20 years (34.7% vs. 18.9%, p = 0.049). Stress was the most common cause of relapse. The FDP appears to be an effective smoking cessation therapy. Propositions are made in order to improve the success rate of future sessions.

Genetic Variation among Natural and Laboratory Colony Populations of Lutzomyia longipalpis (Lutz & Neiva, 1912)(Diptera:Psychodidae) from Colombia

Genetic diversity among three field populations of Lutzomyia longipalpis in Colombia was studied using isozyme analysis. Study sites were as much as 598 km apart and included populations separated by the eastern Cordillera of the Andes. Genetic variability among populations, estimated by heterozygosity, was within values typical for insects in general (8.1%). Heterozygosity for field populations were compared with a laboratory colony from Colombia (Melgar colony) and were only slightly lower. These results suggest that establishment and long term maintenance of the Melgar colony has had little effect on the level of isozyme variability it carries. Genetic divergences between populations was evaluated using estimates of genetic distance. Genetic divergence among the three field populations was low (D=0.021), suggesting they represent local populations within a single species. Genetic distance between field populations and the Melgar colony was also low (D=0.016), suggesting that this colony population does not depart significantly from natural populations. Finally, comparisons were made between Colombian populations and colonies from Brazil and Costa Rica. Genetic distance values were high between Colombian and both Brazil and Costa Rica colony populations (D=0.199 and 0.098 respectively) providing additional support for our earlier report that populations from the three countries represent distinct species

Rearing and Colonization of Lutzomyia evansi (Diptera: Psychodidae), a Vector of Visceral Leishmaniasis in Colombia

The sandfly Lutzomyia evansi from a focus of visceral leishmaniasis in northern Colombia was reared and maintained under laboratory conditions for five generations. The average time for total development was 41.8 days (range = 35.1- 49.6) at 25 oC and 89-95% of relative humidity. The mean number of eggs laid was lower in laboratory bred females either in pots (13.2 eggs/female) or vials (29.9 eggs/female) than in wild caught females (33.4 eggs/female). Immature mortality, mainly due to fungal and mite contamination, was higher during the first two instars than in the remaining immature stages. Adults were robust and healthy although difficult to feed on hamster or chick skin membrane. In summary, Lu. evansi is a colonizable species but requires specific conditions.

A Five Year Tobacco Action Plan (PDF 109 KB)

Summary of Responses to the Consultation ‘A Five Year Tobacco Action Plan’ document was issued for public consultation in August 2002. The Plan, which was developed by an inter-sectoral Working Group, provides a framework for collaborative working across Government departments, the statutory and voluntary sectors, as well as with business and in local communities. It seeks to combine an overview of the background, scale and nature of the problem with a comprehensive programme of action to reduce the harm caused by tobacco use. åÊ

Equality Information Work Plan (PDF 24 KB)

Monitoring of the usage of health services by the different Section 75 groups is a key aspect of the equality information agenda.

Flies (Calliphoridae, Muscidae) and Beetles (Silphidae) from Human Cadavers in Cali, Colombia

Adult specimens of Cochliomyia macellaria, Chrysomya megacephala, Ch. rufifacies, Lucilia sp. (Calliphoridae), Musca domestica (Muscidae), Oxelytrum discicolle (Silphidae) and Sarcophagidae were recovered from 12 human cadavers in Cali, Valle, Colombia. Information regarding these findings is presented.

Biting Indices, Host-seeking Activity and Natural Infection Rates of Anopheline Species in Boa Vista, Roraima, Brazil from 1996 to 1998

The epidemiology of the transmission of malaria parasites varies ecologically. To observe some entomological aspects of the malaria transmission in an urban environment, a longitudinal survey of anopheline fauna was performed in Boa Vista, Roraima, Brazil. A total of 7,263 anophelines was collected in human bait at 13 de Setembro and Caranã districts: Anopheles albitarsis sensu lato (82.8%), An. darlingi (10.3%), An. braziliensis (5.5%), An. peryassui (0.9%) and An. nuneztovari (0.5%). Nightly 12 h collections showed that An. albitarsis was actively biting throughout the night with peak activities at sunset and at midnight. An. darlingi bit during all night and did not demonstrate a defined biting peak. Highest biting indices, entomological inoculation rates and malaria cases were observed seasonally during the rainy season (April-November). Hourly collections showed host seek activity for all mosquitoes peaked during the first hour after sunset. An. darlingi showed the highest plasmodial malaria infection rate followed by An. albitarsis, An. braziliensis and An. nuneztovari (8.5%, 4.6%, 3% and 2.6%, respectively). An. albitarsis was the most frequently collected anopheline, presented the highest biting index and it was the second most frequently collected infected species infected with malaria parasites. An. albitarsis and An. darlingi respectively, are the primary vectors of malaria throughout Boa Vista.

Ecological Aspects of Phebotomine (Diptera, Psychodidae) in an Endemic Area of Tegumentary Leishmaniasis in the Northeastern Argentina, 1993-1998

The first epidemic tegumentary leishmaniasis´ outbreak in the province of Misiones was recorded in 1998, in the locality of Puerto Esperanza. Phlebotominae collected in the region, previously or simultaneously to the outbreak (September 1993-December 1998) showed that the species Lutzomyia intermedia s. l. was prevalent (94%, n 6,150) at all the sites sampled with miniature light trap (10) and Shannon trap (3). L. pessoai, L. whitmani, L. migonei, L. shannoni, L. fischeri, L. misionensis, Brumptomyia avellari and B. guimaraesi were also captured. Sand fly distribution in time and space suggests that in the province of Misiones (1) the species already present before 1990 could give rise to the epidemic by the density/dispersion fluctuation of their local populations; (2) the abundance of L. intermedia s. l. was associated with environments with ecotones of primary-secondary vegetation, close to water bodies and with moderate human disturbance; (3) this species showed, towards the end of 1997, peaks of exceptional abundance, subsequent to rainfall peaks in 1996. This increase in abundance of potential vector sand fly populations close to houses with colonizable surroundings could have generated the 1998 epidemic outbreak.

Descrição dos Ovos e dos Estádios Ninfais de Triatoma jurbergi Carcavallo, Galvão & Lent, 1998 Vistos Através de Microscopia Óptica e Eletrônica de Varredura (Hemiptera, Reduviidae)

Eggs and nymphs of Triatoma jurbergi were described using optical microscopy and scanning electron microscopy. T. jurbergi is a wild species, found in State of Mato Grosso (15ºS and 300 m.a.s.l), Brazil. Eggs showed the operculum and surface with pentagonal and hexagonal cells, with small fractures and punctuations randomly distributed. Differences were found in the five nymphal stages of T. jurbergi, that allow their to be distinguished from the similar species T. guazu. The diagnostic characters most useful for differentiation were the general color of the insect, abdomen shape and its length.

Domiciliation Trend of Panstrongylus rufotuberculatus in Colombia

The present paper presents evidence of the domiciliation of Panstrongylus rufotuberculatus in La Gardenia, Colombia through the collection of 2 unhatched eggs, 81 nymphs and 10 adults (4 males and 6 females), from 2 rural houses. The transmission risk indicators of Trypanosoma cruzi by P. rufotuberculatus in La Gardenia, were: domiciliary infestation 7.5%, density 2.35, colonization 66.6%, overcrowding 31.33, natural infection 4.6%, and relative infection 2.5%. These results and findings in Peru and Argentina, show that P. rufotuberculatus has a potential success in domiciliation and could some day become an alternate vector of American trypanosomiasis.

Action Plan for People Management in the Health Service

In November of 2001 the Government launched its new National Health Strategy â?" â?oQuality and Fairness, A Health System for youâ?Âù (hereafter referred to as Quality and Fairness). Quality and Fairness was developed following one of the largest consultation processes ever undertaken in the public service. It sets out the vision for the health service, the four principles upon which this vision will be built, it also establishes four National goals and finally sets out six â?~frameworks for changeâ?T, which will be used to achieve the vision, principles and goals. One of the six frameworks for change is Developing Human Resources. The health service is one of the largest employers in the public sector, with the employment level at the end of 2001 approaching 93,000 full time employees. These employees are spread across a large number of organisations, in multiple locations and settings across the country. Each employee plays a key role in the delivery of health service, in all settings, to the public. Download document here

Assessment of Therapeutic Response of Plasmodium vivax and Plasmodium falciparum to Chloroquine in a Malaria Transmission Free Area in Colombia

In order to determine the frequency of therapeutic failures to chloroquine (CQ) in patients with malaria due to either Plasmodium falciparum or P. vivax, and to explore the usefulness of a malaria-free city as a sentinel site to monitor the emergence of drug resistance, 53 patients (44 infected with P. vivax and 9 with P. falciparum) were evaluated at the Laboratory of Parasitology, Universidad del Valle in Cali, Colombia. Patients received 25 mg/kg of CQ divided in three doses over 48 h; they were followed during 28 days according to WHO/PAHO protocols. While therapeutic failures to CQ in the P. vivax group were not detected, the proportion of therapeutic failures in the P. falciparum group was high (78%) and consistent with the reports from endemic areas in Colombia. The diverse origin of cases presenting therapeutic failure confirmed that P. falciparum resistant to CQ is widespread in Colombia, and further supports the change in the national antimalarial drug scheme. Monitoring of drug resistance in malaria free areas would be useful to identify sites requiring efficacy evaluation, and in some situations could be the most appropriate alternative to collect information from endemic areas where therapeutic efficacy studies are not feasible.

Presence of American cutaneous leishmaniasis vectors surrounding the city of Medellín, Colombia

The presence of Lutzomyia (Helcocyrtomyia) hartmanni, as a vector of Leishmania colombiensis and L. columbiana (Verrucarum group), recently incriminated in the transmission of leishmaniasis, and L. pia (Verrucarum group) are reported for the first time in a periurban area of Medellín city. There is thus a risk of leishmaniasis transmission in this town.

Phlebotomine sand flies (Diptera: Psychodidae) associated with the appearance of urban leishmaniasis in the city of Sincelejo, Colombia

Although once associated only with rural areas, the American leishmaniasis vectors now appear to be associated also with urban and suburban areas of the Neotropics. Following the appearance of the first autochthonous visceral and cutaneous leishmaniasis cases in the urban area of the city of Sincelejo, Colombia, a preliminary entomological survey of the sand fly species composition was performed using Shannon and CDC light traps. A total of 486 sand flies representing six Lutzomyia species were collected. L. evansi, L. panamensis and L. gomezi, known vectors of Leishmania spp. were the predominant sand fly species around dwellings. The finding of these species in relation to the appearance of the first cases of leishmaniasis in the city mentioned is discussed.