Resource-poor Area Research Articles

Oral health in rural South African type 2 diabetic patients

Diabetes increases the risk of periodontal disease, but information from the tropics is lacking, and the relationship between periodontal disease and glycaemic control is uncertain. We examined 23 type 2 diabetic patients in a rural and resource-poor area of South Africa. Mean age was 59 +/- 10 (1SD) years, and diabetes duration 6 +/- 6 years. In all,11 were 'well controlled' (glycosylated haemoglobin (HbA1c) < 8.0%, mean 6.5%), and 12 'poorly controlled' (HbA1c > 8.0%, mean 13.0%). Periodontal disease was more common in the poorly controlled group (42% versus 18%, P < 0.002). We conclude that dental health is poor in type 2 diabetic patients in rural Africa, and that periodontal disease is closely related to glycaemic control. Improved dental and diabetes care is needed in such communities.

Establishment of a pediatric oncology program and outcomes of childhood acute lymphoblastic leukemia in a resource-poor area.

The cure rate for childhood acute lymphoblastic leukemia (ALL) differs markedly between developed and developing countries. To assess the effect of a multidisciplinary team approach and protocol-based therapy on the event-free survival of children with ALL in an area with limited resources. DESIGN, POPULATION, AND SETTING: A retrospective cohort study at a pediatric hospital in the resource-poor city of Recife, Brazil. We reviewed medical records of the outcomes of 375 children with ALL diagnosed between 1980 and 2002. Eighty-three children were diagnosed in the early period (1980-1989), in the absence of a dedicated pediatric oncology unit, protocol-based therapy, specially trained nurses, 24-hour on-site physician coverage, and ready access to intensive care. Seventy-eight children were treated (all according to protocol) during the middle period (July 1994 to March 1997). During the recent period (April 1997 to December 2002), 214 children were treated with protocol in a dedicated pediatric oncology unit staffed 24 hours by pediatric oncologists and oncology nurses. Improvements were implemented gradually during the middle period and were completed during the recent period. Event-free survival was estimated by the Kaplan-Meier method. Events included death from toxicity, disease progression or relapse, and abandonment of treatment. The 5-year event-free survival improved steadily: 32% (95% CI, 21%-43%) in the early period, 47% (95% CI, 36%-58%) in the middle period, and 63% (95% CI, 55%-71%) in the recent period. The probability of cause-specific treatment failure in the early, middle, and late periods, respectively, within 1 year of diagnosis was 14% vs 3.8% vs 3.3% for relapse; 6.0% vs 12% vs 9.8% for death from infection; 2.4% vs 13% vs 4.2% for death from noninfectious toxicity; and 16% vs 1.3% vs 0.5% for abandonment of therapy. Treatment of childhood ALL in a dedicated pediatric oncology unit using a comprehensive multidisciplinary team approach, protocol-based therapy, and local support and funding is associated with improved outcomes in a resource-poor area.

Resource distribution and surface activity of adult Lumbricus terrestris L. in an experimental system : The 7th international symposium on earthworm ecology · Cardiff · Wales · 2002

Lumbricus terrestris L. is noted for activities on the soil surface and descriptions of feeding, movement and mating have previously been recorded. The aim of this study was to investigate the effects of resource availability on these behaviours using an experimental system. The laboratory set-up consisted of an arena with a continuous area of 1 m 2 with soil-filled tubes to a depth of 1 m. Eighteen mature, field-collected L. terrestris were used and fed with dried barley straw on the soil surface, either evenly or in one patch. Both patterns were applied twice over an experimental period of 56 days. An infrared video system was used to provide permanent records of a 12:12 hrs dark : light cycle. Earthworm behaviour was classified into three major groups; foraging/exploration, over-surface movements and mating, with time spent in each activity recorded for all individuals. Seventeen earthworms survived to the end of the experimental period. Surface activity peaked one hour after darkness and diminished steadily until lights up. Foraging activity increased by a factor of 1.6 in a resource-rich area whereas away from the patch it reduced by a factor of 0.8 compared with even straw distribution. Over-surface movement increased by a factor of nine after provision of a patchy straw distribution, with two thirds of movements initiated by individuals in a resource poor area. The majority of matings occurred early in the dark period. During even resource distribution, matings occurred equally in different parts of the arena whereas under patchy distribution, more matings were recorded in the resource-rich area. Presented results suggest that resource availability is an important factor affecting different aspects of surface behaviour in L terrestris .

Resource distribution and surface activity of adult Lumbricus terrestris L. in an experimental systemThe 7th international symposium on earthworm ecology · Cardiff · Wales · 2002

Lumbricus terrestris L. is noted for activities on the soil surface and descriptions of feeding, movement and mating have previously been recorded. The aim of this study was to investigate the effects of resource availability on these behaviours using an experimental system. The laboratory set-up consisted of an arena with a continuous area of 1 m 2 with soil-filled tubes to a depth of 1 m. Eighteen mature, field-collected L. terrestris were used and fed with dried barley straw on the soil surface, either evenly or in one patch. Both patterns were applied twice over an experimental period of 56 days. An infrared video system was used to provide permanent records of a 12:12 hrs dark : light cycle. Earthworm behaviour was classified into three major groups; foraging/exploration, over-surface movements and mating, with time spent in each activity recorded for all individuals. Seventeen earthworms survived to the end of the experimental period. Surface activity peaked one hour after darkness and diminished steadily until lights up. Foraging activity increased by a factor of 1.6 in a resource-rich area whereas away from the patch it reduced by a factor of 0.8 compared with even straw distribution. Over-surface movement increased by a factor of nine after provision of a patchy straw distribution, with two thirds of movements initiated by individuals in a resource poor area. The majority of matings occurred early in the dark period. During even resource distribution, matings occurred equally in different parts of the arena whereas under patchy distribution, more matings were recorded in the resource-rich area. Presented results suggest that resource availability is an important factor affecting different aspects of surface behaviour in L terrestris .

Rural Community Substance Abuse Prevention and Intervention

The Community Health Demonstration Project (CHDP) was organized to develop, implement, and evaluate substance abuse prevention programming in a resource-poor rural Appalachian area. The goals of the CHDP were to develop new community-initiated and community-based programs and services for the prevention of alcohol, tobacco, and other drug (ATOD) use during pregnancy and for the first 2 years after birth by women and their families in the target community, to increase use of prevention services, and thereby to reduce ATOD use among this population. Measurable results of the community wide prevention project included increased awareness and knowledge of problems associated with ATOD use during pregnancy and postpartum, new services adopted by local agencies and organizations, more cooperative efforts to provide prevention programs for all ages throughout the community, a range of new or expanded programs to enhance development, and a reduction in ATOD use during and after pregnancy by women in this rural area.

Archeological and Geomorphological Investigations at Prehistoric Sites 41WY50 and 41WY60, Willacy County, Texas

In January through March 1993, archeological and geomorphological investigations were conducted at two clay dune sites, 41WY50 and 41WY60, in the outfall area of the Hidalgo-Willacy Drainage Ditch system. This work represents the final investigations of a cultural resource management program conducted for the U.S. Army Corps of Engineers and the local sponsors, Hidalgo County Drainage District No. 1 and Willacy County Drainage District No. I, by Prewitt and Associates, Inc. The results of the archeological investigations were poor. Neither site yielded materials of unquestionable cultural origin, although several small basin-shaped hearth features were encountered. Based on radiocarbon assays from soil humates and the stratigraphic provenience of the features, it is speculated that the occupation(s) at 41WY50 is late Archaic and the occupation(s) at 41WY60 is Late Prehistoric to Historic. Both sites represent very short term occupations and most likely do not represent repetitive use on a seasonal or yearly basis. These investigations suggest that, since the development of the modem coastal environments approximately 3,000 to 4,000 years ago, the south Texas coast between Baffin Bay and the Holocene delta of the Rio Grande has been a resource-poor and inhospitable area that probably was utilized only sparsely or intermittently. The geomorphological investigations were more successful, adding valuable data ahout paleoenvironments and the formation of the modem coastal environments of the Lower Rio Grande Valley. The clay dunes formed through the eolian transport of fine to very fine quartz sand and fine to very fine sand-sized aggregates of clay from adjacent wind-tidal flats during the late Holocene. Stable carbon isotope studies of soil humates suggest that the clay dune plant community was and still is dominated by C, and/or CAM plants. These investigations also disclosed fluctuations in sea level during the late Holocene. An abandoned wind-tidal flat, encountered at 41WY50, indicates that sea level was at least I m higher than present mean sea level between 2300-1100 B.P.